Prescription Drugs and the Trans-Pacific Partnership

By Samuel Metz

There are convincing reasons why Oregon should embrace the Trans-Pacific Partnership (TPP), but a compelling reason for opposition is protection of our health care. The trade partnership treats prescription medications as commodities, selling at the highest price the market will bear. This promotes businesses that sell medications, but it’s a poor way to get lifesaving drugs to Oregonians who need them.

Unaffordable medications are not a trivial problem. Based on national estimates, over 10 Oregonians die each week of treatable conditions because they cannot pay for treatment, a mode of death unknown in other developed countries. Last year, prices for specialty drugs rose by 19 percent. The most dramatic example was the 5,000 percent increase for an essential medication marketed by Turing Pharmaceuticals. The company pledged to reduce that increase. So far, the $750 price per pill to patients has not changed.

Turing is not alone in maximizing revenue on branded drugs. Bristol-Myers Squibb, Merck, and Eli Lilly raised drug prices by as much as 22 percent, 25 percent and 65 percent, respectively; Pfizer’s highest increase was 115 percent. These price increases were not for new drugs with unrecovered development costs; these were older drugs enjoying high demand.

Can we justify these increases on free market principles? No. Simple economics do not apply to critical medications: When prices go up, need stays the same. Consequently, patients must choose to either pay the high market price, or to pay a still higher personal price: dying of their disease.

Americans already pay more for prescription drugs than citizens anywhere else in the world. One of the few constraints is the ability of our government to negotiate lower drugs prices on behalf of patients who need them — and on behalf of taxpayers who pay for them. The TPP allows private pharmaceutical companies whose profits are impeded by such negotiations to bring suit for restraint of trade. Such suits bypass American courts, being referred instead to an international court responsible to the economic interests of TPP signatories. This court possesses the power to overrule laws of participating TPP countries and to compel governments to compensate pharmaceutical companies for their lost profits.

Would such a court indeed place private profit over public health? Experience with NAFTA mediation indicates TPP mediation will favor business interests over consumer interests. Our government healthcare agencies, serving the sickest, poorest and oldest among us, must then either increase taxes to subsidize private profit or withhold essential drugs to patients who need them.

In its Oct. 6 endorsement of the TPP, The Oregonian/OregonLive editorial board challenged opponents of the TPP “to present a better alternative for boosting the region’s economy.” A more humane approach challenges TPP supporters to create an economic boost that does not further corrupt Oregon’s deteriorating ability to provide lifesaving medications to the people who need them.

For the sake of Oregonians who depend upon prescription drugs to stay alive, Oregon’s congressional delegation should vote against the TPP. Oregon needs an economic stimulus that saves lives, not destroys them.

Samuel Metz is a private practice anesthesiologist who lives and works in Portland. He is a member of Physicians for a National Health Program and a founding member of Mad As Hell Doctors, both of which advocate for universal health care.
This article is reprinted with kind permission of Samuel Metz, MD, after first appearance on the Oregonian/OregonLive website, 2 January 2016.