Few healthcare sectors bemoan Trump's rejection of TPP trade deal

The Trans-Pacific Partnership that President Donald Trump abandoned last week had few steadfast fans in healthcare.

Many feared its intellectual property protections would increase global pharmaceutical prices. The drug industry, meanwhile, argued those protections didn't go far enough.

The trade agreement negotiated by the Obama administration extends greater protection for pharmaceutical patents across a dozen Pacific Rim countries. The U.S. was a signatory, but President Barack Obama failed to garner enough support in Congress to ratify the pact into law. Trump pledged during his campaign to remove the U.S. from the partnership. Hillary Clinton, his Democratic opponent, also criticized the agreement.

The trade pact would have eliminated 18,000 taxes that other countries place on goods from the U.S. The other nations that agreed to the pact are Australia, Brunei, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore and Vietnam.

Consumer advocacy group Public Citizen and aid organization Doctors Without Borders decried the deal's intellectual property provisions that required participating countries to extend data protection for biologic medicines—drugs produced with living matter—for at least five to eight years. They argued that doing so would keep biosimilars—the reproduced “generic” versions of biologics—from entering the market and bringing prices down.

“I think the Trump administration should use its power under existing law to make it clear we will allow generic competition,” said Peter Maybarduk, director of Public Citizen's Access to Medicines Program. “They should work with legislators, and legislators should push for a comprehensive agenda on drug pricing, recognizing that monopoly power is the core of the problem.”

Judit Rius Sanjuan, the U.S. manager for Doctors Without Borders' Access Campaign, said it would be possible to draft a trade agreement that satisfies both the private sector as well as nongovernmental organizations that are concerned about drugmaker monopolies. “We would like to see an agreement that is a win-win for innovation and access,” she said.

But Sanjuan said it's too early to know what the Trump administration's next steps will be, and it's hard to tell how the White House will treat the interests of pharmaceutical companies and NGOs. While the Republican Party tends to be pro-industry, Trump chastised the pharmaceutical industry's pricing practices at many points throughout his campaign.

He has also said that he supports importing drugs from other countries and allowing Medicare to directly negotiate on drug prices—measures that are opposed by Pharmaceutical Research and Manufacturers of America, which represents the U.S. drug industry.

PhRMA was no fan of the TPP either. The industry was concerned that its intellectual property protections weren't strong enough. Drugmakers wanted 12 years of data exclusivity to match the period required under U.S. federal law. Some of the countries in the deal don't currently have any exclusivity laws for biologics.

“PhRMA is supportive of bilateral and multilateral free-trade agreements that include strong intellectual property protections, enhance market access and help us deliver lifesaving medicines to the world's patients,” said Stephen Ubl, the lobby's CEO. “As the incoming administration and Congress prepare to shape our trade agenda, we look forward to working with our government's leadership to secure smart, fair trade agreements that open new markets and help grow our economy and create better, higher-paying jobs.”

The Generic Pharmaceutical Association said in a statement last week that policymakers should develop patent rules that balance incentives for innovation with a desire for generic competition. GPhA also called on the Trump administration and Congress to stop manufacturers of brand-name drugs from interfering in generic drug development and access.

“Increasing competition from generic drugs and biosimilars is a proven way to lower health spending,” GPhA said. “We look forward to working with the Trump administration, bipartisan members of Congress and others on policies that encourage access to more affordable medicines in the United States and around the world.”

U.S. manufacturers of medical devices, on the other hand, supported the TPP. The Advanced Medical Technology Association, known as AdvaMed, said early last year that the agreement would combat “corrupt business practices” and establish global “codes of conduct” for device trade. AdvaMed did acknowledge, however, that certain issues and concerns raised by other business sectors and Congress needed to be solved.

In response to Trump's order last week, AdvaMed offered a short statement. “The medical technology industry has consistently supported trade agreements that open markets and improve patient access to needed medical advancements. We look forward to working with the new administration as it pursues these pro-innovation, pro-patient goals,” Ralph Ives, AdvaMed's executive vice president of global strategy and analysis, said in the statement.

Early in his campaign, Trump called the TPP a “horrible deal … designed for China to come in, as they always do, through the back door and totally take advantage of everyone.” China isn't involved in the partnership; in fact, it's possible that China could now swoop in with its own deal to entice Pacific Rim countries.

Sen. John McCain (R-Ariz.), chairman of the Senate Armed Services Committee and a former presidential candidate, said in a statement that withdrawing from the TPP was a “serious mistake” that would have lasting consequences for the U.S. economy and its position in the Asia-Pacific region.

“This decision will forfeit the opportunity to promote American exports, reduce trade barriers, open new markets, and protect American invention and innovation,” McCain said. “It will create an opening for China to rewrite the economic rules of the road at the expense of American workers.”