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TABLE 2 Thailand's pharmaceutical exports and imports (million baht) Generic and branded drugs A common marketing technique widely employed in the pharmaceutical industry is to launch a product in different packaged forms, and to use more than one brand name for one therapeutic drug.32 So-called "me-too" drugs, which are molecularly distinct but therapeutically identical to an existing medicine, are widespread in the market.33 In Britain, for example, there were 3,550 different brand names used on about 1,200 medical substances.34 The Patented Medicine Prices Review Board evaluated 1,147 newly patented drugs in Canada between 1990 and 2003, and found only 142 to be breakthrough drugs. The remaining 1,005 were classified as "me-too" drugs, which did not provide any "substantial improvement over existing drug products".35 In the United States, the Food and Drug Administration (FDA) approved 415 new drugs between 1998 and 2002. It was found that 14 per cent of the approved drugs were truly innovative, 9 per cent were regarded as significant improvements, and 77 per cent were not more effective than the drugs already on the market.36 As a result of this practice, WHO observes that the number of brand-name drugs throughout the world is over 100,000.37 The proliferation of brands has recouped large profits for the original companies. The total sale of the top 10 brands in 2004, for example, is as high as US$53,500 million (Table 3). The marketing technique of product differentiation (using several brand names for one drug) is widely used in Thailand. For example, there are 88 different brand names TABLE 3 Top 10 brands, global sales, 2004 (US$ million) In 1981, the Thai government established an "Essential Drug List" as part of the National Drug Policy. The National Drug Policy requires state hospitals and health centres to buy essential drugs from GPO which sells the drugs under generic names. The use of generic names is designed to limit the number of drugs and to control the proliferation of branded drugs. Despite this attempt, branded drugs still play a leading role in the market. This is because the drugs on the Essential Drug List represents only 5 per cent of the total drug consumption in Thailand.40 In addition, state hospitals and health centres are not obliged to buy generic drugs from GPO if the purchase fund comes from their income budget.41 As a result, generic drugs are unable to totally replace branded drugs in the public health sector. In Thailand, medicines can be advertised under brand names, which are protected by the Trade Marks Act B.E. 2534. The advertisement of prescription drugs are regulated under the Drugs Act B.E. 2510. While non-dangerous OTC drugs may be advertised directly to the general public, the advertisement of potentially dangerous drugs (or prescription medicines) cannot be directed to the consuming public. It is restricted to professionals such as doctors, veterinarians, nurses and pharmacists. The absence of advertising control in the public market allows the pharmaceutical companies to run intensive promotional campaigns to influence doctors' prescribing practices. |
Footnotes 32. British Medical Association, The British National Formulary, London, 1988. 33. J. Braithwaite, Corporate Crime in the Pharmaceutical Industry (Routledge & Kegan Paul, London, 1986), p.164. 34. British Medical Association, cited above fn.32. 35. S.G. Morgan et al.,"'Breakthrough' Drugs and Growth in Expenditure on Prescription Drugs in Canada", B.M.J., October 8, 2005, pp.815-816. Available at: http://bmj.bmjjournals.com/cgi/content/full/331/7520/815 36. M. Angell, The Truth about the Drug Companies (Random House, New York, 2005), p.75. 37. WHO, The World Drug Situation, Geneva, 1988, p.43. 38. Food and Drug Administration, Thai Medical Directory, Ministry of Public Health, Bangkok, 2002. 40. Kanavos and Paganelli, Emerging Pharmaceutical Markets--Potential & Problems (URCH Pharmaceutical Publications, London, September 2000). 41. K. Rattanarojsakul, "The Pharmaceutical Industry in Thailand", Unpublished Master of Economics Thesis, Thammasat University, Bangkok, 1986, p.138. |
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