Thailand is likely to widen its use of cheaper, generic versions of patented drugs, unless western drug companies cut the prices of their original medications, the country’s health minister has said.

Dr Mongkol Na Songkhla, health minister, told the Financial Times that the military-installed government was considering whether to ignore the patents for drugs used to treat leading causes of death – such as cancer and heart disease – as it escalates its confrontation with big pharmaceuticals groups.

“We have to provide our health services to about 49m people with limited resources,” he said.

While impoverished African countries routinely buy generic versions of patented drugs to cope with their HIV/Aids epidemics, Thailand is the first middle-income country to break the patent on a medicine to treat a non-infectious disease and to threaten compulsory licences for such an array of other drugs.

However, Dr Mongkol said Thailand remained willing to buy original versions of drugs, if the patent-holders made the medicines more affordable.

Thailand infuriated big pharma and pleased health activists with its recent decisions to break the patents of two HIV/Aids drugs and a popular cardiovascular blood-thinner to reduce buying costs for its scheme to provide universal healthcare for the poor.

The moves have put Bangkok at the front of the global debate over how to widen access to life-saving drugs, while preserving incentives for innovation in
pharmaceuticals.

The western drugs industry – which fears other middle-income countries may follow Thailand’s precedent – has warned that Bangkok’s tactics have “global implications” and could threaten its ability to fund research and development.

The industry has also complained that companies were given no warning of Bangkok’s intention to break their patents.

But Dr Mongkol – who began his career as a doctor in remote rural areas and later headed Thailand’s Food and Drug Administration – said Thai public health officials had tried for years, mostly unsuccessfully, to negotiate with drug companies for discounted prices.

“We have thought about this for more than five years,” he said. “[Drug companies] never change their way of dealing with the government.”

Dr Mongkol, previously the health ministry’s senior bureaucrat, said the coup had given him the chance to act. “The politicians, the true politicians, will not do this,” he said. “I think they are afraid of some consequences. But I am not a politician, and I have nothing to lose.”

He denied that Bangkok’s demand for sharply lower prices would undermine future research, saying companies could compensate by cutting bloated marketing costs. “The drug companies have to adjust their marketing,” he said. “R&D costs not so much. But they [spend a lot] on marketing.”

He also insisted that the use of generics in public hospitals would not affect demand for patented drugs by wealthier patients in private Thai hospitals.

Instead of chastising Thailand, he said, drug companies should support Bangkok’s effort to provide universal healthcare. ”If you have the poor people in your heart, you will be very happy to contribute the low price product,” he said. ”We have good infrastructure for the health service. Drug price is our main limiting obstacle.”

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