The Trans-Pacific Partnership Agreement: a threat to affordable medicines and public health

PhRMA has long criticized medicines insurance schemes premised on cost-effectiveness and reference pricing such as the Pharmaceutical Benefits Scheme (PBS) in Australia and PHARMAC in New Zealand. The PhRMA submission to the USTR on the TTPA specifically targets alleged ‘market access barriers... inadequate consultative mechanisms and transparency concerns in countries like New Zealand’6. But the governments of Australia and New Zealand are unlikely to accept the whole-sale winding-back of the PBS and PHARMAC. The Australian government affirms that it ‘has not and will not accept provisions that limit its capacity to put health warnings or plain packaging requirements on tobacco products or its ability to continue the Pharmaceutical Benefits Scheme’7. But US pressures may well result in incremental policy adjustments which weaken cost-effectiveness assessments and reference pricing. The largest generics supplier to the PBS, Alphapharm (a subsidiary of the global generics firm Mylan), is ‘deeply concerned about the impact that the [TPPA] could have on the generic pharmaceutical industry in Australia, on consumers and on the Government’s budget’8.