Thailand is planning to "legally" break the patents of three more drugs, two of which are medications for HIV treatment and the other for the country's most common type of heart disease, Public Health Minister Dr Mongkol na Songkhla said yesterday.

The country is in critical need of the drugs yet cannot afford to cover the cost of treatment due to the limited healthcare budget, he said.

The universal healthcare scheme that takes care of around 48 million Thais, including about 500,000 people living with HIV and an enormous number of patients with cardiovascular heart disease, has an insufficient budget to ensure treatment for all, said Mongkol.

He added that many people receiving treatment for HIV had faced severe allergy problems with drugs and needed to move on to a second-line drug which remained expensive.

Drugs for heart disease were also too expensive for the scheme to pay for.

In the case of heart disease, the drug required costs about Bt70 per tablet, or 10 times higher than the price of a generic version of the same drug, he said.

The average cost of HIV treatment using second-line drugs is between Bt1,300 to Bt2,000 per patient per month - compared to only about Bt680 for treatment using generic drugs.

"We need to use this method in order to make good drugs more affordable and accessible," said Mongkol.

The minister requested to withhold further details of the three drugs until the ministry announces the government's compulsory licensing officially on January 29.

Moreover, Mongkol said, the Clinton Foundation along with 22 American house representatives had expressed their support for Thailand's move to impose compulsory licensing to improve public access to life-saving drugs.

There were more drugs being considered for compulsory licensing (CL), he said. "We are not simply going to do CL on more and more drugs, but only the drugs in critical need that the state cannot afford to buy."

Usually, it would be a drug the country had bought at the price of the original product for several years - not a new drug, Mongkol said.

"CL is legitimate domestically and internationally and Thailand is not the first to do compulsory licensing," he said, adding the US had done over 300 compulsory licensings of drugs

The first so-called compulsory licensing in Thailand was carried out on Efavirenz, an antiretroviral drug.

The first import of the generic version of the drug from India is expected to arrive on February 10, said Mongkol.

The imported drug is to be used while waiting for the Government Pharmaceutical Organisation to produce a generic version of Efavirenz on its own.

Arthit Khwankom

The Nation