How Big Pharma Is Arm-Twisting U.S. Foreign Policy to Keep Cancer Drugs Prohibitively Expensive

The administration of President Barack Obama has so far refused to publicly respond to new revelations that U.S. officials, at the behest of Big Pharma, may have attempted to obstruct the Colombian government's efforts to lower the price of a life-saving cancer medication. Amid this silence, civil society organizations, along with some lawmakers from the House and Senate, are demanding answers.

At issue is the drug imatinib, which is produced by Novartis under the brand name Glivec and is used to treat certain cancers of the blood, including leukemia. Imatinib is listed as an essential medicine by the World Health Organization, yet it can be prohibitively expensive, at an annual cost of $15,161 in Colombia—nearly double the country's gross national income per capita.

Beginning in April, the Colombian government began a long process of considering compulsory licensing provisions that could reduce the price of the medication by more than half. As the watchdog organization Public Citizen explains, compulsory licensing is a “special mechanism that authorizes a government to introduce generic competition for a patented product in exchange for royalty payments to the patent holder.” Numerous countries have used such provisions to expand access to vital medicines, like HIV and cancer treatments.

The fact that such a measure is being considered at all is a testament to the hard work of public health and civil society organizations in Colombia, including IFARMA and Misión Salud, which petitioned their government in 2014 to address the exorbitant costs of the drug. Novartis has so far been uncooperative, refusing in April to negotiate a lower price with the Colombian health ministry.

Yet, recent letters that were leaked to Colombian media outlets and the nonprofit organization Knowledge Ecology show that U.S. officials may have also intervened to obstruct the effort to expand access to the drug. The letters were written by Andrés Flórez, deputy chief of mission at the Colombian Embassy in Washington, D.C., and they are addressed to Maria Angela Holguin of Colombia’s Ministry of Foreign Affairs. In the messages, Flórez stated that he was pressured by Senate Finance Committee International Trade Counsel Everett Eissenstat to abandon the cost-cutting provision.

Flórez wrote that Eissenstat warned that if “the Ministry of Health did not correct this situation, the pharmaceutical industry in the United States and related interest groups could become very vocal and interfere with other interests that Colombia could have in the United States.”

“[T]his case could jeopardize the approval of the financing of the new initiative ‘Peace Colombia,’” wrote Flórez. (In February, the Obama administration promised $450 million in aid for peace efforts in the country.)

“It appears that the U.S. government may have sought to intimidate a country that is trying to protect its people’s health. That is unconscionable,” said Peter Maybarduk, director of Public Citizen’s Access to Medicines Program, in a press statement released last week. “If any member of the U.S. government further implied that U.S. support for peace in Colombia would be in jeopardy, that would represent a terrible new low for American foreign policy.”

Meanwhile, there are signs that a Senate Finance Committee staffer may have exerted such pressure due to industry influence. As Intercept reporter Zaid Jilani noted earlier this month, the Senate Finance Committee is headed by by Sen. Orrin Hatch (R-Utah) who has deep ties to Big Pharma, with the industry and health product manufacturers forming "the second-largest pool of donors to his campaigns."

In an angry letter to U.S. Trade Representative Michael Froman last week, senators Sherrod Brown and Bernie Sanders declared, "In light of the potentially chilling effect of these reported intimidation efforts, we urge you to immediately and publicly clarify that compulsory licenses are not only permitted under international trade agreements, including the Colombia FTA and TRIPS agreement, but also a legitimate means of promoting access to medicines."

Reports that a U.S. official threatened to withhold aid earmarked for Colombia’s peace process are especially egregious given the American role in backing and arming the Colombian military’s war crimes and massacres over the course of years.

"More than 50 years of war in Colombia has claimed the lives of more than 22,000 people," wrote a coalition of civil society organizations, including the AFL-CIO and Oxfam, in a recent letter to President Obama. "Violent conflict within the country has internally displaced more than 6 million Colombians and has resulted in the forced disappearance of more than 25,000 Colombians since 1985.”

The letter continued, “It is wholly inappropriate, reprehensible, and intolerable for anyone from [the Obama administration] or the U.S. Congress to ask Colombia to choose between peace and its people’s health.”

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