Pharmaceutical Pricing Hostages

By Ellen ‘t Hoen, Global Health Unit Department of Health Sciences, UMCG Groningen,

Ireland seems to be the stage of some of the most bizarre pharmaceutical company behaviour these days. This month, the pharmaceutical company CSL Behring announced it will no longer provide Respreeza (human alpha1-proteinase inhibitor), a treatment for hereditary emphysema, for free. Most of the patients that depend on the programme had volunteered to be part of the clinical trials to test the product, which was necessary to obtain a marketing authorisation for the product. CSL Behring gained such authorisation  in 2015 and priced the product at €103,768 (VAT incl.) per year’s treatment. Here you can find the cost-effectiveness evaluation by the Irish National Centre for Pharmacoeconomics (NCPE). The company has now told the patients that the donation programme they depend on will come to a halt. Of course, if they pay the price or persuade the government to pay, the patients can get access to the product. This case is particularly bitter because the patients who are left out in the cold are the very people that helped the company get its marketing approval. In other walks of life, this would be called a hostage situation.

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Guilin, 2017: China Hosts Country’s First International Symposium on Global Health Law

By Yi Zhang (Eva), University of Groningen Faculty of Law, PhD Candidate,

In order to further promote the level of global health governance and encourage research in global health law, the 2017 International Symposium on Global Health Law was held in Guilin city, China from July 2nd to July 3rd, 2017. The organizer of the symposium was Central South University, China. The symposium was hosted jointly by the Institute of Medical and Health Law of Central South University, the O’Neill Institute for National & Global Health Law of Georgetown University, and the Global Health Law Research Centre of the University of Groningen (GHLG).


The theme of this symposium was “Global medical health and relevant legal issues”. Altogether, over 80 academic papers were accepted, and more than 80 experts from all over the world from colleges, universities, research institutes, and law practice departments attended the symposium and shared a comprehensive discussion on the abovementioned theme. The experts were from Central South University, China; Georgetown University, US; Groningen University, the Netherlands; Yale University, US; Harvard University, US; Temple University, US; Hokkaido University, Japan; Taiwan University, China; Tsinghua University, China; and Peking University, China.

The Director of the Office of International Cooperation and Exchange, Yi Bai, stated in his address that 2017 was an important year to carry out the theme of National Health and Wellness and to carry through the “13th five-year plan” of deepening the health care system reform in China. He also emphasized that it is the key year to construct the basic framework of a proper functioning medical and health care system and to accomplish staged tasks of reforming the pharmaceutical and health care system in China. It can be predicted that holding the first International Symposium on Global Health Law would promote the development of global health law research in China.

Throughout the symposium, expertise were shared on global health issues including discussions on disease prevention and treatment, global health governance,  international law and human rights in health protection, and national policy approaches to health-related issues such as drunk-driving, tobacco, health insurance, and access to medicines.

In their academic summary, Central South University Xiangya School of Public Health Professor Guoqing Hu said of the symposium that it was, on one hand, a real interdisciplinary crossing had been realised at the symposium with each paper having its own special value; on the other hand, through taking advantage of every subject and international communication, new challenges and problems home and abroad had been explored.

At noon on July 3rd, 2017, after a day and a half of heated discussion, the closing ceremony was held. University of Groningen Prof Brigit Toebes hereby functioned as the host. In her speech, she praised the huge success of the symposium, and she took great pleasure in seeing that many famous scholars from different countries were invited to attend the symposium and that over 80 professors assembled at the symposium to have an in-depth discussion of global health law issues. She was inspired by the speeches of each individual expert, and accordingly made a wonderful comment on the symposium with ten questions to share with the delegates and to cast light for the future global health law research,:

(1) What is global health law; what are its scope and implications?

(2) What are the roles and positions of human rights, ethics, governance, and other related disciplines in global health law?

(3) What are the implications of global health law for domestic health care settings?

(4) What can we learn from other countries when it comes to ‘good practice’ in domestic health laws?

(5) How can we measure the effectiveness of health laws in a transdisciplinary manner?

(6) How do we balance care and prevention?

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(7) How can health insurance best be organized and what can we learn from countries like Japan, Taiwan, and the Netherlands: public, private, or a mix?

(8) Against the backdrop of an aging population, the rising cost of medicines and care, and the increase in non-communicable diseases, how can costs be reduced whilst maintaining equality in access to care?

(9) How may overconsumption of medical services be reduced?

(10) How can health lifestyles be encouraged, while e paying due attention to the autonomy, privacy, and self-determination of individuals?

Finally, Prof Yunliang Chen delivered a closing speech, and he concluded that a great power must participate in global health governance and the research on global health law was a major demand for China. He also wished the participants would strengthen global health law research to promote global health governance in China.

For the full report, click here.


The Legal Ban on Sex-Selective Abortions: a Step Backwards to Women’s Reproductive Health and Rights in Armenia

By Nikolay Hovhannisyan, University of Groningen LLM International Human Rights Law,

Sex-selective abortions raise moral, legal, and social issues, reinforcing discrimination and sexist stereotypes towards women by devaluing females.[i] In countries like Armenia, where the underlying reason for sex-selective abortions is the widespread son preference, it implies the concept of valuing women only if they are able to produce sons. To tackle son preference in the country and normalize the sex-ratio, in 2016 the Government introduced a legal ban on sex-selective abortions. Whereas the harms of sex-selective abortions are severe, the question is whether such restriction is the most effective and acceptable tool in preventing the practice of sex-selective abortions from occurring and what the implications of such restriction are.

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Dolutegravir Patent Licences Can Provide Access To All

By Ellen ‘t Hoen, Global Health Unit Department of Health Sciences, UMCG Groningen,

This year the World Health Organization (WHO) added dolutegravir, an antiretroviral medicine for the treatment of HIV infection, to its Model List of Essential Medicines in response to the recent evidence showing the medicine’s safety, efficacy, and high barrier to resistance. A recent study HIV drug resistance report 2017 launched by the WHO at the IAS2017 shows that in 6 of the 11 countries surveyed in Africa, Asia and Latin America, over 10% of people starting antiretroviral therapy had a strain of HIV that was resistant to some of the most widely used HIV medicines. This is a worrying trend and such levels of resistance demand a review of the treatment practices including switching to more robust ARV regimen.

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Euthanasia in the Netherlands: a slippery slope?

By Brigit Toebes, Academic Director, Global Health Law Groningen Research Centre

The Dutch euthanasia legislation has been lauded as well as criticized by legal scholars and physicians in the Netherlands and abroad. The legal framework so established is renowned for setting a number of valuable due-care criteria for the physician to follow when performing euthanasia on a patient. However, is the Dutch approach traveling down a slippery slope now that euthanasia is increasingly performed on patients suffering from dementia and on patients with chronic psychiatric conditions?

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The Most Common Misunderstanding About Compulsory Licences

By Ellen ‘t Hoen, Global Health Unit Department of Health Sciences, UMCG Groningen,

The belief that a country can only use compulsory licensing in cases of public health emergencies is a myth that has proven difficult to bust.

Recently Jay Taylor, a lobbyist for Phrma, stated: “In certain instances, such as public health emergencies, trade partners may legally issue a compulsory license.” Mr Taylor references his statement with a link to the World Trade Organization’s fact sheet on compulsory licensing, which says:

Does there have to be an emergency? Not necessarily. This is a common misunderstanding. The TRIPS Agreement does not specifically list the reasons that might be used to justify compulsory licensing. However, the Doha Declaration on TRIPS and Public Health confirms that countries are free to determine the grounds for granting compulsory licences.

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A New Access to Medicines Initiative: Medicines Law & Policy

By Jacquelyn Veraldi, University of Groningen,

This week during the WHO’s 70th World Health Assembly, GHLG member Ellen ‘t Hoen announced the launch of the new website, ‘Medicines Law & Policy’, established with colleagues Pascale Boulet and Kaitlin Mara, all experts in intellectual property and access to medicines.  ML&P provides expertise in the form of policy and legal analyses, best practice models, and other information to work toward the goal of ensuring the availability of effective, safe, and affordable medicines for all.
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