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HEALTH

Novartis patent case threatens cheap drug supply: MSF

Supply of cheap, copycat drugs for the developing world could be badly threatened if Swiss firm Novartis wins a challenge to India's patent law, medical charity MSF said on Monday.

Novartis patent case threatens cheap drug supply: MSF
Andrew Hecht

The warning came as India’s Supreme Court was due to hear more arguments on Tuesday in an appeal by Novartis seeking patent protection for a newer version of its leukaemia drug Glivec — a case watched closely by global pharmaceutical firms.  

“If the patent law challenge is successful, it would have a devastating impact on access to affordable medicines across the developing world,” Leena Menghaney, India representative of Medecins Sans Frontieres (MSF), told a news conference.  

Novartis is contesting the Indian patent office’s rejection of a patent application for the updated version of Glivec that is better absorbed by the body. MSF calls the improvement a “minor modification”.  

The drugmaker’s challenge goes to the heart of India’s patent act, which says a patent cannot be granted for an old drug unless changes make it significantly more therapeutically effective.  

The Supreme Court case is the final act in a lengthy legal battle between Novartis and patient rights groups in India, where local firms produce generic drugs at a fraction of the cost of brand-name originals.  

Indian generic versions of Glivec sell for 8,000 rupees ($174) for a month’s treatment compared with 120,000 rupees for the brand-name version, MSF said.  

Pharmaceutical multinationals argue that protecting patents is crucial to stimulating the research and development of new drugs.  

India, known as the “pharmacy to the developing world,” has long been a key provider of cheap generic medicines as it did not issue drug patents until 2005, when it was obliged to adhere to WTO intellectual property regulations.  

Now, India allows patents for new inventions after 1995 or for an updated drug showing much greater therapeutic efficacy. The base compound for Glivec was discovered in 1993.  

But India rejects applications for minor changes to existing drugs, which critics say are aimed at extending the life of original patent monopolies from their original 20 years — a practice known as “evergreening”.  

A spokesman for Novartis said on Monday the court’s decision was essential to the “viability of the innovative pharmaceutical business in this country”, adding that Glivec had received patent protection in nearly 40 countries.  

The cost difference between generic and brand name drugs is crucial for poor people around the world, MSF said, noting generics from India have pushed down prices for older anti-AIDS drugs by 99 percent.  

MSF buys 80 percent of its generic AIDS drugs from India and the humanitarian group said it is currently keeping 170,000 people in 19 countries alive on the treatment.  

“We couldn’t afford to treat them all without these generic drugs,” Joanna Keenan, spokesman for Geneva-based MSF, told AFP.  

If the court accepts Novartis’s arguments, the ruling could set a precedent allowing firms to acquire patents on modified versions of existing medicines — extending the time of their exclusive right to make drugs, MSF said.  

“It would create a scenario in which only the richest survive. The outcome of this case is literally a matter of life and death for people,” Loon Gangte, who heads an Indian group representing people living with HIV/AIDS, told AFP.

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HEALTH

How you can save money on healthcare in Switzerland

Between insurance premiums and over-priced drugs and other costs, healthcare in Switzerland comes at a steep price. Clare O'Dea looks at why the costs are so high and some of the ways you can save money.

How you can save money on healthcare in Switzerland

On the surface, the Swiss healthcare provision model looks egalitarian. All residents are obliged by law to purchase the same basic package of insurance, and the premiums are subsidised for those on low incomes. So why is cost such a bone of contention?

The problem is that the healthcare itself is very expensive, the second most expensive system in the world after the United States. And most of the cost is shouldered by households one way or another. This hurts those on low to middle incomes the most.

Between health insurance premiums, out-of-pocket expenses and over-priced drugs, households are spending a significant chunk of their income on health. Amazingly, Swiss residents fund 59 per cent of the national expenditure on health, according to the Federal Office for Public Health figures for 2020. The rest comes from state coffers, and, to a small extent, from employers.

To bring it down to an individual level, Swiss residents shell out 478 francs per person per month on health costs. Compulsory health insurance premiums account for 252 francs of that total on average. The rest goes on supplementary (top-up) health insurance premiums (42 francs), co-payment on policies plus out-of-pocket expenses (174 francs) and ‘other funding’ (10).

Politicians across the spectrum seem to be incapable of doing anything to curb health inflation. The latest is that health insurance premiums are set to increase by 8.7 per cent in 2024. That’s not a projection but a fact, as announced by the health minister in September.

KEY POINTS: What you need to know about Switzerland’s health insurance price hikes

Public purse

The worst thing would be to miss out on your entitlements. To find out if you qualify for premium subsidies, you’ll have to go through your home canton. Each canton has its own reduction rates and rules on eligibility. In some, there are systems in place to identify and notify eligible people but in others, you have to check and apply yourself.

This possibility is definitely worth looking into if you think you might be eligible – around a quarter of the population qualify for these payments. In some cantons, the proportion of recipients is higher. Moneyland.ch has put together a list of the contact information for premium reductions in each canton.

Take the initiative

Generally speaking, to save money on healthcare costs, the insured have to take the initiative themselves. New arrivals to Switzerland are required to take out a policy within three months, and should definitely shop around. Pricing comparison websites such as moneyland.ch , comparis.ch and Priminfo (in the national languages only) help to cut through the noise and find the best deal for your individual circumstances.

Age and location are important criteria. There are infinite tiny pricing variations between the 40+ non-profit insurers (known as “Krankenkasse”, “caisse maladie” or “cassa malati”), which means you may even find a better deal by buying policies from different insurers for different members of the family.

For those who already have a policy, it makes sense to do an annual price check up when the following year’s rates are announced in the autumn. Chopping and changing, which everyone has a right to do once a year, can really pay off.

The window for changing providers has just closed but you can be ready to notify your current provider by November 30th next year. Handily, the comparison websites also provide template letters for cancelling a policy.

READ ALSO: Which Swiss health insurance providers have the lowest rates in 2024?

Different models

Even if you decide to stay with the same insurer, you can obviously change the type of policy to a cheaper version. The so-called standard model is the most expensive. Under this arrangement, you decide which doctor you’d like to see, including specialists, and make appointments when you feel the need. 

There are other cheaper managed care models which are designed to cut down on unnecessary visits to the doctor. With these, you have to have a telemedicine consultation or visit a pharmacy before you get the green light to make an appointment with a doctor. There is another model where you have to see your general practitioner to get a referral to a specialist.

Calculations

The best way to save overall is to get clever with your deductible. That’s the share of medical expenses that you have to pay from your own pocket in the space of the year before your insurer starts reimbursing. The lower the deductible, the higher the premium.

Making the right choice involves a certain risk. But it is at least possible to make an educated guess based on past experience. There are several bands between 300 and 2,500 francs per year for deductibles (the amounts are lower for children).

If you tend not to need medical care and think your health costs are likely to be low in the coming year, it would make sense to go for the maximum deductible, which can translate into a saving up around 40 per cent on premiums. If you have reason to believe your bills will add up to 2,000 francs or more, then you’re better off going for the minimum deductible.

Don’t double up

That’s all speaking about the mandatory insurance package, which includes illness, accident and maternity care. But make sure you really need that accident insurance. Anyone who is employed for more than 8 hours per week is covered by their employer’s accident insurance, in which case it should be removed from their personal policy.

If you are looking to save money on health insurance, chances are you won’t be looking for additional insurance, also known as supplementary insurance. These policies give you more freedom over choice of hospital, and also cover therapies and treatments that are not included in the basic mandatory package. You can have both policies from the same provider or mix and match.

Though it can be irritating to hear this, especially if you already have a health condition, there is one final way that you can save on health costs – don’t get sick. What this advice really means is to lead a healthy lifestyle by taking exercise, eating a balanced diet, not consuming too much alcohol and cutting out smoking. Those are things we have control over, unlike genetics and luck.

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