A patent represents the recognition of intellectual property rights regarding a new invention. Crucially, oversight must be exercised throughout the entire process—from registration and recognition to the pricing of patented drugs—to ensure that patents do not become instruments of unchecked monopolistic exploitation.
A case in point is the shortage of antiretrovirals (ARVs)—medications used to treat HIV that can slow the virus's progression to the clinical stage known as AIDS. ARVs—often administered as a combination of three separate drugs—are central to global HIV/AIDS control programs because they effectively suppress viral loads to undetectable levels. Furthermore, ARV treatment prevents people living with HIV from transmitting the virus to others.
Unfortunately, in December 2018, the Ministry of Health’s tender for Fixed-Dose Combination (FDC) ARVs—which eliminate the need to take three separate pills—failed. The two pharmaceutical companies participating in the limited tender rejected the rational pricing proposed by the Ministry.
PT Kimia Farma had been selling ARVs for Rp404,370, while Indofarma sold them for Rp385,000; in contrast, the international market price for these drugs hovers around just Rp112,000.
The government faced an option to purchase the three individual ARV components—Tenofovir, Lamivudine, and Efavirenz (TLE)—at prices exceeding international market rates. For context, Tenofovir was sold to the government for Rp252,720, whereas the international price was set at only Rp47,000.
There are concerns that such drug monopolies will persist, leaving the government without bargaining power as long as fair, transparent, and healthy competition is not implemented. Involving other pharmaceutical companies could lower ARV prices and ensure a stable supply. If the ARV shortage is allowed to continue, the risk of treatment interruption increases significantly, and the state will ultimately bear far higher treatment costs once viral resistance becomes widespread. References:
- https://tirto.id/mengendalikan-perangkap-monopoli-obat-paten-cmyJ
- https://tirto.id/ancaman-krisis-kelangkaan-obat-hiv-akibat-monopoli-dd7y
