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GLOBAL REPORT // INVESTIGATION Brenda Medina, Rep
orter, ICIJ “There is a lack of transparency in research and development, so much information is protected by trade secrets, and this benefits the industry. We hope this leads to reconsideration of how the system works.” to file and obtain secondary patents beyond Keytruda’s main pharmaceutical component, potentially extending the drug’s commercial exclusivity until at least 2042 in the US,” the ICIJ notes. And while health officials in other countries might be able to negotiate lower prices for Keytruda behind the scenes, the cost still puts it out of reach for many governments and citizens. “We compared the drug price to purchasing power,” explains Medina. “Even if it’s half the price in India as it is in the US, fewer people can afford it because of their income level.” “The lack of transparency in pricing globally was startling and shocking especially at a time of scandalously rising drug prices,” adds Freedberg. As a result, Indian doctors try to increase access to the drug by administering lower dosages, Freedberg says. Prices in Europe might be lower, but fewer people are prescribed the drug because of the cost to national healthcare systems. Medina says she heard many moving stories in Guatemala, where few people could afford the drug. At one public hospital, a doctor only was able to give Keytruda to three people in 16 years. A symptom of a system Biosimilars are under development, which could lead to cheaper drugs coming to the market, Freedberg notes. Also, the spotlight ICIJ beamed on the issues of pricing and availability make them hard to ignore. “This is a symptom of a system,” Medina says. “It’s the best-selling drug in the world, and they try to price it in secrecy. There is a lack of transparency in research and development, so much information is protected by trade secrets, and this benefits the industry. We hope this leads to reconsideration of how the system works.” NLS LEARN MORE: CANCER CALCULUS The International Consortium of Investigative Journalists: icij.org Cancer Calculus: icij.org/investigations/cancercalculus/merck-keytruda-cancer-drug-price/ NORDICLIFESCIENCE.ORG | 21