e23Abstracts / Research in Social and Administrative Pharmacy 8 (2012) e1–e66
p!0.001). A significantly lower proportion of patients
from WA compared to EA chose the GP (9.7% vs.
16.5%, p!0.001). As for advice provision on medica-
tion use, pharmacists provided the most advice
(WA:52.8% vs. EA:53.0%, p¼0.224), followed by the
specialist (WA:32.0% vs. EA:27.4%, p!0.001). The
second part of the questionnaire revealed that patients
expect brief counselling (2 minutes) on medication use
from their pharmacist (WA:81.3% vs. EA:83.1%,
p¼0.216). A small proportion of patients (WA:18.2%
vs. EA:20.0%, p¼1.07) perceived the need for a paid
Medication Management Review (MMR) service.
Conclusions: Patients have high perception of the role of
the pharmacist in Jordan, being the most accessible
health care professional in the country. The role of the
GP seems to be diminished. The low proportion of
patients who perceived the need for a paid MMR service
shows that this concept is not yet established in the
Jordanian community.
ORAL PRESENTATION 2: POLICY, REGULATIONAND ECONOMICS
TRIPS+ of FTAs to TRIPS+ without FTA:Pharmacopolitics in ThailandK. Kijtiwatchakul1, N. Tien Udom2, 1Coordinator of FTA
Watch, Thailand, 2Director of AIDS Access Foundation
Objectives: To study the tactics of policy interference by
multinational pharmaceutical industry and the strategic
movement by the multinational pharmaceutical industry
that lobbies policy makers to manipulate Intellectual
Property Rights protection for its profit, regardless of
FTA negotiations.
Methods: Literature review; in-depth interview; and
focus group discussion.
Results: While the Thai-US FTA negotiation has been
suspended since 2006, the Thai-EU negotiation has not
started yet. Thus, Thailand has not officially accepted
the more high standard of Trade Related Intellectual
Property Right protection (TRIPS plus) provision of
which might have an adverse effect on access to medicine
and health care. According to an impact analysis, if the
Thai-US FTA’s TRIPS plus provision be accepted, the
total cost of a lifetime treatment of HIV/AIDS patients
would be escalated, resulting in a tremendous increase in
government health care budget. Moreover, the TRIPS
plus would have devastating impacts on many areas of
laws, including those governing patents. Patent laws
would be strengthened under this FTA, making it more
difficult for these countries to access affordable, quality,
and life-saving medicines. However, even if the Thai
FTA negotiations are interrupted, aggressive lobbying
for TRIPS plus provisions is continuously pursued. Thai
government is pressured to amend Thai laws or regula-
tions through different approaches by multinational
pharmaceutical corporations. These drug corporations
are manipulating behind the controversial movement by
some conservative and profit-oriented physicians attack-
ing the quality of generic medicines and delaying the
quality improvement process in granting IPR aiming to
prevent the so-called ‘evergreening patent’.
Conclusions: Although FTA negotiations are pending,
and the TRIPS plus are not yet be accepted, situation on
the threat by pharmaceutical industry on Thai health
system is still going on unabated. Thus, public surveil-
lance on these movements is necessarily crucial by the
FTA watch (a coalition of Thai non-government orga-
nizations working on FTA) and the NGOs working on
access to medicines.
Evergreening� Patent: Playing Monopoly with MinorIncremental Development of Pharmaceuticals inThailandN. Kessomboon1, U. Maleewong2, K. Kijtiwatchakul2, A.Eksaengsri3, S. Atsawintarangkun3, J. Limpananont4,1Faculty of Pharmaceutical Sciences, Khon Kaen
University, Khon Kaen, Thailand, 2Independent
Researcher, Thailand, 3Government Pharmaceutical
Organization, Bangkok, Thailand, 4Faculty of
Pharmaceutical Sciences, Chulalongkorn University,
Bangkok, Thailand
Objectives: To explore the situation of ‘evergreening’ of
pharmaceutical patents in Thailand during 2000-2010.
Methods: The pharmaceutical patent applications during
2000-2010were re-examined by using the guideline for the
examination of pharmaceutical patents in Thailand. The
guideline was developed from the guideline elaborated by
the International Center for Trade and Sustainable De-
velopment, the United Nations Conference on Trade and
Development, and theWorld Health Organization (2007)
and adopted from the focus group discussions among key
informants including academics; theDepartment of Intel-
lectual Property, Ministry of Commerce; Pharmaceutical
Research andManufacturersAssociation; andThai Phar-
maceuticalManufacturers Association. The patent appli-
cation examiners were also standardized until reaching
the almost perfect agreement among the examiners
(kappa coefficient ¼ 0.89).
Results: Patents over minor incremental developments
(often termed as ‘evergreening’ patents) may be used to
exclude generic competition and thereby block access to
affordable drugs. Of the 2,034 patent applications during
2000-2010, 1,960 were categorized as ‘evergreening’. The
‘evergreening’ ranged from new use of a known sub-
stance (73.7%), formulations (36.4%), markush claims
(34.7%), and combinations (15.2%). Top three of the
patent application holders, (58.2%) in Thailand were