Second Precept & Generic Drugs

General discussion of issues related to Theravada Training of Sila, the Five Precepts (Pañcasikkhāpada), and Eightfold Ethical Conduct (Aṭṭhasīla).

Second Precept & Generic Drugs

Postby No_Mind » Sat Jun 28, 2014 3:56 pm

I will not argue the issue of illegal download. It is too complex. I can argue for both sides of the debate but I choose not to. Those who wish to go through it again will find the thread here http://dhammawheel.com/viewtopic.php?f=42&t=7499

Something almost similar to illegal downloads though not illegal - generic drugs. Drugs made by companies that did not discover the drug and sold at a cheaper price by breaking patent laws. It is not illegal but it is annoying to those who discovered it. In 2001, Indian company sold anti AIDs drugs to French charity Médecins sans Frontières (Doctors without Borders) for $350 a year per patient, on condition that the organization provides the treatment free to patients in Africa. The drug will have cost $10,000 if purchased from original maker in US. Even if the cost of developing the drug is $4 billion, a price tag of $10,000 yearly (it is life long prescription) seems wee bit too much.

Did Médecins sans Frontières (which won Nobel Prize for Peace in 1999) or the generic maker break second precept (they are organizations and have no Kamma but what if the buyer is a senior citizen in Milwaukee who is ordering generic from online pharmacy)

Is buying generic drugs breaking second precept? If I am a cheap generic drug maker, I am cheating the company which holds patent, but I am also making medication available (from cancer to hypertension to HIV-AIDS) to billions who would have died or led very painful life otherwise. Is the drug maker breaking second precept? Is the buyer breaking second precept?

For those who are unaware of generic vs name brand drug debate here is a short primer

No matter in which country you are the debate over generic drug is important. Elderly in USA smuggle in drugs from Canada. From Seattle to Somalia it affects everyone. Tiny number of people download media and software. Perhaps 400,000 people illegally download a movie - at $10 per ticket, loss of 4 million dollars for a movie which cost $200 million to make. Almost whole of humanity buys generic drugs. The scale of generic drug business is much greater and debate exponentially more important.
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Re: Second Precept & Generic Drugs

Postby lyndon taylor » Sat Jun 28, 2014 4:24 pm

Legally manufactured generic drugs are not illegal, so your not breaking any law, even in India, where the government refuses to honour some US patents because they price the drug way above what average Indians can afford, and condone the manufacture of a generic in India, whereas that would be illegal in the USA, you're still not breaking any law in India.
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Re: Second Precept & Generic Drugs

Postby No_Mind » Sat Jun 28, 2014 4:31 pm

lyndon taylor wrote:Legally manufactured generic drugs are not illegal, so your not breaking any law, even in India, where the government refuses to honour some US patents because they price the drug way above what average Indians can afford, and condone the manufacture of a generic in India, whereas that would be illegal in the USA, you're still not breaking any law in India.


Legally manufactured generic drugs in which country? That drug would be legal in rest of the world but not in USA. But even Americans hop over by bus to Canada to buy cheaper generics medicines. (I am keeping patent expired drugs out of the equation. They are the only fully legal generics in all countries of the world)

How does this lie precept wise? If an American were to buy generic drugs from Canada are they breaking second precept? If a Canadian was buying it in Canada are they breaking second precept?

The reason I am using USA as an example in this thread is because it is where most drug companies except AstraZeneca, Roche, GlaxoSmithKline are headquartered.
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Re: Second Precept & Generic Drugs

Postby lyndon taylor » Sat Jun 28, 2014 4:41 pm

Seeing that the drug manufacturers are basically crooks and thieves, it may not be so bad to buy the cheaper drugs, as to Canada those cheap generics are also available in the USA, they're just priced less in Canada because Canada puts price controls on drugs which america refuses to do, you're buying exactly the same drug from the same manufacturer, it just costs less in Canada.
18 years ago I made one of the most important decisions of my life and entered a local Cambodian Buddhist Temple as a temple boy and, for only 3 weeks, an actual Therevada Buddhist monk. I am not a scholar, great meditator, or authority on Buddhism, but Buddhism is something I love from the Bottom of my heart. It has taught me sobriety, morality, peace, and very importantly that my suffering is optional, and doesn't have to run my life. I hope to give back what little I can to the Buddhist community that has so generously given me so much, sincerely former monk John
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Re: Second Precept & Generic Drugs

Postby mikenz66 » Sat Jun 28, 2014 9:42 pm

I think there's some confusion here.

Once a patent has expired then anyone can sell the drug (or device, etc) without paying royalties. However, different countries may have different time limits on patents, and that may mean that a generic drug is currently legal to sell in some countries and not in others.

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Re: Second Precept & Generic Drugs

Postby No_Mind » Sun Jun 29, 2014 3:39 am

There is some confusion about what I asked. Let me explain the OP

Introduction -

A drug maker in USA Babbot Bailey discovers an anti-diabetic drug Glotin in 1994. They prices it at $40 for a month's use. Patent expires in 20 years. The profit margin is 350%

An Indian drug maker LoChem recreates it in 1998 and sells with the name Botin for $5 for a month's use - first in India, then S.E Asia and then through online pharmacies worldwide from 2004.

Situation 1 ) Alex is an American and a Buddhist. He comes to visit Bodh Gaya in 2002 and picks up 1 year's worth of unlicensed generic medicine (Botin) from India for his father. Did Alex break second precept?

Situation 2 ) In 2003 Alex's father Archie (also a Buddhist living in in Seattle) needs a refill. Archie hops over to Canada to buy the unlicensed generic medicine (generic which does not pay license fee to owner of patent). Is Archie breaking the second precept by buying Botin? (In USA Archie will only be able to find licensed generics not Botin).

Situation 3 ) Archie's wife Ada (also a Buddhist living in Seattle) who has same drug prescription for diabetes, buys the drug Botin from an online pharmacy in Canada (which sources it from India) and delivers it to her home in Seattle.

Situation 4 ) In 2001, Rahul, an Indian who is a Buddhist has a choice between buying (in Delhi) the US original Glotin at scaled down (for Asian markets) price of $30 monthly or Indian generic Botin at $5 monthly. Does he break second precept by buying Botin, the unlicensed Indian generic (though while he stands on Indian soil he breaks no law by buying the medicine)

In 2014 patent expires after 20 years and everyone can have the drug for $5 worldwide, no licensing, no rules. It is a molecule that can be freely produced and distributed.

Key word here is unlicensed generic medicine (generic made without approval of the original maker before patent has expired which is usually 20 years)

Question 1 ) Did owner of LoChem, Alex, Archie, Ada, Rahul breal second precept? Why?

Question 2 ) Why did the owner of Babbot Bailey not break any Buddhist rule even though he extorted sick people for a profit margin of 350 %. Where is the justice in that?

Note 1 - "who is Buddhist" is mentioned since we are not concerned about how a Hindu or a Christian thinks of the ethical issue. Piracy of any type is not a large enough ethical issue in any other religion.

Note 2 - USA is mentioned since most patent laws broken will be in USA. Consuming a US origin, Indian manufactured unlicensed generic drug, in Japan is not illegal (distributing it maybe illegal but consuming is not)

Note 3 - Babbot Bailey and LoChem are assumed names so that you do not have to type "US drug maker" "Indian drug maker". Same for "Glotin" and "Botin". Takes long to type "US original drug" and "Indian unlicensed generic"
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Re: Second Precept & Generic Drugs

Postby mikenz66 » Sun Jun 29, 2014 4:25 am

Regarding the US (or Swiss, etc...) drug companies:

As I understand it, the process of getting drugs approved for human use is very expensive. If the companies could not make large profits for the duration of the patent then they could not afford to bring them to market.

I understand that there are some drug candidates that would most likely be better than current drugs. But because they are not patentable (because they have been published), they will not be developed. There are also some drugs that are out of patent that it is hard to persuade any company to make, even though they are effective.

The situation is complicated, even before starting on the ethics...

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Re: Second Precept & Generic Drugs

Postby No_Mind » Sun Jun 29, 2014 4:43 am

mikenz66 wrote:Regarding the US (or Swiss, etc...) drug companies:

As I understand it, the process of getting drugs approved for human use is very expensive. If the companies could not make large profits for the duration of the patent then they could not afford to bring them to market.

I understand that there are some drug candidates that would most likely be better than current drugs. But because they are not patentable (because they have been published), they will not be developed. There are also some drugs that are out of patent that it is hard to persuade any company to make, even though they are effective.

The situation is complicated, even before starting on the ethics...

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Which would bring me to my block buster question - why is buying pirated software and movies on streets of Shanghai breaking of second precept? If you can buy pirated drugs and that not be a violation then why is buying Windows Office on streets of Shanghai for $5 a violation of second precept. If you read carefully, buying of unlicensed generic from India and buying pirated Windows Office has almost all the same steps.

Use of Windows Office is as necessary as an anti diabetic drug. Not providing cheap unlicensed generic anti-HIV drugs to Africa and not providing them pirated Windows Office has about same effect when seen at end of 40 years.
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Re: Second Precept & Generic Drugs

Postby mikenz66 » Sun Jun 29, 2014 4:55 am

I've got no particular wish to enter into a discussion of the precepts. I'm just pointing out practicalities.

There is an interesting difference between software and (legal) drugs.

Fully functional, free (in both the monetary and open-source meanings of the word) operating systems and program suites exist, courtesy of the GNU project, Linux, and other initiatives, so most IT could still function quite happily (after a little initial adjustment) if Microsoft and Apple ceased to exist. Some interesting statistics here: http://en.wikipedia.org/wiki/Usage_shar ... y_category

The same isn't true of the drug industry. The current reality of development means that it's not practical to develop drugs in an open-source way (even though basic scientific research does work that way...).

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Re: Second Precept & Generic Drugs

Postby No_Mind » Sun Jun 29, 2014 5:09 am

mikenz66 wrote:I've got no particular wish to enter into a discussion of the precepts. I'm just pointing out practicalities.

There is an interesting difference between software and (legal) drugs.

Fully functional, free (in both the monetary and open-source meanings of the word) operating systems and program suites exist, courtesy of the GNU project, Linux, and other initiatives, so most IT could still function quite happily (after a little initial adjustment) if Microsoft and Apple ceased to exist. Some interesting statistics here: http://en.wikipedia.org/wiki/Usage_shar ... y_category

The same isn't true of the drug industry. The current reality of development means that it's not practical to develop drugs in an open-source way (even though basic scientific research does work that way...).

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Not correct. I can at most replace Office. But what about the Windows 7 OS?

In India a plain vanilla desktop costs $500 and the OS costs $200. How can an OS cost that much unless there is price gouging. Why will it not cost $40 so everyone can buy a genuine copy?

It is quite the same as medication. Everyone has shifted to laptop to avoid this pirated OS in desktop issue. But it did exist for 15 years (now also does but less and less)

The irony is 30% of those who work at Microsoft USA are Indians. And without using pirated Windows they would never have been there!! They stole $200 worth of products from Microsoft but have made Microsoft richer by many billions of dollars. And Bill Gates takes those billions and sends them back to poor nations for his philanthropic work.

So it all works out just fine. No harm, no foul.

The second precept was meant for simple situations - like shop lifting. Not complex issues like illegal downloads or generic drugs.
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Re: Second Precept & Generic Drugs

Postby mikenz66 » Sun Jun 29, 2014 5:55 am

No_Mind wrote:Not correct. I can at most replace Office. But what about the Windows 7 OS?

Not correct in what sense? Running just Linux is perfectly viable, but might be slightly unfamiliar. The difference between a computer running Linux and one running Windows is no more than the difference between computers running Windows or MacOS. I.e. different flavours of the GUI (Graphical User Interface). Of course, some prefer one over the others. Personally I prefer Linux (and that's what I'm using to post this message), but that's due to my background of using various Unix GUIs since the 80s, before Windows existed...

On the other hand, it can be difficult to buy a computer without paying for Windows. That's a different issue.

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Re: Second Precept & Generic Drugs

Postby No_Mind » Sun Jun 29, 2014 10:00 am

mikenz66 wrote:Not correct in what sense? Running just Linux is perfectly viable, but might be slightly unfamiliar.

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Incorrect because Linux has no drivers. I can install Linux but what about drivers for my motherboard, graphics card, sound card, ADSL modem, other types of wireless modems, printers and so on. They work only with Windows. And without a modem a computer is as well as dead. Maybe Linux kernel will contain motherboard driver but not the rest. In India, Vodafone and NTT Docomo dongles (wireless USB modem for 3G) does not work on Linux. Do Nextel and Sprint dongles work with Linux?

There are no Linux versions of free softwares we use daily - such as there is no way to connect an Android phone to a LInux desktop and backup all contacts, application, sms to a file using a free Android management software which installs on Linux (like Wondershare MobileGo android backup software). Does Flash work seamlessly on Linux?

Linux is okay for enterprise use. Linux is okay as a second or third computer for someone who uses Windows or Mac OS primarily. But Linux as primary machine is not possible.

This guy put it well "Open-source ideology be damned, Microsoft Office will create more compatible files and lead to a more successful employee."
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Re: Second Precept & Generic Drugs

Postby Modus.Ponens » Sun Jun 29, 2014 10:28 am

Jesus!

I thought this was a serious question without an agenda. I was really interested in the medication question, and ready to answer it, until the piracy "equivalency" came into place.

Ask a cancer patient the following: "what is most important for you a medication to save your life, or windows 7?"

:shrug:
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Re: Second Precept & Generic Drugs

Postby mikenz66 » Sun Jun 29, 2014 10:29 am

Incorrect because Linux has no drivers.


My primary (only) computer is a Lenovo laptop running Linux, connected to my network via wireless, and have no problems with printer and other such drivers. I can connect to my android phone.

[I do run Windows in a virtual machine, but only because at work I have to have complete compatibility with MS Office tools to do my job properly. Open/Libre Office is just a capable, but conversion can cause issues...]

Certainly there is more consumer-oriented software available for Windows, but there are often equivalent packages.

And you have a point that some companies don't provide Linux solutions for their devices.

But if you want to use free software you might have to make some compromises or use slightly different solutions.

This is getting somewhat off topic, but I will make the point that in this area, as in many others, if you want inexpensive, legal, solutions, you may need to compromise and/or work a little harder.

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Re: Second Precept & Generic Drugs

Postby No_Mind » Sun Jun 29, 2014 10:31 am

mikenz66 wrote:
This is getting somewhat off topic,

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Yes off topic Mike, but will have been a great conversation. Good to hear you are working solely with Linux. Perhaps it is because of your confidence due to lot of practice with Linux and Unix. :thumbsup:


Modus.Ponens wrote:Jesus!

I thought this was a serious question without an agenda. I was really interested in the medication question, and ready to answer it, until the piracy "equivalency" came into place.

Ask a cancer patient the following: "what is most important for you a medication to save his life, or windows 7?"

:shrug:


Disregard the piracy equivalency part. Please share your opinion on what was asked other than that.

This thread is a serious question without an agenda.

Reply to the generic drug part which was the actual question. Do you break second precept by consuming unlicensed generic drugs?

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Re: Second Precept & Generic Drugs

Postby Modus.Ponens » Sun Jun 29, 2014 11:49 am

No_Mind wrote:
mikenz66 wrote:
This is getting somewhat off topic,

:anjali:
Mike


Yes off topic Mike, but will have been a great conversation. Good to hear you are working solely with Linux. Perhaps it is because of your confidence due to lot of practice with Linux and Unix. :thumbsup:


Modus.Ponens wrote:Jesus!

I thought this was a serious question without an agenda. I was really interested in the medication question, and ready to answer it, until the piracy "equivalency" came into place.

Ask a cancer patient the following: "what is most important for you a medication to save his life, or windows 7?"

:shrug:


Disregard the piracy equivalency part. Please share your opinion on what was asked other than that.

This thread is a serious question without an agenda.

Reply to the generic drug part which was the actual question. Do you break second precept by consuming unlicensed generic drugs?

:anjali:


Ok.

Technicaly, yes. Moraly, no.

If you go just by the letter of the rule against stealing, this is in fact stealing. But if you face the precepts stirctly as legal "documents" you will face ridiculous contradictions.
For example, if there was a murderer ready to murder 2 people and you had a clear and completely safe way to steal his weapon, wouldn't you steal it?

A real case of corporate thievery is Monsanto. They are patenting seeds that are not theirs to begin with. And now they're lobying (at least european) governments so that only a restricted number of seeds can be used in agriculture. Not to mention what they do in court to the farmers who, by no fault of their own, get their corn seeds fertilised by GM corn, and try to use those seeds for their next year crop.

In the case of pharmaceutical industry the problem is delicate. On one hand 90% of the research relevant to make a specific pill is done by universities. The pharmaceutical companies spend some money on research but not even comparable to the money they claim they spend. AFAIK, no exaustive report of what was spent is presented _ far from it. So they lie to government, patent and health authorities on how much they spent to do the research. They end up with a price for their product that is extremely inflated. That is lying to get money, aka, stealing.

On the other hand, there must be some financial incentive for original research to be done so that the fundamental research done in universities gets application to specific cases.

In my opinion, as long as these companies have a predatory behaviour, I don't find it wrong for people to save their lives and good health by using patented medicine. After all, if medical research was like a company, the pharmaceutical companies would only have 10% of the shares. Yet, they are the ones deciding how much a person's life is worth.
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Re: Second Precept & Generic Drugs

Postby Modus.Ponens » Mon Jun 30, 2014 7:32 pm

I forgot to say something important.

Even though I don't find it wrong, I wouldn't advise to do it unless it's an emergency. Online pharmacies are not trustworthy. Plus, it is likely that you wouldn't have medical assistance from your doctor.
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