Parallel trade of pharmaceuticals: A review of legal, economic, and political aspects

Objectives: An overview of the status quo of parallel trade of pharmaceuticals (pharmaceutical parallel trade [PPT]) was performed. The different economic, political, and legal viewpoints as well as the public health perspective are being taken into consideration. Analysis is being undertaken on a worldwide level, focusing on the situation of Switzerland in the context of current developments in the United States as well as in the European Union (EU). Methods: Desktop analysis using publicly available information (e.g., scientific literature, congress reports, official statistical databases) was performed during the years 2006 through 2007. Such gathered information was compiled and systematically structured to allow a crude overview of the development of intellectual property law in the last 100 years (as a prerequisite under which PPT legally can exist) as well as a description of the health economic and political context in which PPT is set currently. Results: It could be shown that PPT is an ubiquitous phenomenon, appearing in industrialized countries as well as in the developing world. Economically, it has gained a significant weight in substantial parts of the EU in the last decade. This has to be seen in the context of EU efforts of enhanced economic and political integration. The worldwide constant growth of health-care expenditures, with its strain on national health-care budgets, has led to increased discussions about the necessity and consequences including possible dangers of PPT, namely, in the United States and in Switzerland, where up to now PPT has been only of marginal importance. Conclusions: The analysis of the value of PPT depends strongly on the importance that is given to different perspectives by the individual analyst. It is clear that an item-centered view of PPT is not able to analyze this phenomenon in an equitable way. Further attempts have to be made to standardize evaluation as well as to increase available information to empower science and decision-makers to perform objective analyses and informed decisions.