The debate over access to medicines has principally centered on pharmaceutical patents and prohibitively high drug prices. Although a less recognized problem, counterfeit pharmaceuticals are certainly a more insidious barrier to access. Pharmaceutical counterfeiting is an invisible threat, not only by nature, but also because the industry has historically downplayed it. However, that has changed. Pharmaceutical firms now not only readily concede counterfeiting is a threat to their business, but in some cases publicly address their strategies and the anticounterfeiting technologies in use and development. Acknowledging the problem has benefited the industry because it alters the ways in which firms are able to combat counterfeiting, allowing them to more overtly confront the problem. In addition, it allows them to better partner with governments and health advocates since their incentives are aligned in efforts to prevent counterfeiting. In light of the more public and more aggressive campaign against counterfeiting, it is important to examine the variety of strategies firms may utilize to prevent their sale. Through a theoretical model of the market in a representative developing country, several anticounterfeiting strategies are considered. Some strategies appear to be more effective than others in the battle against fake drugs. Copyright © 2007 John Wiley & Sons, Ltd.

This paper examines two recent examples of compulsory licensing legislation: one globally embraced regime and one internationally controversial regime operating under the same WTO rules. In particular, we consider Canadian legislation and the use of compulsory licensing for HIV/AIDS drugs destined for a developing country. This is then contrasted with the conditions under which Thai authorities are pursuing compulsory licenses, the outcomes of their compulsory licenses, as well as the likely impact of the Thai policy. Finally, we construct a rubric to evaluate characteristics of a successful regime. This is used to analyze the Canadian and Thai regimes and frame the expected implications of each national policy. It is hoped that the assessment will guide changes to compulsory licensing design to ensure that legitimate regimes are embraced while illegitimate ones are disallowed.

Although pharmaceutical counterfeiting incidents can be traced back thousands of years, it has been downplayed and even dismissed by pharmaceutical manufacturers in the past. That has changed. Pharmaceutical firms are newly dedicated to eradicate counterfeits globally and spending more money on anticounterfeiting efforts than ever before. The confluence of three factors seems to have drastically changed the existing paradigm for the pharmaceutical industry: increasing globalization, advancing technology, and the controversies surrounding the WTO Trade-related Aspects of Intellectual Property Rights Agreement and access to medicines. Given that counterfeit pharmaceuticals slip into the supply chain at every link, multinational pharmaceutical firms are searching for global solutions through increased interfirm cooperation along the supply chain. This research presents a theoretical model for characterizing the implications of these interventions on the motivations driving counterfeiters. The interventions are shown to increase the share of real pharmaceuticals and decrease the welfare losses attributable to counterfeiting. In practice, it is too early to evaluate the success of these new measures, but this research reflects on the extent of cooperation both across the supply chain and national boundaries and examines the likely long-run implications of these measures. Copyright © 2008 John Wiley & Sons, Ltd.

In this paper, we employ three simple theoretical models of nonprofit hospitals to investigate equilibrium behavior when hospitals compete. Utilizing a differentiated Bertrand model, we examine how prices, quantity of patients served, service to the uninsured, and quality of care are affected as nonprofits place more weight on profit maximization. We find that the specification of the nonprofit motive greatly impacts the results. When the nonprofit motive is maximizing output, prices rise for both hospitals as the nonprofit moves away from its nonprofit motive. However, if the nonprofit cares about serving the uninsured, prices in the market fall. Finally, when hospitals compete on price and quality, more emphasis on profits results in an increase in price at the for-profit hospital and a decrease in price at the nonprofit hospital. These results suggest that the importance of the nonprofit motive has been underestimated and should be further investigated.

Developing nations are challenged to strike a balance between their patent obligations as members of the World Trade Organisation (WTO) and their drug pricing strategies. The Brazilian approach to pharmaceutical price negotiations has been strikingly effective. Describing the context of the Brazilian pharmaceutical sector, their public health system and the Brazilian AIDS policy, this paper examines the Brazilian strategy vis‐à‐vis the international pharmaceutical manufacturers to explore why their tactics were successful and the potential for wider application by other developing countries.