Hidden Hegemony: The Marginalization of Patent Reform in China’s Pharmaceutical Politics

Lantian Li, Northwestern University

Patent is central to global pharmaceutical politics. Since the 1990s, the United States, Europe, and Japan - home to most multinational pharmaceutical companies - have been pushing for the international harmonization of a strong product patent regime to sustain market monopoly through multilateral and bilateral trade agreements. While subsequent battles against this patent hegemony were among the fiercest political contestations across and within many developing countries from India, Brazil, to South Africa, which struggled to safeguard local access to affordable medicines, drug patent reform has never even gained prominence as a controversial issue in the public sphere of China. This is surprising because in the past three decades, China’s imports of Big Pharma products grew rapidly, the prices of these brand-name drugs under generous parent protection rose to an extraordinarily high level, and the out-of-pocket payments for such medicine bills made up an unusually large percentage of healthcare expenditures. The paper adopts a historical institutionalist framework to explain the puzzling marginalization of patent reform in China’s pharmaceutical politics. Specifically, I examine four factors: 1) the political system that launched and enforced patent reforms in a top-down authoritarian manner; 2) the institutional complex that prioritized innovation promotion in drug policy and transformed the incentive and ideology of local industry; 3) the state repression that forestalled coalition building among potentially active social groups that could have staged open protest against the imposed patent harmonization; and 4) the public discourse that attributed the inflation of drug costs to stagnated healthcare reforms in general and corrupt medical professionals in particular. I argue that these four historical conditions together allowed the Northern-initiated strong patent regime to easily take root in China and operate to facilitate the rapid invasion of Big Pharma into the increasingly lucrative market as a hidden hegemony.

No extended abstract or paper available

 Presented in Session 265. Social Origins of Institutions