Sarah Gardner: India's Supreme Court heard arguments this week in a long-running legal case about drug patents. Swiss drug maker Novartis is fighting for exclusive rights to produce its blockbuster cancer drug, Gleevec. If it wins, that will change the rules for generic drugmakers who supply millions of poorer patients in India and elsewhere. It's also sparked a wider debate about the affordability of life-saving drugs.
Christopher Werth reports.
Christopher Werth: India is a growing market for advanced cancer drugs like Gleevec. With rising incomes have come rising cancer rates. But access to the best treatment divides between those who can pay for it and the people I met here. Amid the clamor of bicycles and taxis, hundreds of low-income cancer patients live on the sidewalk in front of India's premier cancer hospital, Tata Memorial in Mumbai.
And like Golo Bari Mohanto, who traveled from a thousand miles away to begin chemotherapy, they can remain on the street for a long time as they receive treatment.
Golo Bari Mohanto (through interpreter): He has been here for 18 days and he has been told he has to live here for six months.
And as Mohanto told my interpreter, he'd already spent $350 on medications -- nearly a third of the average annual earnings for many Indians.
Mohanto (through interpreter): He says that the medicines cost a lot here. Besides that, I come from a very small village, and I have two kids at home. And I don't have enough money.
Most in India pay out of pocket for prescription drugs. That's thought to push millions of Indians into poverty each year.
Inside the hospital, Dr. Pankaj Chaturvedi lays the blame on big Western drug companies that, he says, charge too much for the most advanced treatments.
Pankaj Chaturvedi: Half of my patients may not be getting adequate treatment. I'm seeing them dying everyday. It is such a frustrating experience. We would like the best drugs which are currently available, but those drugs may be beyond their purchasing power.
Novartis first developed Gleevec in the 1990s. It's modified the drug since then -- which is why Ranjit Shahani, a company president, says it deserves a patent in India.
Ranjit Shahani: Gleevec is widely recognized as a medical breakthrough and has been granted a patent in more than 40 countries, including China, Russia, Taiwan...
And the U.S., where patented Gleevec can cost $70,000 for a year's supply.
But India refused a patent in 2006 because it says the drug isn't really new. Under Indian law, pharmaceutical companies are prevented from continually renewing patents on existing drugs by making slight changes to original medications -- a process known as "evergreening."
Leena Menghaney: Evergreening is basically, you take an old drug and you apply for many more patents on it.
Leena Menghaney is with the aid organization Doctors Without Borders. She says while advanced patented drugs are out of reach of most Indians, India is actually home to a thriving generic drug industry that exports across the world. Generic versions of Gleevec in India cost 96 percent less than in the U.S.
And Menghaney argues a victory for Novartis would curb access to low cost drugs globally.
Menghaney: If Novartis wins, the generic industry will possibly move back from producing some of the drugs they produce today. So this will have a chilling effect on generic competition.
And it's not just India where Novartis is coming under pressure. American health campaigners are urging the Obama administration to force the company to lower the price of Gleevec in the U.S.
I'm Christopher Werth for Marketplace.
That story came to us with the help of the International Reporting Project in Washington, D.C.