Based on our preceding discussion, the pharmaceutical industries in developing countries have had various experiences in the post TRIPS agreement period. The pharmaceutical industries in some countries have had successful experiences and have continued to grow and survive after the TRIPS agreement. In contrast, the pharmaceutical industries in some countries have had unsuccessful experiences and have failed to grow in the new patent regime and market liberalization.
For example, Brazil enacted the rules for liberalizing its economy in the 1990s and followed the new technology regime only two years after the TRIPS agreement. As White and Linden (2002) have stated, organizations would not survive if the pace of economic reforms exceeded the pace at which organizations can adopt appropriate strategies (
53). These problems include (
1) prohibiting the local production of patented drugs and replacing them with imported products from the companies that have the patents of these drugs, (
2) allocating resources to imported products instead of investing these resources in national R&D and purchasing other drugs, (
3) inability to export local products due to the unpreparedness and incompatibility of Brazilian ports and airports with export rules (
54).
Chittoor et al. (2008) have shown in their study that the prominent features of India’s institutional environment include a combination of private and public sector enterprises, substantial presence of foreign firms, better quality institutions, and gradual acceleration of institutional changes, which has led to local firms that have relatively higher knowledge or experience about market economies (
24).
The strategies adopted by companies with successful experiences were studied in this paper. The pharmaceutical industry is shaped by external forces, such as economic reform, health system reform, industrial policy regimes, and changing business ethics alongside internal forces, such as enterprise competition (
25,
39).
As mentioned earlier, choosing a proper strategy should be in line with the external and internal environment of firms. Due to their strengths and weaknesses, pharmaceutical companies of developing countries are taking advantage of the opportunities created in the new patent regime, penetrating new and regulated markets, and enhancing their capabilities and innovativeness, either by collaborating or by competing with MNCs.
Pharmaceutical companies that are strong enough in drug discovery research activities begin to compete with the world’s leading pharmaceutical companies in the new patent regime. Therefore, they follow competitive strategies such as research on NCE, biopharmaceutical research, novel drug delivery system, innovation, specialty generics, development of the non-infringing process, positive patenting, and defensive patenting.
The availability of financial resources is an essential constraint that companies face in competing with multinationals. Local firms’ strategies for building internal capabilities and meeting international standards include modernizing manufacturing plants, investing in R&D, and importing technology depending on the availability of financial resources (
25).
Because of the limited funds, pharmaceutical companies in developing countries collaborate with MNCs through contract agreements to obtain foreign funds to build their own product-research cultures and competitive capabilities (
55). Hence, strategies like collaborative R&D, joint venture, in-licensing arrangement, out-licensing of innovation, co-marketing, clinical trial, contract research and manufacturing service have been followed by these firms. On the other hand, many MNCs tend to cooperate with local pharmaceutical companies in developing countries to reduce costs, increase development capacity, and shorten the “market entry time” for new drugs.
In his study, Rai (2008) shows that the Indian pharmaceutical industry is adopting a mix of competitive and collaborative business and R&D strategies to overcome the challenge posed by the new patent regime. He mentions that business strategies, comprised of in-licensing, out-licensing, and co-marketing alliances, are adopted by firms that have branded products but do not have adequate sales networks. They would be able to use the existing sales network of alliance companies by entering into such alliances. He also mentioned that Indian companies are increasingly seeking to create in-licensing arrangements with MNCs to launch their products in India. The arrangement covers a wide range of relationships, from marketing relationships (including Joint Ventures) to local production by Indian companies and sharing part of the profits with MNC. To produce innovative products, the in-licensing arrangement strategy is cheaper and less risky than buying companies or conducting research and development, which are much more expensive. Companies would be able to bring novel drugs into the country at a reasonable price with the help of the in-licensing strategy. Since these products have already been approved for marketing in other countries, they will be directly studied in the bio-equivalence study and phase-III trial, so regulatory procedures are more accessible and faster.
He also believes that companies trying to increase their market share and expand into regulated markets are pursuing strategies such as international acquisition, creation of production facilities abroad, and marketing alliance abroad (
40). Active Product Ingredient (API) supply, focus on traditional knowledge, and emphasis on herbal medicine are other aggressive strategies that pharmaceutical companies in developing countries have adopted to expand their market in the new patent regime. On the other hand, small pharmaceutical companies that cannot compete with multinationals have merged with MNCs in the form of a conservative strategy (
22).
Rai (2008) has argued that pharmaceutical firms have adopted two sets of strategies: High-End Competitive Strategies (HECS) and Low-End Competitive Strategies (LECS). HECS focuses on innovation, research on NCE, positive patenting, defensive patenting, and biopharmaceutical research, while LECS emphasizes specialty generics, non- infringing processes, and Novel Drug Delivery Systems (NDDS). Compared to LECS, HECS requires higher investment and more technical knowledge and skills (
40).
Yin
et al. (2003) have stated that among the strategies adopted by Chinese pharmaceutical companies, M&A had the most significant impact on the pharmaceutical industry and market. M&A led to the development of better management methods. Many failed pharmaceutical companies survived by being sold to major companies. Thus, the risk of bankruptcy and downsizing is avoided (
25).
Globalization causes fundamental changes in the external and internal environment of enterprises. The reduction of trade restrictions and the inflow of foreign investment are the critical components of economic liberalization. Reducing trade tariffs leads to less protection of domestic companies against imports (
24). New regulatory environments or radical innovations are changes that occur in fast-changing business environments. Various studies have testified that after the TRIPS agreement, the different strategies and policies for the pharmaceutical sector were adopted by companies in developing countries. Companies were able to survive and even grow in the face of remarkable changes resulting from the TRIPS agreement by rebuilding their structures, improving their competencies and capabilities, and adopting appropriate strategies in line with the new conditions. Comparing the pharmaceutical industry experiences in developing countries related to industrial development and technological capability after the TRIPS agreement indicates that adopting suitable strategies is not enough to succeed in the industry. Factors such as the industry background, government approach to industry development and technological capability, market liberalization, technological infrastructures, human resources, sectoral regulation, and macroeconomic aspects help companies survive and thrive under the new patent regime. The impact of government-adopted industrial policies to support the pharmaceutical industry following the TRIPS agreement is significant in developing countries. To increase R&D spending, the governments have provided incentives such as various tax exemptions for the pharmaceutical companies and have facilitated collaboration between the private sector and the publicly funded research institutes (
10,
39).
The screening and selecting articles in accordance with the PRISMA statement
The successful and unsuccessful experiences of the pharmaceutical industry in developing countries after the TRIPS agreement. CRAMS= Contract Research and Manufacturing Services, NCE = New Chemical Entities, DMF= Drug Master Files, ANDA= Abbreviated New Drug Application, R&D = Research, and Development
Internal–External (IE) matrix and strategies adopted by pharmaceutical companies after the TRIPS agreement. API = Active Product Ingredient, NCE = New Chemical Entities, R&D= Research, and Development
| Author/s (Year) | Country | Experience |
|---|
| Successful | Atul Gupta (2000) | India | Indian companies have filed more DMF and ANDA cases with the US FDA in the post-TRIPS period (36). |
| Kensuke Kubo (2004) | India | R&D intensity and the patent to R&D ratio have increased after 1995 (36). |
| Alka Chadha (2006) | India | To secure non-infringing process patents in foreign countries, maximum resources are being spent by Indian firms (38). |
| Biswajit Dhar and K M Gopakumar (2006) | India | Indian pharmaceutical companies have grown after 1995. The consolidation of Indian firms has improved since the beginning of the current decade. R&D spending of some of the leading firms has increased, and consequently, R&D intensities of the firms have improved significantly (10). |
| Dinar Kale and Steve Little (2007) | India | Duplicative imitation, creative imitation, and collaborative R&D made the Indian pharmaceutical industry to move from basic R&D capabilities to advanced level R&D capabilities (39). |
| Rajnish Kumar Rai (2008) | India | The industry is pursuing a combination of a competitive and collaborative business and R&D strategies in the new business environment (40). |
| Raveendra Chittoor et al (2008) | India | Indian pharmaceutical firms have used the internationalization of resources and product markets. The indigenous growth model has been followed by Indian pharmaceutical firms (24). |
| M D Nair (2010) | India | India has the most number of FDA approved manufacturing plants, the most number of DMFs and ANDAs in the US, and three or four blockbuster drugs from indigenous or collaborative R&D (41). |
| Madhur Mohit Mahajan (2011) | India | Firms have moved toward the development of advanced-level process and product R&D capabilities. Many Indian pharmaceutical companies have recognized the difference of knowledge-based, organizational practices in imitative and innovative R&D quickly. They have gone for suitable measures like investing more resources into product and process development (42). |
| Sunita Mishra and Ravi Kiran (2012) | India | Better technology, increase in in-house R&D, higher R&D performance, increase in the proportion of turnover spent on R&D, and increase in the therapeutics of the drugs have occurred in Indian firms after the TRIPS agreement (43). |
| Satyanarayana Rentala et al. (2014) | India | The Indian pharmaceutical industry is experiencing an increasing trend of export competitiveness after 2005 (23). |
| Sunil K Sahu (2014) | India | Outsourcing, consolidations, mergers, acquisitions, CRAMS, and other kinds of alliances and tie-ins have risen significantly in the post-TRIPs era (22). |
| Salla Sariola et al. (2015) | India | The increase in clinical trial activity has been more than the introduction of NCE after the TRIPS agreement (44). |
| Teg Alam and Rupesh Rastogi (2016) | India | More spending on R&D activities and strengthening the core competencies have yielded improvement in the financial position of pharmaceutical companies in the post TRIPS period (16). |
| Mark Duggan et al. (2016) | India | Significant increases in pharmaceutical prices or the dramatic consolidation of the market did not happen by product patents in the new patent regime (18). |
| Ravi Kiran (2017) | India | Product innovation, process innovation, and R&D intensity are being increased slowly by small and medium-scale pharmaceutical firms after the TRIPS agreement. To enhance their competitiveness, firms continue to rely on government policies rather than organizational policies (45). |
| Hongjun Yin J and Warren Salmon (2003) | China | The M&A phenomenon was very helpful in order to save many state-owned pharmaceutical companies and improve the performance of the entire pharmaceutical industry (25). |
| Unsuccessful | Maria Pluvia Zuniga and Emmanuel Combe (2002) | Mexico | Licensing activity in the Mexican pharmaceutical industry is insufficient because of the weak interest or the weak usage of patent data (46). |
| Rohit Malpani (2009) | Jordan | Generic competition of medicines launched by multinational pharmaceutical companies has delayed due to the data exclusivity, which is a TRIPS-plus rule. Jordanian generic companies are not encouraged by TRIPS-plus regulations to participate in drug research and development (12). |
| Daniel Benoliel and Bruno Salama (2010) | Brazil | One of the reasons for the absence of innovation in the Brazilian pharmaceutical industry is the lack of more strict enforcement of intellectual property laws as well as the early adherence to the TRIPS agreement (27). |
| Criteria | Explanation |
|---|
| Successful experiences | DMF and ANDA filing | Increase in the number of DMF and ANDA filing with FDA to enter into regulated markets indicate the R&D capability and bulk drug export intensity of Pharmaceutical industry (47). |
| R&D spending | Increase in R&D expenditures is expected to have positive and significant impact on export competitiveness (23). |
| R&D intensities | R&D intensity is defined as the ratio of a firm’s R&D investment to its revenue (48). |
| Different type of alliances | Entering into different types of alliances can create an international-level, innovation-based drug industry (44). |
| Government supportive policies | The results of a research study (2007) by EXIM Bank’s Occasional Paper Series showed that favorable government policies along with industry/firm level initiative have helped the industry to grow over the years (49). |
| Introduction of NCE | NCEs are the result of highly sophisticated research and demonstrate the most advanced capabilities (39). |
| CRAMS | CRAMS is a new growth strategy for pharmaceutical companies (22) to provide additional sources of revenues, access to new technologies, marketing networks, and best business practices abroad (50). |
| Unsuccessful experiences | Weak licensing activity | Due to the weak R&D activity, the number of patenting of domestic firms is less than 1 % of total numbers after the TRIPS agreement (51). |
| Absence of innovation | Intellectual property protection acts as a tool that fosters domestic innovation (27), so lack of innovation refers to inability to generate new products and process innovations (39). |
| Lack of generic competition | Data exclusivity, which is a TRIPS-plus rule, has delayed generic competition of medicines launched by multinational pharmaceutical companies (12). |