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Kathryn Rubino Interviews Tahir on Pharma’s Monopoly Tactics and US Patent Law Failings

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10

Why it matters

On July 2, 2026, Above the Law published "Medicine's Monopoly Problem," a detailed analysis of how U.S. pharmaceutical patent strategy has systematically delayed generic competition and inflated drug prices. The article features Tahir of the Initiative for Medicines, Access & Knowledge (I-MAK), who traces the problem to policy shifts in the late 1970s when "innovation" replaced "invention" as legal justification for corporations to charge premium prices on publicly funded research. The piece examines specific cases: Novo Nordisk filed over 320 patent applications around Ozempic's active ingredient, while Bristol Myers Squibb generated $5 billion in Pomalyst revenue while using patent thickets to block generic entry. I-MAK argues that drugmakers deploy what the article calls a "Monopoly Extension Menu"—layered patents, evergreening strategies, and aggressive filing tactics—to extend market dominance far beyond initial patent protection.

The analysis also addresses the 340B federal health program, which requires manufacturers to offer discounts to safety-net providers. As of June 2023, manufacturer restrictions on these discounts placed an estimated $8.4 billion in annual savings at risk, effectively transferring resources away from hospitals and clinics serving uninsured and low-income patients. The article notes that the Health Resources and Services Administration lacks sufficient regulatory authority to enforce the program's intent, allowing companies to impose unilateral restrictions. The Trump administration's 2026 proposed rules on Medicare rebates and potential legal challenges to existing pricing models remain in flux.

For attorneys, this story underscores a structural problem unlikely to resolve through incremental price negotiations. One in three Americans are skipping doses or cutting pills to afford medications—a crisis the article frames as a patent system failure requiring long-term legal reform. Practitioners should monitor ongoing challenges to manufacturer restrictions under the 340B statute, anticipated litigation over the administration's rebate proposals, and whether Congress moves toward substantive patent reform rather than temporary pricing interventions.

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