The Indonesian Coalition for Patient Rights Advocacy for Access to Medicines is pursuing a judicial review of a renewed Patent Law enacted in 2024, warning that it undermines access to essential medicines and threatens the sustainability of the National Health Insurance (JKN) program. According to the coalition, the “new law contains provisions that threaten public access to essential medicines, particularly due to the removal of Article 4(f), which previously served as a safeguard against patent evergreening – a strategy used by pharmaceutical companies to extend patent monopolies on essential medicines.”

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Activists from the coalition told People’s Health Dispatch that the provision in question had served, for many years, as a critical legal safeguard and the basis for civil society to oppose patents, including in campaigns related to the drugs Bedaquiline and Lenacapavir. Originally, Article 4(f) stipulated that new uses of known products – as well as new forms of known products that are chemically similar and do not provide a significant improvement in efficacy – could not be protected as new inventions. The core content of the article “closely resembled Section 3(d) of India’s Patent Act,” activists pointed out.

“The removal of this article opens the door to dangerous patent monopolies that harm patients,” Tony Richard Samosir, chairperson of the Indonesian Dialysis Patients Community, said in a statement outlining the reasons behind the judicial review application. These are far from abstract concerns, seeing that evergreening is a well-documented, harmful practice.

“When patents are extended without clear innovation, drug prices remain high and place an enormous burden on patients, families, and the JKN program,” added Arni Rismayanti from the Indonesian Pulmonary Hypertension Foundation. She focused on Sildenafil as a concrete example of how pharmaceutical companies manipulate patent rules to increase profits at the expense of patients’ health. Used to treat both pulmonary hypertension and erectile dysfunction, Sildenafil can now be patented in Indonesia under two separate claims, “allowing monopolies to persist and prices to remain high,” Rismayanti stated.

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Another example raised by activists is Bedaquiline, a medicine used to treat multi-drug-resistant tuberculosis. “The primary patent for Bedaquiline in Indonesia expired in 2023, but five secondary patents have extended the monopoly until 2036,” pointed out Irwandy Wijaya from the Indonesia AIDS Coalition. “Similar situations have occurred with medicines for HIV/AIDS, hepatitis C, cancer, diabetes mellitus, and even COVID-19.”

“Without protections like Article 4(f), such strategies can block generic drug production and severely limit public access,” warned Rahmat Maulana Sidik, executive director of Indonesia for Global Justice. “With the removal of Article 4(f) in the current Patent Law, public oversight over pharmaceutical patents that do not meet patent standards has been significantly weakened,” he added.

As part of the judicial process, the Coalition is demanding for Article 4(f) to be reinstated in order to protect the right to health in Indonesia and to resist pressures by pharmaceutical companies on the health sector.

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