Takeaway: An advocacy group is urging the U.S. government to use patent laws to reduce the price of the prostate cancer drug Xtandi, highlighting substantial pricing gaps between the U.S. and other countries. Patents do incentivize drug innovation, but also keep drug prices high.

An advocacy group, led by James Love of Knowledge Ecology International, is pressing the U.S. government to leverage patent laws to decrease the cost of the prostate cancer medication Xtandi, which is being sold by Pfizer for $136 per pill in the United States. Love’s group points out that the same drug is sold for significantly lower prices elsewhere, such as $22 in Japan and $20.75 in Australia. They argue that Xtandi’s development occurred at UCLA through funding from the U.S. Army and the National Institutes of Health, yet its pricing in the U.S. is disproportionately high compared to other high-income countries.

The letter from Love’s group, cosigned by two other organizations, emphasizes that the patents covering Xtandi are set to expire in 2026 and 2027. The group urges the Centers for Medicare & Medicaid Services to facilitate access to generic versions of enzalutamide, the active ingredient in Xtandi, by providing contracts to qualified drug companies.

The letter lists nine generic drug manufacturers currently producing generic versions of enzalutamide, primarily available in India at prices below $3 per 40 mg capsule. Love’s group argues that the federal agency can legally use the patents for Xtandi due to the research’s origins at UCLA, which received grants from U.S. government entities. Notably, UCLA had initially licensed the patents to Medivation, a biopharmaceutical company later acquired by Pfizer, and sold off its remaining royalty interests for approximately $520 million.

This initiative is part of ongoing efforts to address the affordability and accessibility of taxpayer-funded drugs, aligning with statements from the Biden administration supporting public access to such inventions. Love expresses hope that the current political climate may lead to action regarding Xtandi’s pricing, particularly through discussions on “march-in rights,” a concept concerning the government’s ability to intervene in patent licenses for public interest reasons.