Legal director Sandeep Vaheesan writes about the competition problem between large drug companies and their domination over lower-cost rivals using a tactic known as “pay for delay”.

Antiretroviral drugs are one of the pharmaceutical industry’s great achievements. They have turned HIV/AIDS from a death sentence into a treatable condition. Still, even after being on the market for decades, effective antiretrovirals cost tens of thousands of dollars a year, making them unaffordable for many patients.

One reason for persistently high drug costs, according to many experts, is the exclusion of generic competition. Using a tactic known as “pay for delay,” brand-name drug companies who hold the patents to blockbuster medications pay other companies to put off introducing generic equivalents. This lets them keep charging high prices.

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