The chorus of critics of the Trans-Pacific Partnership (TPP) – a sweeping U.S. pact under negotiation with 11 Pacific Rim countries – keeps expanding.

Today the largest U.S. nonprofit, nonpartisan group – the American Association of Retired Persons (AARP), representing 38 million members – joined the American Federation of State, County and Municipal Employees (AFSCME), Consumers Union and other U.S. health and consumer advocacy groups in sending a letter to President Obama to express "deep concern" that TPP rules will thwart efforts to control escalating healthcare costs.

The groups outline an array of U.S. policies and proposals to make healthcare more affordable that are jeopardized by TPP provisions "being advanced by the United States Trade Representative." These threatened cost-saving measures include Medicare prescription drug discounts under the Affordable Care Act (Obamacare), an administration proposal slated to save $134 billion by providing rebates to low-income Medicare beneficiaries, and state-level Medicaid policies used to control drug costs.

The groups also state their opposition to Big Pharma's agressive push for U.S. trade officials to grant pharmaceutical corporations special monopoly rights in the TPP for biologic drugs, which are some of the costliest on the market. In another letter late last month, AARP warned that this TPP proposal alone could cost Americans billions in additional health expenditures annually and undermine the Obama administration’s efforts to ensure more affordable healthcare.

Biologic medicines – the latest generation of drugs to combat cancer, rheumatoid arthritis, and multiple sclerosis, among other diseases – are exceptionally expensive, even for those with comprehensive insurance coverage. Derived from living organisms, these treatments cost approximately 22 times more than conventional medicines. According to AARP, patients can face annual treatment costs of $400,000.

While the Obama administration pushes for measures at home to contain rising health care costs, Big Pharma is urging the administration to include measures in the TPP that would increase costs by expanding pharmaceutical monopoly protections. The proposed TPP measure under consideration, a 12-year period of data exclusivity protection, would allow brand-name companies to obtain an automatic monopoly on biologics even in the absence of patent protection.

During this period, access to cheaper versions of the drugs would be restricted, as governmental regulatory bodies would be prohibited from relying upon the brand-name company’s clinical trial data to approve biosimilars – more affordable versions of the high-cost drugs. While exclusivity is in force, biosimilar applicants would have to replicate costly, time-consuming clinical trials despite already-known outcomes. This would prevent many biosimilar groups from even seeking market approval, keeping their more affordable, life-saving drugs off of pharmacy shelves for years as pharmaceutical corporations accrue monopoly profits.

Although U.S. law currently requires 12 years of data exclusivity for biologics, the White House has repeatedly proposed reducing this period to tamp down spiraling costs. According to the White House budget for fiscal year 2014, shortening exclusivity to 7 years could save federal programs such as Medicare and Medicaid more than $3 billion over the next ten years. But if Obama administration trade officials propose 12-year exclusivity for the TPP at the request of Big Pharma, the binding pact could lock into place pharmaceutical firms’ lengthy monopolies here at home, barring the administration’s proposed cost-cutting changes.

That’s right – Obama administration officials are contemplating TPP rules that would effectively scrap the administration’s own proposal to save billions in unnecessary healthcare costs.

Other TPP countries have been rejecting U.S. pressure to include data exclusivity and other pharmaceutical monopoly protections in the deal, given the large humanitarian cost and financial burden of delaying access to more affordable drugs. In fact, no other TPP country allows a special data exclusivity protection period for the high-cost biologic drugs.

However, in addition to data exclusivity protection, U.S. trade officials are urging TPP countries to accept egregious measures that would lengthen and broaden patent rights and drug monopolies, stifle cost-cutting generic competition, and favor pharmaceutical companies in court.

Stronger drug monopolies would force consumers to pay high drug prices for longer and would have devastating humanitarian and financial consequences in developing countries. According to the World Health Organization (WHO), more than 100 million individuals fall into poverty due to catastrophic health payments each year. In developing countries including Vietnam, a TPP country, patients often have to pay 50 to 90 percent of pharmaceutical costs out-of-pocket, making medicines the second-highest household expenditure after food.

But this problem is not only a developing country issue. In the United States, medical expenses account for 60% of bankruptcies. And in three-fourths of those cases, the person even had health insurance. As AARP, AFSCME, the Consumers Union and others make clear in today's letter, we cannot afford to roll back cost-saving policies and lock in unaffordable healthcare costs via a “trade” deal.

As we strive to recover from an economic crisis, reduce the government deficit, and expand access to health care, it is imperative that our “trade” policy not undermine these goals. How can the Obama administration continue pushing abroad a secretive trade pact designed by and for Big Pharma while pushing at home access to affordable medicines?

--Stephanie Rosenberg, Public Citizen's Global Access to Medicines program