“Flynn has traditionally looked to ‘rescue’ such product lines. They are the tail end products that the major pharmaceutical companies no longer have in their focus; they are not core to their business. There is still a role for these products though and doctors and patients will still be relying on them. They do not want that product to disappear from the market, so that is really our role. We look for products that we can acquire the rights to, or enter into some kind of commercial deal, to ensure continuity of supply into the market. Obviously as part of that we make a margin.”
“100. Flynn is the marketing authorisation holder (the "MAH") for Phenytoin Sodium Flynn in the UK. … We own the licences so we are responsible in law for the product. We deal with every aspect of the regulation of that product and we would also be the party to notify customers, the NHS, if there were critical supply shortages (as there have been on two or three occasions for this product) or patient safety issues following receipt of an adverse event report (if sufficiently serious). We have an obligation to ensure the continued availability of the product. We must have in place arrangements for provision of technical support and medical information to healthcare professionals. We have staff whose sole job is to provide information and respond to technical and medical information enquiries, which can be of all types, typically from healthcare professionals, but occasionally from patients. 101. Flynn's ownership of the licence imposes on us all the regulatory obligations pertaining to that licence for the manufacture of the product in accordance with its licence and in accordance with current standards of good manufacturing practice and current scientific knowledge. We are responsible for the quality, testing and specification of the ingredients, not only the [active pharmaceutical ingredient] but all the ingredients that go into the manufacture of the finished product and we are obliged to keep our labelling up to date. If new information comes to light relating to the possible risks associated with use of the product, we must take steps to amend the product information leaflet and notify the MHRA, doctors, pharmacies and patients. 102. We are responsible for notifying in advance, and getting prior approval, of any changes to the product which would need to be reflected in the marketing authorisation. You cannot make a change and not tell the MHRA in advance and obtain their approval, even if it is the most trivial of changes to the product testing, for example. This is all part of the MAH's total control of the quality of the product. …”
“Phenytoin was never the drug of choice for all epilepsies but it was a preferred agent for some epilepsies in the past. However, as newer agents have come to the market with improved efficacy, fewer contra-indications (side effects) and/or better safety profiles, the place for Phenytoin Sodium in therapy has declined such that it is no longer the drug of first choice for any seizure type - it is not even the drug of second choice. It is considered as a tertiary or an adjunctive agent in some patients in whom perhaps the initial first approach and backup approach do not provide adequate control. One can look at the sales data by volume over the last five or ten years and generally you will see a decline in the sales of phenytoin sodium of approximately 5% per year. NICE CG137, published in January 2012 and updated most recently in January 2015, provides authoritative guidance as to the diagnosis and management of epilepsies. Appendix E to that guidance sets out the AED options by seizure type, offering recommendations as to first-line AEDs, adjunctive AEDs, other AEDs that may be considered in tertiary care and finally AEDs that should not be offered. Eight different seizure types or categories are delineated. Phenytoin is first-line in none and adjunctive treatment in only one (convulsive status epilepticus). The guidance reserves its use in one seizure type (focal) for tertiary referrals and advises that it is not recommended at all in three seizure types.”
“Dave Walters and I set out our approach of how Flynn Pharma would manage Phenytoin Sodium if Pfizer were to divest it to us. We presented a 'wall-to-wall' solution covering all aspects of the manufacture, supply and support for the product such that we could take it on from them. We explained that our intent (at the time) was to genericise the product, which would mean removing the Epanutin branding and selling it by reference to the generic name 'phenytoin sodium hard capsules Xmg' thereby removing the product from the constraints of the [PPRS] giving freedom of pricing; market-based pricing. This would have allowed Flynn Pharma to increase the price to make the product sufficiently worthwhile to fund the increased stocks and to guarantee its continued availability. However, before Pfizer could be persuaded to divest the product, they had to be sure that Flynn Pharma had the wherewithal, that we had considered and had viable plans for every aspect of what we proposed to do. They did not want to sell this product to a company in whom they did not have confidence that we would maintain its availability. That would still reflect badly on them.”
“88. We communicated the name change to patients through the epilepsy support groups and charities who are often the first port of call for a patient in distress, or a patient seeking information. In addition to the communications circulated to those groups, we also worked with them to agree the announcements on their websites (see for example our discussions with the Epilepsy Society). We also set up the helpline which was, and continues to be, manned by a clinical nurse specialist employed by Flynn. The free phone number was widely communicated through the advocacy groups and responses to requests for medical information were drafted and pre-agreed. I understand from the clinical nurse, Christine Wakefield, that the helpline has received 408 calls (to27 March 2015 ), and peaks in call volumes were noted at the launch of our Phenytoin Sodium Flynn product and around the time of the launch of the NRIM product. Several patients have also sought to communicate with Flynn directly about their concerns and as a registered health care professional, I am able to respond to those concerns and handle confidential patient data … .” 89. In addition a letter/mailing went to a total of 42,523 GPs (which was also published on the MHRA website) and a different letter went to 19,364 pharmacists. We also placed advertisements in a range of journals to try and get the announcement of this change seen on at least one occasion by all health care professionals who might possibly have an interest in, or be affected by it. There were adverts in popular doctor communications such as Pulse and in the Journal of the Pharmaceutical Society of Great Britain (read by many pharmacists). 90. Finally we sent emails to prescription software providers (whose software assists primary care providers in writing prescriptions for patients) with a view to them updating the product name in their software and to our wholesalers to notify them of the situation.”
“Will the capsules be the same as Epanutin? Yes. The new capsules will be exactly the same as Epanutin. The only thing that is changing is the name The capsules will not differ in any way: they will contain the same ingredients and be prepared and packaged in the same way. They will also be made in the same manufacturing warehouse. To reassure you that the capsules are the same as Epanutin, they will look the same – the same size and colour, even down to the word ‘Epanutin’ on the capsule itself.”
“Flynn is a trademark of Flynn Pharma Ltd. However, this product is not manufactured or sold by Flynn Pharma Ltd but has been imported from the EU as Epanutin by Tenolol Limited. It is considered by the Medicines and Healthcare products Regulatory Agency to be equivalent to Phenytoin Flynn”
"Quantitative restrictions on imports and all measures having equivalent effect shall be prohibited between Member States."
“The provisions of Articles 34 … shall not preclude prohibitions or restrictions on imports … justified on grounds of … the protection of industrial and commercial property…”
"Such prohibitions or restrictions shall not, however, constitute a means of arbitrary discrimination or a disguised restriction on trade between Member States."
“25. This question is all the more important because parallel importers are very often in a position to offer the goods at a price lower than the one applied by the duly appointed importer for the same product, a fact which, where medicinal preparations are concerned, should, where appropriate, encourage the public health authorities not to place parallel imports at a disadvantage, since the effective protection of health and like of humans also demands that medicinal preparations should be sold at reasonable prices.”
“i) Subject to compliance by the importer with all the BMS conditions, a trade mark owner may not enforce his mark against parallel imported goods which are re-branded if it is established that it is necessary to re-brand in order to gain effective access to the market. ii) Effective access to the market is not achieved by being able to place some goods on the market. iii) It may be necessary to re-brand where the parallel importer is not excluded from the whole of the market, but is merely excluded from a substantial part of it or from a significant proportion of consumers (like the alternate local sizes in BMS, andthe label-resistant group in Boehringer); iv) In determining whether it is necessary to re-brand, the court must consider what alternatives exist for the parallel importer, and whether they are realistic (e.g. trying to eliminate label-resistance amongst pharmacists or consumers). v) Whether it is necessary for a parallel importer to re-brand in order to gain effective access to the market in a particular case is a question for the national court to decide, applying these principles.”
“67. If the repackaging is carried out in conditions which cannot affect the original condition of the product inside the packaging, the essential function of the trade mark as a guarantee of origin is safeguarded. Thus, the consumer or end user is not misled as to the origin of the products, and does in fact receive products manufactured under the sole supervision of the trade mark owner. 68. Whilst, in these circumstances, the conclusion that the trade mark owner may not rely on his rights as owner in order to oppose the marketing under his trade mark of products repackaged by an importer is essential in order to ensure the free movement of goods, it does nevertheless confer on the importer certain rights which, in normal circumstances, are reserved for the trade mark owner himself. 69. In the interests of the owner as proprietor of the trade mark, and to protect him against any misuse, those rights must therefore, as the Court held in Hoffmann-La Roche, be recognized only in so far as the importer complies with a number of other requirements.”
“When a pharmaceutical manufacturer markets the identical product in EU member state A under trade mark X and in EU member state B under trade mark Y, in what circumstances can a parallel importer take the goods (marked X) from state A to state B and re-brand them with mark Y?”
“Drug safety is always of paramount importance and particularly important with products such as Phenytoin Sodium. If a licence holder is supplying his product in any market, he has a legal responsibility and a moral duty to collect and respond to information about the safety of that product in use. Pfizer, in selling us the product licences, was taking a step away from what was happening with the use of a number of presentations of this product in the UK. However, they continue to be responsible for certain presentations and its sale on an international basis and therefore they have a legal, clinical and professional obligation and interest in the ongoing monitoring of the safe use of this product.”
“a contract of assignment by itself, that is in the absence of any economic link, does not give the assignor any means of controlling the quality of the products which are marketed by the assignee and to which the latter has affixed the trade mark.”
“The consent implicit in any assignment is not the consent required for application of the doctrine of exhaustion of rights. For that, the owner of the right in the importing State must, directly or indirectly, be able to determine the products to which the trade mark may be affixed in the exporting State and to control their quality. That power is lost if, by assignment, control over the trade mark is surrendered to a third party having no economic link with the assignor.”
“It should be added that, where undertakings independent of each other make trade-mark assignments following a market-sharing agreement, the prohibition of anti-competitive agreements under Article [101] applies and assignments which give effect to that agreement are consequently void. However, as the United Kingdom rightly pointed out, that rule and the accompanying sanction cannot be applied mechanically to every assignment. Before a trade-mark assignment can be treated as giving effect to an agreement prohibited under Article [101], it is necessary to analyse the context, the commitments underlying the assignment, the intention of the parties and the consideration for the assignment.”
‘… the overall message is clear: the condition of necessity is satisfied if, in a specific case, the prohibition imposed on the importer against replacing the trade mark hinders effective access to the market of the importing member state.’
“23. It is very important to understand what the court is saying here about “substantial part of the market”
“58. I have found it helpful to consider the market for trospium chloride in the UK … as having two potential points of sale for the drug importer: pharmacists and doctors. If the only point of sale were pharmacists, then … the UK rule or practice that a branded prescription can only be filled with the branded product, means that it is necessary to re-brand in order to get access to that part of the market. I do not accept that access to the remaining part of the market is an answer in law to exclusion from a part of it unless that part can be dismissed as insignificant. I think that whether one looks at the 20 mg product or the 60mg product the effect is that Doncaster is hindered from reaching a substantial part of the market.”