BIMA Webinar - TEVA Boycott & Global Health BDS for Palestine

Brief History of Teva

• Originally founded in pre-mandatory Palestine in 1935.
• Has been the largest supplier of generic drugs to the US since 2000, is the 18th largest pharmaceutical company in the world, the largest manufacturer in Israel and the largest Israeli company trading on the NYSE.
• Also produces proprietary medications (Deutetrabenazine), various monoclonal antibodies (latest is Fremanezumab) and biosimilar agents.
• CEO since Jan 2023 = Richard Francis, a British pharmaceutical executive.
• Production facility in Runcorn, Cheshire.
    • UK commercial headquarters + legal/marketing/sales in Castleford, Yorkshire.
    • UK sales/marketing in Harlow, Essex.
    • R+D facility in Larne, Northern Ireland.

Teva and Boycott, Divestment and Sanctions

BDS has designated Teva as a priority pressure target, requesting boycotts wherever possible.

Has been involved with numerous legal challenges, such a s price-tixing, bribery of government officials and a $4.25 billion settlement due to its contribution to the US opioid epidemic, legal challenges from rival drug companies over patent infringement and surreptitious funding of disease-oriented NGOs to boost drug sales.

In 2024 Teva was fined € 462 million by the European Commission due to abuse of patent procedures and using disease advocacy groups to slander generic companies creating a rival form of Glatiramer.

In a 2006 interview, while Teva was engaged in 15 simultaneous patent challenges, Teva's CEO boasted of the agility of its legal department as what set it apart from other legal firms.

"Teva's legal department is big. We have many, many top notch lawyers that work for us around the country. Do you think that Pfizer puts us against the low-key lawyers?"

How Teva profits from apartheid

There are 6 Palestinian pharma companies, Megapharm in Gaza (currently inactive). In the West Bank; Pharmacare, Al-Quds Pharmaceuticals, Birzeit Pharmaceutical Company, Beit-Jala Pharmaceutical Company, and Sama Pharmaceuticals account for 50% of all pharmaceutical sales in Palestine.

The Paris Protocol, governing economic relations, dictates that Israel controls all Palestinian imports and exports through taxes and border control. This classifies Palestinian drugs as imports, and allows Israel to prevent the import of drugs from their Arab allies, as well as the large cheap generic producers in India, China and the former USSR. This creates a dependency on the Israeli pharmaceutical industry.

Movement of Palestinian drugs is additionally restricted not just due to the usual 'security' concerns that the Israeli authorities use to starve the Palestinian economy, but quality concerns are also raised. On this basis, Palestinian pharma is completely blocked from Occupied East Jerusalem. Manufacturing Palestinian pharma is further constrained by Israel's control over the import of raw materials and equipment into the Palestinian occupied territories. Many Palestinians therefore find Israeli medicines more affordable

A captive market for Israeli pharma is thereby formed by the barriers created to prevent the free operation of Palestinian competitors.

Previously threatened with inclusion on the UN blacklist of companies operating in OPT, Teva was subsequently not included and media reports indicate that Teva's production facilities are within Israel's legal borders.

However in HRWs landmark 2021 report A threshold crossed, the treatment of Palestinians is condemned as falling under the definition of apartheid, a crime against humanity under IHL. Therefore any government or corporation complicit in this would be in breach of IHL.

"In the occupied West Bank, Israel subjects Palestinians to draconian
military law and enforces segregation, largely prohibiting Palestinians
from entering settlements. In the besieged Gaza Strip, Israel imposes a
generalized closure, sharply restricting the movement of people and
goods-policies that Gaza's other neighbor, Egypt, often does little to
alleviate... This level of discrimination amounts to systematic oppression."

Foreign aid given to Palestinians, to a large extent, is absorbed by the Israeli economy, as the lockade of Gaza results in aid money being used to pay for the bare essentials , which Palestinian companies are disadvantaged from accessing, as well as the various arbitrary tariffs and taxes that Israel levies on Palestinian products.

The economist Shir Hever estimated in 2018 that 72% of aid money given to Palestine ends up in the Israeli economy.

"I believe that with globalization, there will be a
time that unless you are able to compete on the
international market, you will not be able to
compete in your home market."

Bassim Khoury. Former Palestinian Pharmaceutical Association, Palestinian Economic Minister,FormerChairmanon the CEO of Pharmacare Palestine.

Teva's response to 7th October 2023

Statement from TEVA on Oct 10 - "As an Israeli company we condemn this appalling assault and Teva stands with Israel in this time of great loss and challenge".
• CEO Richard Francis speaking on Oct 10 regarding the assault on Gaza - "We currently don't expect a meaningful impact on our business and/or our financial and operational performance".
• Sales in Israel account for just 2% of global revenue, while production in Israel constitutes less than 8% of total global manufacturing in dollar terms.
• This demonstrates that any support that Teva might then provide to the Israeli military cannot simply be due to a concern over a loss of income due to the Israeli/Palestinian conflict.

• In April 2024 the local CEO of Teva Israel, Ukraine, Africa and Middle East Clusters, Yossi Ofek, said:

"As the national pharmaceutical company of Israel, we have been harnessed - since the beginning of the war - for the benefit of Israel, the wounded and the families of the evacuees and the security forces. [...] we donated essential medicines, baby food compounds and computers, [...] we helped with harvesting and agriculture..."

"For over a decade, the Israel Defense Force (IDF) has offered companies, groups and individuals the chance to "Adopt-a-Battalion". This unique program builds deep and lasting relationships between IDF soldiers and civilians who support them...

Those wishing to adopt a battalion make a significant commitment to the welfare of Israeli soldiers. Donors must agree to give 100,000 NIS (about $27,000) annually for
three years. Not only does the adoption of a battalion increase army morale and help the well-being of soldiers, but it also builds a true bond between donors and soldiers...

Over the years, several Israeli companies, including Israeli banks and Teva Pharmaceuticals, have adopted a battalion. With the deep relationships developed through this program, soldiers are often invited to work at these companies during their off-times and after their service is completed, allowing them to earn much-needed money as well as ensuring a better future in the job market."

How prescription pharmaceuticals get from the manufacturer to the patient in the UK

Once a prescription drug has a licensed indication (in the UK, these licenses are given by the MHRA), any fully registered doctor can legally prescribe the drug.

A pharmacist will check that t h e prescription has been written correctly and is safe for the patient, will obtain the drug and prepare it for the patient.

Most medicationsare tablets / capsules and produced in bulk, nearly all are supplied by pharmaceutical wholesellers.

Pharmacies order common medications in volumes so they are kept in stock .

The main wholesellers for the UK are AAH, Phoenix and Alliance .

Pharmacies purchase the drug on an open market, specialist price comparison tools are used to look up the cheapest version of the drug from the various wholesellers.

The NHS sets a publicly advertised drug tariff, along with a fixed national dispensing tariff, and the pharmacist is paid by the NHS by combining these 2 tariffs for the drug dispensed.

If the cost paid for the drug is less than the reimbursement tariff, the pharmacist keeps the difference.

Though wholesellers will try to respect the wishes of pharmacies, there is no mechanism by which pharmacies can refuse/demand the products of a particular pharma company. This includes scenarios where the doctor has made specific instructions regarding the manufacturer on their prescription, e.g. do not dispense leva.

The same applies to patients, i.e. if a patient said that they do not want to have a particular medicine from Teva, the patient may be told to try a different pharmacy if only Teva versions are in stock.

Overall, these scenarios are rare, and pharmacies are usually able to fulfil the request on the prescription, or the request of the patient.

Teva's UK product lines

There are 3 core streams by which Teva gains its income

• Novel proprietary drugs - Austedo, Ajovy, Uzedy, Treanda/Bendeka

• OTC products - Sudocrem, Infacol, Peptac

• Generic drugs - approx 80% of Teva's income

 

 

Sudocrem (15% zinc oxide) • Invented in 1931 by an Irish pharmacist and originally manufactured in Ireland. • Company acquired by Actavis in 2014, Actavis then acquired by Teva in 2015. • Irish production plant closed in 2021 leading to the loss of 110 jobs, production moved to Bulgaria. • 15% zinc oxide cream, mainly used to treat nappy rash but has also gained popularity with adults as a treatment for acne. • There are many alternative nappy creams, with no evidence of superiority/inferiority of any alternatives.
Infacol (Simeticone) • Simeticone is also used for adults with IBS, but the convenient dropper applicator makes Infacol suited for babies with colic. • Most pharmacy chains have their own brand versions of this medication.
Peptac (Alkaline/sodium alginate solution) • An antacid solution. • Not only an OTC medicine, also commonly prescribed by doctors. • There are several popular alternatives available (Gaviscon, Pepto-Bismol, Rennie).

How to get Teva off your prescription list

Teva, like other big pharma companies, are experienced with how the drug market works, and are likely to drop their prices if their revenue falls to force their drugs into medicine cabinets.

How to get Teva off your prescription:
• Write to or ask your pharmacist or doctor - "Please leave a note on my records stating that I do not want Teva medicines, unless there are no alternatives".
• Write to your pharmacy/doctor to ask that they stop doing business with pharmaceutical companies that support genocide.
• Ask your doctor to switch your medicine to a similar alternative if they cannot supply a non-Teva version of the same medicine. 

 Read here about alternatives: Teva Alternatives.