Abstracts Objectives Recent international trade agreements require member countries a prolonged statutory exclusivity for biologics, and domestic legislation guarantees various forms of exclusivity for specific drugs, indications, or studies. This study notes prolonged exclusivity provisions for biologics in the United States and international trade agreements. We aim to review various exclusivity systems, including chemical entities, in selected high-income countries and to suggest implications for establishing the system specifically relevant for biologics in low- and middle-income countries. Methods We conducted a review of a comprehensive range of literature to develop the framework. Then, a comparative legal analysis was conducted to analyze the deviations among the systems in the European Union, Canada, South Korea, Australia, and the United States. Results There is constructive ambiguity in international trade agreements, specifically for provisions regarding biologics. Furthermore, the selected countries operate different statutory exclusivity systems in terms of eligibility for statutory exclusivity, specific measures for exclusivity, and other elements of exclusivity. In addition, market exclusivity, which is distinguished from data exclusivity, is not available in Korea and Australia. There are also various forms of statutory exclusivity for specific drugs, indications, or studies requested by the marketing authority. Conclusions Given constructive ambiguities in international agreements and variations in the manner of implementations of the systems in selected countries, statutory exclusivity for biologics could be established with cautions to mediate the harms. In this study, we suggest several solutions and alternatives for low- and middle-income countries.
