This chapter is a political economy analysis of the current pharmaceutical patent system and its impact on access to medicines. We offer an historical perspective of the development of the international regulatory framework for patented drugs through the Trade-related Aspects of Intellectual Property Rights (TRIPS) Agreement in 1995. We go on to criticize the high international costs for patented drugs deriving from the TRIPS, and the results of creating access problem especially in low-middle income countries. He chapter analyses the pros and cons of patents. The chapter finally discusses the most recent attempts to modify the current policies in terms of alternative means for sustaining medical R&D, and other initiatives brought forwards within the WHO regarding the accessibility of patented drugs to low and middle-income countries.