We consider a policy game between a high-income country hosting a drug innovator and a low-income country hosting a drug imitator. The low-income country chooses whether to enforce an International Patent Regime (strict IPR) or not (weak IPR) and the high-income country chooses whether to allow parallel imports (PI) of on-patent drugs or market based discrimination (MBD). We show that, for a moderately high imitation cost, both (Strict IPR, PI) and (Weak IPR, MBD) emerge as the Subgame Perfect Nash Equilibrium (SPNE) policy choices. For relatively smaller imitation costs, (Weak IPR, MBD) is the unique SPNE policy choice. The welfare properties reveal that although innovation may be higher at the (Strict IPR, PI) policy regime, the market coverage and national welfare of the low-income country, and the total welfare are all lower. This opens up the efficiency issue of implementing TRIPS and at the same time allowing international exhaustion of patent rights. JEL ClassiÞcation: D4, L1, I1. Keywords: Income Inequality; Intellectual Property Rights; India; TRIPS; Parallel Imports; Pharmaceuticals; * We would like to acknowledge Þnancial support from the British Academy Grant number SG-50473 and the University of Kent Small Faculty Grants. We thank Kaushik Basu, Sugato Bhattacharyya, Javier Coto, Jagjit Chadha, Martin Jensen, Sugata Marjit, Indrajit Ray, Mathan Satchi and seminar participants at University of Birmingham, University of Kent, Centre for Studies in Social Sciences, Kolkata and Imperial College for their comments and suggestions on an earlier version of the paper. We would also like to thank two anonymous referees for their helpful suggestions. The usual disclaimer applies, however.