Legal provisions in trade agreements, including those related to intellectual property (IP), can impede access to medicines. The 12-party Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) is currently undergoing a review. This provides an opportunity to update the CPTPP’s Intellectual Property Chapter to remove certain provisions that were negotiated in the context of its precursor, the Trans Pacific Partnership (TPP), many of which have been suspended. These include several ‘TRIPS-Plus’ provisions – IP provisions exceeding the requirements of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). This paper reviews the CPTPP’s TRIPS-Plus provisions, including those suspended and those still in place, and argues for their removal based on evidence of their likely effects on medicines access and recent changes in the political environment. Since the CPTPP was signed in 2018, accumulated evidence has demonstrated that TRIPS-Plus provisions negatively impact access to medicines. Lack of access to COVID-19 medical products in low- and middle-income countries has highlighted major problems with TRIPS. Furthermore, the US has diverged from a TRIPS-Plus agenda, rendering the suspended provisions obsolete. Removing the CPTPP’s TRIPS-Plus provisions, while challenging, would preserve Parties’ policy flexibility to design their laws in ways that protect access to medicines.