This article examines the current wave of US bilateral agreements with respect to their strategic and political value at the plurilateral level. The US government has explicitly recognized its objective of leveraging bilateral agreements in order to influence regional and multilateral negotiations. Although it may be too early to assess the full effectiveness of this US strategy, the article argues that there are clear signs that the exploitation of bilateral agreements will not independently achieve the goal of strengthening plurilateral patent norms. This finding is supported by an assessment of six potential roads from bilateralism to plurilateralism: chain reaction, pressure for inclusion, coalition building, emulation, legal interpreta...