[Ip-health] Companies shut down HIV drug discount programmes in middle-income countries: MSF report

Joanna Keenan-Siciliano joanna.l.keenan at gmail.com
Mon Jul 18 01:19:46 PDT 2011

*Companies Shut Down HIV Drug Discount Programmes In Middle-Income
Countries, Where Prices Can Be Over Ten Times Higher*

* *

*Médecins Sans Frontières releases HIV drug pricing report at Rome AIDS

* *

*ROME**, 18 July 2011* – Several pharmaceutical companies have abandoned HIV
drug discount programmes in middle-income countries, according to an HIV
drug price report released today by Médecins Sans Frontières (MSF) at the
International AIDS Society Conference in Rome.

The report* Untangling the Web of ARV Price Reductions –* which analyses the
prices of 23 antiretrovirals with information provided by 19 manufacturers –
also shows continued trends of price reductions for drugs not blocked by

“While there is continued progress to reduce prices for the poorest
countries, a significant number of people with HIV/AIDS live in countries
that are now excluded from price reductions,” said Nathan Ford, medical
director of MSF’s Campaign for Access to Essential Medicines.

Tibotec/ Johnson & Johnson exclude all countries classified as
‘middle-income’ from their price reductions; Abbott excludes low-income and
lower middle-income countries from discounts for one of its drugs; and ViiV
(Pfizer + GlaxoSmithKline) no longer offers reduced prices to middle-income
countries, even when programmes are fully funded by the Global Fund to fight
AIDS, TB and Malaria or the US-government’s PEPFAR programme.

In a reversal, Merck has now announced that it will no longer issue price
discounts for 49 middle-income countries for its new drug raltegravir.  This
move leaves out countries with large numbers of people living with HIV/AIDS,
such as India, Indonesia, Thailand, Viet Nam, Ukraine, Colombia and Brazil.
 Today, Brazil is paying $5,870 per patient per year (ppy) for just this one
HIV drug; in least-developed countries, Merck charges $675 ppy for the drug,
which is already four times the price of the recommended triple first-line
combination (TDF/3TC/EFV).

This development comes on the heels of a number of developing countries
being excluded from last week’s agreement between drug company Gilead and
the new Medicines Patent Pool, which aims to increase access to affordable
ARVs by negotiating licencing that can be used by generic manufacturers.

MSF started HIV treatment programmes in Latin America and Asia over ten
years ago, but has since handed many of them over to local authorities in
the confidence that people would be able to access the treatment they need
from government programmes.  People in these countries in particular have
been on HIV treatment for a number of years now, and therefore need access
to newer drugs – but patents block access to more affordable generics.

“Drug company discount programmes have proven not to be a long-term
solution,” said Janice Lee, HIV/AIDS pharmacist at MSF’s Campaign for Access
to Essential Medicines.  “When patents get in the way and drug companies
refuse to cut prices, governments are going to have to start overriding
patents so that they can afford to keep their HIV-positive people alive.”

‘Compulsory licences’ issued by Thailand and Brazil for HIV medicines in
2006 and 2007 helped dramatically bring prices down when patents formed a
barrier to people’s access.  But despite the fact that these measures are
authorized by international trade rules, countries have faced retaliatory
measures from pharmaceutical companies and governments.

The MSF price report also shows good news. Thanks to continued generic
competition, the critical drug tenofovir now costs $76 ppy which is cheaper
than the price of zidovudine (AZT) which costs $88 ppy.  This means it is
becoming more affordable for countries to shift to using World Health
Organization-recommended improved combinations with tenofovir and move away
from the drug stavudine (d4T), which has significant long-term side effects.

The price of a one-pill-once-a-day combination that contains tenofovir has
come down by 70% since the WHO recommended people move to less-toxic
treatment five years ago, from US$613 to $173 ppy today.

“We’re seeing drug prices continue to decline when patents do not form a
barrier to generic production,” said Ms Lee. “These reductions increase the
feasibility of reaching the new UN goal of getting 15 million people on
treatment by 2015.”

*MSF provides antiretroviral treatment to 170,000 people in 19 countries.*


To download the report,* Untangling the Web of Antiretroviral Price
Reductions *visit *utw.msfaccess.org** *and for more information on MSF at
the IAS Conference in Rome, visit:*  aids2011.msf.org*

Joanna Keenan
Campaign for Access to Essential Medicines
Medecins Sans Frontieres


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