[Ip-health] Pharmalot: Pharma Drops AIDS Discounts In Some Countries

Joanna Keenan-Siciliano joanna.l.keenan at gmail.com
Wed Jul 20 04:34:19 PDT 2011

 Pharmalot: Pharma Drops AIDS Discounts In Some Countries

By Ed Silverman // July 18th, 2011 <http://www.pharmalot.com/2011/07/18/> //
8:41 am

Several drugmakers have abandoned discount programs for AIDS drugs in
middle-income countries, raising concerns that untold numbers of HIV
patients will be denied access to life-saving meds, even as drugs are
increasingly made available to the poorest nations, according to a report
from Medecins Sans Frontieres, the non-government organization that is also
known as Doctors Without Borders.

The disclosure comes one week after Gilead Sciences agreed to license four
AIDS meds to the Medicines Patent Pool, a groundbreaking deal that was
generally greeted with considerable enthusiasm. Critics, however, lashed out
at one provision - limits were placed on access to people living in
middle-income countries (see

“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,” Nathan Ford, medical director
of MSF’s Campaign for Access to Essential Medicines, says in a statement
accompanying the report. Here is what MSF found….

The Johnson & Johnson unit called Tibotec excludes all countries classified
as middle income from its price reductions; Abbott Laboratories excludes
low-income and lower middle-income countries from discounts for one of its
drugs; and ViiV, a joint venture between Pfizer and GlaxoSmithKline, no
longer offers reduced prices to middle-income countries, even when programs
are fully funded by the Global Fund to fight AIDS, TB and Malaria or the
PEPFAR program run by the US government.

And Merck has apparently reversed a policy and will no longer issue price
discounts for its new raltegravir drug (known as Isentress) for 49
middle-income countries, such as India, Indonesia, Thailand, Vietnam,
Ukraine, Colombia and Brazil. Brazil, for instance, pays $5,870 per patient
per year for just the drug, according to MSF, while in least-developed
countries, Merck charges $675, which is four times the price of the
recommended triple first-line combination of drugs - TDF/3TC/EFV.

We have asked Merck for a comment. *UPDATE*: A Merck spokesman pointed us to
this statement<http://www.merck.com/about/views-and-positions/hai-statement.pdf>issued
last month: “Merck is committed to facilitating access to Isentress
in middle-income countries through the implementation of a differential
pricing policy mainly based on country income and disease burden, and
through the development of country-specific models.” There was no further

“This is of great concern for the affordability of products and
sustainability of government treatment programs, especially given that
Merck’s previous pricing strategy was to offer middle-income countries
prices that were up to more than ten times the price of generic versions.
The price of raltegravir is of particular concern, given the extremely high
prices charged in wealthy countries, at $8,000 per patient per year,” the
MSF report contends. In Brazil, the drug costs $5,870 (read the report

MSF also notes that, in middle-income countries, the cost of the first-line
treatment containing the Gilead drug known as tenofovir, or Viread, costs
more than $1,000 for a year, which is almost six times more than in
countries where a generic can be had. “Drug company discount programs have
proven not to be a long-term solution,” Janice Lee, HIV/AIDS pharmacist at
MSF’s Campaign for Access to Essential Medicines, says in a statement.

Instead, she adds that compulsory licenses must be pursued by middle-income
countries. A notable example over the past few years has been Thailand,
which has sparred with several drugmakers that refused to lower prices on
various meds for treating AIDS and cancer. In response, Thailand issued
compulsory licenses for several drugs, citing international treaties that
allow such actions (back

Meanwhile, a spokeswoman for the Medicines Patent Pool writes us that “our
mandate is to work to reduce prices for all people living with HIV and we,
therefore, seek the inclusion of all developing countries in our licences.
So in future licenses – and in our work with Gilead going forward – we will
constantly strive to improve the terms and conditions in our licenses to
achieve maximum public health benefits.” The MPP, meanwhile, has now started
talks with two more drugmakers - Bristol-Myers Squibb and Boehringer

Joanna Keenan
Campaign for Access to Essential Medicines
Medecins Sans Frontieres


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