[Ip-health] Pharmatimes: Drugmakers under fire over high HIV prices in less poor countries

Joanna Keenan-Siciliano joanna.l.keenan at gmail.com
Tue Jul 19 07:00:02 PDT 2011

 Drugmakers under fire over high HIV prices in less poor countries
World News | July 19, 2011
| Kevin Grogan


 As the International AIDS Society Conference gets underway in Rome, several
pharmaceutical companies stand accused of abandoning HIV drug discount
programmes in middle-income countries.

The claim is made by Medicins Sans Frontieres (MSF – Doctors Without
Borders) which has analysed the prices of 23 antiretrovirals with
information provided by 19 manufacturers. It notes that Johnson & Johnson's
Tibotec unit exclude all countries classified as middle-income from their
price reductions, while Abbott Laboratories gives no discounts to low-income
and lower middle-income countries for one of its drugs.

MSF's report goes on to state that ViiV, the joint venture between Pfizer
and 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". It also
claims that Merck & Co has reversed a previous policy and will no longer
issue price discounts for 49 middle-income countries for Isentress

This move leaves out countries with large numbers of people living with
HIV/AIDS, such as India, Indonesia, Thailand, Vietnam, Ukraine, Colombia and
Brazil, MSF argues. The latter is paying $5,870 per patient per year (ppy)
for Isentress in least-developed countries, while Merck charges $675 ppy for
the drug, which is already four times the price of the recommended triple
first-line combination, ie TDF/3TC/EFV.

*Discount programmes not working*

“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.”

However, the MSF analysis says there is some good news to report. Thanks to
continued generic competition, Gilead Science's "critical drug" Viread
(tenofovir) now costs $76 ppy which is cheaper than the price of AZT
(zidovudine) which costs $88 ppy. This means "it is becoming more affordable
for countries to shift to using World Health Organisation-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 $613 to $173 ppy. “We’re seeing drug prices
continue to decline when patents do not form a barrier to generic
production,” added Ms Lee, saying that "these reductions increase the
feasibility of reaching the new United Nations goal of getting 15 million
people on treatment by 2015".

*B-MS, Boehringer in patent pool talks*

The report comes a week after it was announced that Gilead Sciences has
signed up to the Medicines Patent Pool to improve access to HIV treatments
in poor countries. The MPP has just revealed that it has begun negotiations
with Boehringer Ingelheim and Bristol-Myers Squibb regarding an agreement.

Ellen ‘t Hoen, executive director of the MPP, said that of "all
pharmaceutical companies with HIV medicines patents, only three are
currently not in negotiation with the Pool. We call on J&J, Merck, and
Abbott to follow the lead of their colleagues and enter into negotiations
with us".

Joanna Keenan
Campaign for Access to Essential Medicines
Medecins Sans Frontieres


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