Mapping Pathways is a multi-national project to develop and nurture a research-driven, community-led global understanding of the emerging evidence base around the adoption of antiretroviral-based prevention strategies to end the HIV/AIDS epidemic. The evidence base is more than results from clinical trials - it must include stakeholder and community perspectives as well.

21 July 2011

ARV Access Fears Across the World

A slew of recent articles have appeared in the news lately which express concern over the availability and accessability of many countries including Swaziland (PlusNews), Indonesia (Jakarta Globe), and middle-income countries around the world (below). This comes on the heels of the Ranbaxy-Gilead deal which has the potential to greatly increase the supply of these life-saving drugs.

Bad News for Drug Prices in Middle-Income Countries

Middle-income countries with large numbers of people living with HIV will no longer benefit from preferential pricing when buying antiretroviral drugs from large pharmaceutical companies, according to the annual Médecins Sans Frontières drug pricing report, Untangling the Web of ARV Price Reductions.

“The main bad news in the study is the fact that a number of pharmaceutical companies will no longer be providing preferential pricing to middle-income countries like Brazil, China, India and Thailand,” Nathan Ford, medical director at MSF’s Campaign for Access to Affordable Medicines, said at the launch of the report at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Rome.

According to the report, pharmaceutical firm ViiV Healthcare – owned by Pfizer and GlaxoSmithKline – no longer offers reduced prices to middle-income countries, even when their programmes are fully funded by the Global Fund to fight HIV, Tuberculosis and Malaria.

Merck has also ceased to offer discounted prices to all lower middle- and upper middle-income countries, proposing instead to negotiate discounts on a case-by-case basis. Previously, Merck offered middle-income countries discounts that were still up to 10 times the price of generic versions. Of particular concern is the price of UN World Health Organization-recommended third-line drug, raltegravir – an integrase inhibitor that blocks retroviral replication – which costs up to US$5,870 per person per year in Brazil, compared with $675 in sub-Saharan Africa.

Janice Lee, pharmacist at MSF’s Campaign for Access to Essential Medicine, noted that drug company discount programmes were not a long-term solution, and governments would have to start using trade-related aspects of intellectual property rights (TRIPS) measures to override patents; in the past, Brazil and Thailand have used compulsory licences – when a government allows someone else to produce the patented product or process without the consent of the patent owner – to lower prices in their countries.

The report notes that Abbott excludes low- and middle-income countries from differential prices for the standalone heat-stable ritonavir 100mg tablet. It blocks the enzyme protease, required by HIV to make new viruses. A spokesman for Abbott said the company’s long-standing pricing policy would protect the poorest people living with HIV.

"Abbott’s preferential pricing policy for ritonavir has been in place, unchanged, for a decade,” Dirk van Eeden, director of HIV communication and policy at Abbott, told IRIN/PlusNews via email. “It includes all African and least developed countries, where the outright majority of patients with HIV live.”

ViiV Healthcare also defended its pricing policy, saying it was committed to ensuring access to its medicines.

Read the rest here.

Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

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