PHA-Exchange> Merck Breaks Promise to Reduce AIDS Drug Price

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>Crossposted from E-Drug
>
>MSF: Merck Breaks Promise to Reduce AIDS Drug Price in Developing 
>Countries
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>MSF Calls for Immediate Action to Reduce Price and Register
>Efavirenz
>
>More than sixteen months after the multinational pharmaceutical
>company Merck & Co. announced that it would reduce the price of
>its first-line AIDS drug Stocrin (efavirenz, EFV) to less than
>$1 per day in developing countries, the offer has failed to ma-
>terialize, according to the international medical humanitarian
>organization Doctors Without Borders/Medecins Sans Frontieres
>(MSF). EFV is among the antiretrovirals recommended by the World
>Health Organization for first-line treatment, and is a critical
>component of antiretroviral combination therapy, particularly
>for patients co-infected with HIV and tuberculosis (TB).
>
>Drug price offers have no meaning unless they are followed by
>swift registration of the drug in the countries the offer is
>made for. The 600mg tablet formulation of EFV allows patients to
>take one tablet instead of three 200mg capsules per day. To
>date, Merck has not registered this easy-to-use formulation in
>low- and middle-income countries hardest hit by HIV/AIDS, in-
>cluding South Africa, Malawi, and Nigeria, so the drug is not
>available to patients there.
>
>Merck has refused to offer developing countries the same price
>for a daily dose of EFV whether they are taking three 200mg cap-
>sules or one 600mg tablet, although people living with HIV/AIDS
>in the US and Europe pay the same price regardless of which for-
>mulation they use. As a result, people with HIV/AIDS in develop-
>ing countries who need to take EFV are obliged to take three
>200mg capsules at a cost of 44 percent more than the price an-
>nounced by Merck.
>
>MSF is demanding that Merck immediately lower the price of the
>200mg capsule of EFV to $0.32, so that the real price of the
>drug will be, as advertised, $0.95 per day. MSF is also urging
>Merck to take all steps necessary to register the 600mg formula-
>tion of EFV, as promised, in developing countries.
>
>"They have misled us, and the result for patients is unaccept-
>able. We have been waiting for almost a year and a half since
>this announcement to be able to give our patients with HIV and
>TB the once-a-day formulation of EFV that will make their lives
>easier and lead to better adherence. We are tired of waiting"
>said Dr. Eric Goemaere, head of mission for MSF in South Africa.
>"The real problem is that there is virtually no generic competi-
>tion for EFV, so Merck gets away with charging what it wants and
>delaying registration. Because of the high prevalence of TB
>among HIV positive people in South Africa, we have no alterna-
>tive but to use this drug, but it is three times more expensive
>than the other first-line drug of this class, which is available
>generically."
>
>Merck's offer was announced as the company and its marketing
>partners were launching the 600mg formulation in the U.S. and
>Europe. "It appears Merck's announcement was really about gain-
>ing attention and expanding their market in wealthy countries,"
>stated Ellen 't Hoen, director of MSF's Campaign for Access to
>Essential Medicines. "Had Merck been serious about making EFV
>more widely available in developing countries, it would have not
>only registered the EFV 600mg tablet directly following its an-
>nouncement, but also immediately lowered the price of the 200mg
>formulation. We urge Merck to come clean and immediately lower
>the price of the 200 mg formulation, which is widely available."
>
>Note to Editors: In October 2002, Merck announced a price reduc-
>tion for the 600mg formulation of EFV, bringing the price down
>to $346.75 per person per year ($0.95 per unit). The Merck com-
>munication at the time claimed that this price would be valid
>for low Human Development Index (HDI) countries plus medium HDI
>countries with adult HIV prevalence of 1% or greater. For medium
>HDI countries with adult HIV prevalence less than 1%, the price
>of the 600mg was announced as $767 per person per year ($2.10
>per unit).
>
>MSF provides antiretroviral therapy for over 11,000 people with
>HIV/AIDS in over 20 countries in Africa, Asia, Latin America,
>and Eastern Europe.
>
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