Health & HIV/AIDS

Africa/Global: Merck Breaks Promise to Reduce AIDS Drug Price in Developing

2004-03-11, Issue 147

http://pambazuka.org/en/category/hivaids/20656

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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 materialize, according to the international medical humanitarian organisation Doctors Without Borders/Medecins Sans Frontieres (MSF). EFV is among the antiretrovirals recommended by the World Health Organisation for first-line treatment, and is a critical component of antiretroviral combination therapy, particularly for patients co-infected with HIV and tuberculosis (TB).

Doctors Without Borders/Medecins Sans Frontieres (MSF)

For Immediate Release
Contact for more information & additional fact sheet:
Kris Torgeson, +1-212-655-3764 or +1-917-913-0183
Kevin Phelan, +1-212-655-3763

MSF Calls for Immediate Action to Reduce Price and Register
Efavirenz

New York/Geneva, 3 March 2004

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.

[Moderator comment: MSD is welcome to respond in E-drug! WB]

--
Leela McCullough, Ed.D.
Director of Information Services
SATELLIFE
30 California Street, Watertown, MA 02472, USA
Tel: +1-617-926-9400
Fax: +1-617-926-1212
mailto:leela@usa.healthnet.org
http://www.healthnet.org
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