AIDS drugs pricing

Bristol-Myers Squibb licensed its AIDS drug, Reyataz, free of charge to two generic manufacturers in South Africa and India. This decision will make available the generic form of the drug to sub-Saharan Africa AIDS victims at affordable prices. Reyztaz was first marketed in the United States in 2003 and its patent expires in 2017. 

The U.S. has consistently opposed compulsory licensing by other countries. In January 2001, the U.S. requested a WTO panel against Brazil to prevent Brazilian "local manufacture" of AIDS drugs (WTO 2001). Under international pressure, the U.S. withdrew the panel request in the months leading up to the Fourth WTO Ministerial Conference in Doha (Thomas 2001 t Hoen 2002). More recently, U.S. groups attacked Brazil in July 2005 over a proposed compulsory license of Kaletra (lopinavir and ritonavir), an AIDS fixed-dose combination drug. The patent owner, Abbott Laboratories, reached a voluntary price reduction agreement with Brazil which made the formal compulsory license unnecessary, another demonstration of the power of compulsory licenses to improve access (Benson 2005). 

In a region where the average annual income per person might not even hit 400, and with a year s supply of AIDS drugs selling for 10,000, Merck and other companies insisted that price wasn t the problem. Rather, they said, the focus should be on infrastructure and prevention. People needed trained medical personnel to administer the complex cocktails, and public health education to make sure... 

The Asian Wall Street Journal, AIDS—Drug Makers Escalate Price War— Treatment Price Plimges for Poor Nations, ... 

The price of AIDS drug tritherapy is 10,000 a year per patient in the United States and Europe. Indian companies have reduced the cost to 130 per patient per year and introduced a single tritherapy combination. When Roche was initially reluctant to increase production or reduce the price of its Tamiflu to treat Avian Influenza for developing countries claiming a difficult synthetic process, some Indian companies made the active ingredient from Shikimic acid within one week... 

Many patients in the tropics have diseases that are familiar to Western-trained physicians, but it is the epidemiology that is often different. Comparing the AIDS populations in Los Angeles and Eastern Africa is an obvious example. Different practices in antiviral therapy prescription, distribution, and drug pricing thus emerge in the two environments. 

Simulations may also be used to inform understanding of market dynamics and life cycle management and to aid in understanding the ways in which reference pricing and parallel trading may influence the best sequence of drug... 

In Chapter 4 Aidan Hollis examines three proposals in considerable detail. The first is an Advanced Purchase Commitment by sponsors, who offer an explicit subsidy in advance for innovative products. The subsidy offer includes a fixed-dollar amount per unit as well as a commitment to purchase a specific number of units at that price. The second proposal is that sponsors pay annual rewards based on the therapeutic effectiveness of innovative drugs. The third approach is to offer a patent extension on patented products to pharmaceutical companies if they successfully developed a vaccine for a disease such as HIV/AIDS that is highly prevalent, particularly in some low-income countries. Hollis concludes that the third approach is an extremely inefficient way to reward innovation. By contrast, the second approach could correct the market failure directly by rewarding innovative drugs according to their therapeutic effectiveness, which is measurable by cost-effectiveness analysis, a topic discussed later in greater detail in Chapters 10 and 11. 

Anand, G. 2004. How Drug s Rebirth as Treatment for Cancer Eueled Price Rises Once-Demonized Thalidomide Boosts Celgene s Sales Patients See Costs Soar Avoiding AIDS Activists. Wall Street Journal, November 15, 2004. 

In this book, we critically review both the formal FDA labeled indications, as well as those indications accepted by experts in the field of psychopharmacotherapy. In terms of the latter, meta-analysis is used when possible to formally assess the size and quality of the database that supports the usefulness of a drug for a clinically accepted, but not formally labeled, indication. These analyses can then aid the clinician in the decision to use a given drug for an unlabeled indication in a specific patient. Cost is considered in terms of price of medicine, as well as to the individual and society. 

---