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[e-drug] MSF: Merck Breaks Promise to Reduce AIDS Drug Price

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E-DRUG: MSF: Merck Breaks Promise to Reduce AIDS Drug Price
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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

MERCK BREAKS PROMISE TO REDUCE AIDS DRUG PRICE IN DEVELOPING COUNTRIES
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
materialize, 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, including 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 capsules or one 600mg
tablet, although people living with HIV/AIDS in the US and Europe pay the
same price regardless of which formulation they use. As a result, people
with HIV/AIDS in developing countries who need to take EFV are obliged to
take three 200mg capsules at a cost of 44 percent more than the price
announced 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 formulation of EFV, as promised, in
developing countries.

"They have misled us, and the result for patients is unacceptable.  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
competition 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 alternative 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 gaining 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 announcement, 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 reduction for the
600mg formulation of EFV, bringing the price down to $346.75 per person per
year ($0.95 per unit).  The Merck communication 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]

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