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[e-drug] Big Pharma vs. desperate need for HIV drugs

E-DRUG: Big Pharma vs. desperate need for HIV drugs

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Big Pharma vs. desperate need for HIV drugs
28 mai 2007
by Diana Fong, Journal Chretien

Pharmaceuticals have an imperative beyond the profit motive, since they
are in the business of saving lives. Despite deep discounts, critics
argue that the cost of vital drugs in poor countries is still too high.

How much should multi-national drug companies charge for life-saving
medicine in the world?s poorest countries ?

It is clear that pharmaceutical companies are not in the charity
business. They need to recoup the billions invested in breakthrough
drugs, and do this by acquiring a patent that protects their proprietary
know-how for years, even decades. The patent allows them to reap the
benefits of a virtual monopoly for an essential drug, and legally
prevents cheap copycat versions from flooding the market and drastically
bringing down prices.

Yet on the other hand, can we let millions in Africa and elsewhere
suffer and die, when the medicine that could save them is available, but
costs too much because of such patent protection ?

Big Pharma vs. desperate need for HIV drugs

It?s a debate that has been heating up in the run up to the G8 summit
where the interests of multinational pharmaceuticals are pitted against
the desperate health needs of a poverty stricken continent.

Africa will once again top the agenda on June 6-8 at the Baltic seaside
resort of Heiligendamm, where leaders of the world?s richest industrial
nations, hosted by German Chancellor Angela Merkel, are expected to
renew their pledges to increase aid to the developing world.

The biggest scourge in sub-Saharan Africa is AIDS. Even though a cure
for the disease is a long way off, a new generation of antiretroviral
drugs has made living with HIV at least manageable in the West. But
these treatments are far less available where they are needed most.

The vast majority of the 40 million worldwide who test HIV positive,
live in sub-Saharan Africa. Due to the time delay in the onset of AIDS,
an estimated 7 million currently require therapy, but only 28 percent
are getting any treatment at all, meaning a premature death sentence for
the rest, including millions of babies who are born with the virus,
transmitted by their mothers.

Producing generic drugs more cheaply and legally

Since the AIDS virus keeps mutating and more resistant strains keep
cropping up, what is at issue is access to « second line »
antiretroviral therapy, which costs at least ten times as much as the
older drugs.

« After five years of treatment, some 20 percent of our patients need to
switch to second line drugs, so we are seeing a doubling of drug costs
in the next two years if prices remain at the current level, » Dr. Tido
von Schön-Angerer, a German paediatrician who heads the campaign for
Access to Essential Medicines at Doctors Without Borders (MSF), told

And in spite of deep discounts, those price levels are still way too
high for the developing world, so von Schön-Angerer has strongly backed
Thailand?s decision earlier this month to defy patents through a legal
mechanism called TRIPS that was established by the World Trade
Organization in 2001.

The WTO ruling allows governments to circumvent international patent
laws to ensure the public health of its citizens. That means either
producing their own cheaper generic versions or importing them from
India, which has been the biggest supplier of HIV drugs.

Diseases of poverty not profitable

Until a month ago, the sticker price for Kaletra, the patented
antiretroviral drug produced by US based Abbott Laboratories was $2,200
(1,635 euros) per patient for a year?s supply in developing countries
defined as « middle tier, » such as Thailand. Abbott has since lowered
its price to $1,000.

In comparison Kaletra costs $7,000 in the United States and $500 for the
least developed nations in Africa, with the huge profit margins from the
rich industrial nations cross-subsidizing the poorest countries.

« We believe in differential pricing, » said Abbott spokesman Dirk van
Eeden. « Our approach is to charge the lowest possible price where the
need is greatest in the least developed countries. We are making no
profit whatsoever in Africa. » Eeden also pointed out that the lowest
generic price at $695 for the same drug is even higher than the original
Kaletra brand.

« Generics have not matched Kaletra?s prices in Africa, » countered Dr.
von Schön-Angerer. « At least not yet, but once we see much greater
generic competition, Abbott?s prices will be undercut even further. »

Logistic problems and lack of healthcare workers

Thailand leads the fight against patent monopolies

Although tremendous public pressure has led to lower prices for life-
saving drugs, Africa?s vulnerability to AIDS cannot be explained away by
the lack of access to affordable medicine alone, according to Markus
Preissner, head of the Research Division for Pharmaceutical Distribution
at the University of Cologne.

« Even if governments in Africa could guarantee fully stocked pharmacies
at rock bottom prices, there is still the problem of whether essential
medicines and vaccines wind up with the end users? the patients who need
them, » he said.

The logistics of delivering supplies to patients in remote areas, the
overwhelming lack of doctors and health workers to administer the
medicines, and even the huge price differential between the same pill
sold in Africa and Europe are massive problems.

« There need to be control mechanisms in place, so that life-saving
medication that has been sold cheaply in Africa does not wind up being
resold in Europe at a much higher price, with only the profiteers
benefiting, » said Preissner.

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