Two major drug companies have agreed price cuts which will see cheaper HIV treatments available in Brazil and the Caribbean.
Under pressure from the Brazilian government, Swiss based Hoffman-La Roche, manufacturers of the protease inhibitor nelfinavir, has agreed to provide the drug at a heavily discounted price. Meanwhile, the United States pharmaceutical company Merck has criticised Caribbean countries for not doing enough to provide its discounted drugs to patients.
Roche has cut the cost of nelfinavir by 40 per cent in Brazil after the Brazilian government threatened to start manufacture of a generic version of the drug at vastly reduced cost in February next year. The price of nelfinavir is already discounted by nearly 50% compared to the US price, but the Brazilian government - currently spending $88.5 million a year on nelfinavir – demanded a further price cut. The Roche price cut will save $35.4 million.
Speaking about the price cut Brazilian Health Minister Jose Serra said: 'This is a victory for sick people" adding, "Pharmaceutical companies have to realise that pricing should be different for developing countries...Our resources are tight."
Under Brazilian law the government can issue a compulsory license to manufacture a patented drug when a "national emergency" is declared. Brazil has faced heavy pressure from the United States government to drop its plans for compulsory licensing of pharmacuetical, during the same period that the US government has forced compulsory licensing of a number of devices, including anti-smog filters, at the request of large multinational compnaies based in the United States.
In a reversal of roles Merck, the manufacturers of the protease inhibitor indinavir and NNRTI efavirenz, has attacked governments in the Caribbean for failure to provide its heavily discounted treatments to people with HIV.
In March this year Merck announced that it would be selling its anti-HIV drugs at non-profit prices to the poorest countries worst hit by HIV, including eight in the Caribbean.
With an estimated two percent of the Caribbean's population of 25 million infected with HIV, the region has the highest HIV prevalence rates outside Africa.
Trinidad, the Dominican Republic, Guyana and Suriname will be able to buy Merck's efavirenz and indinavir for $1,100 per patient per year, a saving of 85 per cent on the US price. In St Lucia, Jamaica and St Kitts, the price will be $2,000 for annual supply of both.
However, in the Dominican Republic local pharmaceutical manufacturer Rowe is offering versions of indinavir, AZT and 3TC that are still 75% cheaper than the new discounted price for a two drug PI/NNRTI combination offered by Merck. Rowe is offering AZT/3TC and indinavir for $260.
The Dominican Republic has been placed under heavy pressure by the United States government to tighten up its law on patent protection. Despite the small size of its domestic market, the Dominican Republic is seen as a particularly problematic manufacturer of generic drugs because of its closeness to the southern United States and Puerto Rico (its next next-door neighbour).