Bangkok/New York, 6 July 2006 — People living with HIV/AIDS in developing countries who are in urgent need of an improved version of the AIDS drug lopinavir/ritonavir continue to be denied access to it by its sole manufacturer, Abbott Laboratories, according to the international medical humanitarian organisation Doctors Without Borders/Médecins Sans Frontières (MSF).
The Chicago-based company began shipping the new formulation to a limited number of MSF projects in Africa for $500-per-patient-per-year only after a cumbersome and time-consuming procedure. However, Abbott refuses to sell the drug to MSF for use in its programmes in Thailand and Guatemala and has dragged its feet with registering it in developing countries. The result is that the new formulation of lopinavir/ritonavir remains unavailable and unaffordable for the vast majority of patients who need it.
The new version of lopinavir/ritonavir, a second-line AIDS drug recommended by the World Health Organization, has critically important advantages over the old version, including lower pill count, storage without refrigeration, and no dietary restrictions. But without registration, the drug is virtually impossible to obtain at any price. In China, not even the old version is available, because although it is registered, Abbott has chosen not to market it in the country.
“Here in Thailand, where temperatures exceed 30ºC most of the year, this drug that no longer requires refrigeration is a major advantage, but Abbott refuses to register it,” said Dr David Wilson, of MSF in Thailand. “Instead, Abbott says we can make do with the older drug that is no longer even on the US market, but this is clearly a second-best product and it is sold here at a price that is anyway not affordable. By limiting its $500 price to the poorest of developing countries, Abbott is adopting a policy that deliberately excludes people living with HIV/AIDS in other developing countries.”
There is a growing need in developing countries for second-line regimens for patients that have been on treatment for several years. However, there is great concern that national treatment programmes and funding agencies will not be able to afford the prices of these drugs, which are much higher than those of first-line regimens. In Thailand, Abbott charges at least $2,800 for the old version of lopinavir/ritonavir, which means that it costs roughly ten times more to treat a patient who needs to be switched to a second-line regimen containing this drug.
“This is a classic case of how monopolies hurt patients,” said Dr Tido von Schoen-Angerer of MSF’s Campaign for Access to Essential Medicines. “We need generic competition for these newer essential drugs, because it’s the only way to make them affordable and widely available. It should not be up to a CEO in Chicago to decide who has access to a life-saving medicine.”