Bern, 15 November 2002 — Nearly two and a half years after the Swiss pharmaceutical giant Roche announced dramatic price cuts for its AIDS drugs in poor countries (*), its most essential AIDS medicine nelfinavir (Viracept©) actually costs more in Guatemala and the Ukraine than in Switzerland. Its lowest published price for the same drug is more than five times more expensive than another drug of the same class by a competitor. In an open letter addressed to the company and published today, MSF urges Roche to significantly lower the price of nelfinavir to do its fair share in the fight against the AIDS pandemic.
40 million people are infected with HIV/AIDS, 95 % of whom live in developing countries. As a humanitarian medical organization, MSF has been caring for people living with AIDS for years, and currently offers anti-retroviral (ARV) treatment to patients in 10 resource-poor countries. “MSF buys the needed drugs from generic producers and proprietary companies like Roche, administering them to patients every day. We know from our experience that Roche is deceiving the public by claiming to have reduced its prices. The opposite is true: Roche charges more for the same drug in some poor countries than it does in Switzerland,” said Thomas Linde, General Director of MSF Switzerland.
In Guatemala, Roche charges US$ 8,358 for Viracept per patient per year and in the Ukraine the price is US$ 7,110 whereas a Swiss patient gets the same drug for US$ 6,169. “Roche says they charge only US$ 3,171 ppy in least developed countries, but patients in Cameroon pay US$ 4,124 – a lot for a country in which the annual per capita income is US$ 570. The other main AIDS drug producers have set up differential pricing systems for poor countries, and most drugs are offered at 87-92 % discount off Swiss prices – why can’t Roche do the same?” said Thomas Linde.
MSF attempts to reduce costs and treat more patients by choosing quality generics when possible, but in some cases such as nelfinavir, the only current option is the originator drug. ”The high cost of this WHO-recommended drug is making it difficult for us, and for the governments concerned, to scale up using appropriate medicines,” said Dr Elisabeth Le Saout, Coordinator of the Campaign for Access to Essential Medicines at MSF Switzerland.
When challenged by MSF and others previously, Roche said they sell Viracept at cost and that a licensing agreement with Pfizer, another producer, prevented them from lowering their price. Both claims have since been proven untrue. MSF has uncovered evidence that contradicts the first claim, and Pfizer has gone on record saying that the licensing agreement is based on a percentage of sales and that Roche has the flexibility to price Viracept as they determine on a country-by-country basis.
In the open letter, MSF specifically urges Roche to offer a discount of 85 % off the Swiss price to least developed and sub-Saharan countries; establish a comprehensive and consistent differential pricing system that addresses middle-income countries such as Guatemala and the Ukraine, rather than forcing countries to negotiate on a case-by-case basis (which has resulted in Brazil receiving a better price than any least developing country); and ensure that the published prices are available at the country level.
“We challenge Roche to deliver on its promises and do its share in the global fight against AIDS,” concluded Dr Le Saout.
*The Accelerating Access Initiative was set up by UNAIDS in 2000. Rather than putting in place a system that includes mandatory reductions in least developed and middle-income countries, the initiative requires countries to negotiate the price of each drug with each of the multinational companies participating in it, i.e. Roche, Merck, Boehringer Ingelheim, GlaxoSmithKline and Bristol-Myers Squibb.