Merck’s efavirenz - a story of broken promises

Broken promises

In October 2002, Merck announced its “new 600mg tablet formulation of Stocrin (efavirenz) at a price of US$0.95 per day [US$346.75/patient/year] in least developed countries of the world and those hardest hit by the HIV/AIDS epidemic”. This formulation allows patients to take one tablet (600mg) instead of three capsules (200mg) per day.

However, 16 months later this offer has failed to materialise. It appears that this announcement was a calculated attempt to gain media attention for Merck and its marketing partner Bristol-Myers Squibb for the launch of the new 600mg formulation of EFV in North America, Europe and other wealthy markets. At the time, the drug was registered in the US but registration dossiers hadn’t even been filed in developing countries.

Since October 2002, patients and those supporting AIDS programs in developing countries have been paying a significant surcharge. If Merck had followed through on their offer, the new formulation would have meant a yearly saving of US$153.25 per patient. Today the daily dose of efavirenz (EFV) is not US$0.95 but rather US$1.37 (three 200mg capsules).

To make good on its promise Médecins Sans Frontières urges Merck to immediately:

1. lower the price of the 200mg capsule of Strocrin to US$0.32, so that the real price of the drug will be, as advertised, US$0.95 per day [US$346.75/patient/year] “in least developed countries of the world and those hardest hit by the HIV/AIDS epidemic”.

2. take whatever steps are necessary to register the 600mg formulation in developing countries and publicly report on the status of registration.