MSF distributed the following document to participants of the Sixth International Congress on Drug Therapy in HIV Infection (17-21 November 2002), Glasgow, UK.
During the same conference Roche responded to the call for: a revised pricing policy and reduced price of Viracept® for LDCs and sub-Saharan Africa; a system in place to implement this new pricing policy; application of the same pricing schemes to governments, NGOs and institutional providers.
Why do we need you to get involved?
We at Médecins sans Frontières (MSF) have been trying to encourage Roche to bring down their prices for AIDS drugs in developing countries to the levels of other companies. Despite our best efforts and the best efforts of the Swiss AIDS research community, so far our pleas have fallen on deaf ears. To date Roche steadfastly refuses to offer the level of discounts that other companies have offered. This refusal contrasts to the growing consensus that R&D costs should be recouped in wealthy countries and prices in poor countries should reflect manufacturing costs plus a profit margin. This new system is already the de facto practice of most of the drug companies, at least for AIDS drugs. Needless to say, it is generic competition that has brought drug prices down in poor countries, but sometimes the originator product is the only one available. That’s why their prices can make a life or death difference.
The bottom line is that our patients and the patients of our local colleagues in countries such as Cameroon, Guatemala, Ukraine, Kenya, and South Africa are being denied access to Viraceptâ (nelfinavir) because the price remains too high. Whereas Merck charges $US 600 per patient per year for Crixivanâ (indinavir), Roche’s best price for Viracept for least developed countries (LDCs) and sub-Saharan Africa is $3,171. But they aren’t even offering this price to any of the countries we work in. In Cameroon, Viracept costs US$4,124, and patients in Guatemala and the Ukraine pay more for it than people in Switzerland.
In general the price of drugs in developing countries is a critical issue because scaling up to a national level will not be possible unless drugs are affordable to individuals and/or governments. We have seen in the countries where we are working that when prices come down the numbers of people on treatment dramatically increases.
Why not just switch to Crixivan with a booster?
Because many of our patients don’t have refrigerators or continuous access to pure water sources.
How can you help?
As a prescriber of Roche products, or as a medical professional working with people with AIDS, you have a the right to demand that Roche:
- Revise its pricing policy and reduce the price of Viracept® for LDCs and sub-Saharan Africa by at least 85% compared to the Swiss price, as well as publish an adjusted discount for middle-income countries.
- Put in place a system to implement this new pricing policy, so that published - Apply the same pricing schemes to NGOs, governments and institutional providers, rather than giving ‘rebates’ or donations to NGOs while charging governments much higher prices for the same medicines.
How can you deliver this message?
At Glasgow: Please stop by the Roche booth and let them now how you feel. Give them your card and ask them to let you know when the policy has been revised. Tell them that until they change their policy you will refuse to see their sales reps.
When you go back home: Tell your Roche sales reps about your concerns and tell him/her that you will refuse to meet with them again until they the company changes it pricing policy in developing countries.