Indian Drug Firm Cipla Offers Low-Priced AIDS Drugs to Doctors Without Borders
The Indian generic drug maker Cipla Ltd. yesterday offered to supply unlimited doses of triple-therapy antiretroviral drug "cocktails" to Doctors Without Borders, which runs several AIDS programs in Africa, for $350 per patient per year, the New York Times reports. The offer may allow Doctors Without Borders to provide the drugs free of charge to patients in up to 20 of its 40 AIDS programs worldwide by the year's end. As part of the move, which the Times reports could "force big drug multinationals to cut the prices of their AIDS drugs in poor countries," Cipla would also sell the medications to larger government programs for $600 a year per patient, $400 less than the price offered by patent-holding drug companies and far less than the average annual $10,000 to $15,000 cost of cocktails for patients in the West. Cipla Chair Dr. Yusuf Hamied said the offer "is the way to break the stranglehold of the multinationals," and the Times adds that with its "aggressive entry onto the scene," Cipla hopes to become part of WHO negotiations over sales of antiretroviral drugs in Africa that have been closed to generic drug firms. Hamied said the offer is not an attempt to grab market share in Africa, saying, "I'm not looking to pick anybody's business; there's room for the multinationals at their price and room for us at our price, a partnership."
A 'Humanitarian Price'
Broad drug distribution in Africa is criticized by those who say that the HIV medications are complex and require "careful monitoring" beyond the ability of the African health system, and that money would be better spent on "providing clean water, controlling malaria and increasing the use of condoms." But Doctors Without Borders calls Western testing standards "overcautious" and says that "imperfect treatment is better than none." Dr. Bernard Pecoul, director of the Access to Essential Medicines project for Doctors Without Borders, noted that many HIV-positive Africans live in urban areas where "with quite a simple clinic, you can deal with antiretrovirals." The Cipla cocktail drug combination is two tablets of 40 mg of stavudine, two tablets of 150 mg of lamivudine, and two tablets of 200 mg of nevirapine. Stavudine patent-holder Bristol-Myers Squibb and lamivudine patent-holder Glaxo-Wellcome did not comment on the Cipla offer, and Dr. John Wecker of Boehringer Ingelheim, which holds the nevirapine patent, said he did not know how the company would respond if Cipla "undercut its prices." But the Times says, "Western drug companies have shown themselves determined to defend their patent rights to be sole distributors throughout the world" (McNeil, New York Times, 2/7). Leading pharmaceutical makers have recently negotiated drug discounts of up to 90% with Senegal, Uganda and Rwanda, but this "still leaves their products at a premium to Cipla's offer," Reuters reports. Hamied explained, "We are offering the drugs at a humanitarian price," and noted that this "humanitarian price is only for [Doctors Without Borders] and only if they distribute [the drugs] free, anywhere in the world" (Shankar, Reuters, 2/7).