Bristol-Myers Squibb Announces Plan to Provide Zerit, Videx for $1 a Day to African CountriesBristol-Myers Squibb announced yesterday that it will sell its two AIDS drugs Videx and Zerit at $1 per day to all African nations participating in the ACCESS Program, a joint initiative sponsored by the United Nations and five pharmaceutical companies to provide cheaper AIDS drugs to Africa. In addition, the drug company also announced that it will make the patent rights for Zerit available "at no cost" to South Africa. The actions are two parts of the company's new "four-point program" to fight HIV/AIDS in Africa. The plan also calls for the company to make "fully public" the prices of the drugs offered in the ACCESS program and will also grant an additional $15 million to its Secure the Future program, which works with African governments and communities to foster "local solutions" to the pandemic. John McGoldrick, executive vice president of Bristol-Myers, said of the company's efforts, "This is not about profits and patents; it's about poverty and a devastating disease. We seek no profits on AIDS drugs in Africa, and we will not let our patents be an obstacle."
AIDS Drugs for $1 a Day
Under the plan, Bristol-Myers would sell Videx and Zerit together for $1 per day -- 15 cents per day for Zerit and 85 cents per day for Videx -- to African nations participating in the ACCESS program (Bristol-Myers Squibb release, 3/14). Launched in May, the program was created to "slash HIV drug prices by as much as 85% to 90%" (Kaiser Daily HIV/AIDS Report, 5/11/00). However, only four countries -- Rwanda, Ivory Coast, Uganda and Senegal -- have agreed to participate in the program. The president of Botswana has indicated that he might enroll that country in the program as well.
Patent Contract With Yale
Allowing South Africa to obtain the patent for Zerit at no cost will allow the country to import or manufacture cheaper versions of the drug without opposition from Bristol-Myers (Waldholz/Zimmerman, Wall Street Journal, 3/15). Earlier this week, Doctors Without Borders asked Yale University to allow South Africa to import the generic version of Zerit, known as stavudine, for which Yale holds the patent. Yale, however, cited its patent contract with Bristol-Myers, which licensed the drug from the university shortly after it was developed by a Yale professor. The university added that it had "removed all barriers" for Bristol-Myers to make the drug available in South Africa, leaving the decision in the hands of the drug company ( Kaiser Daily HIV/AIDS Report, 3/13). Doctors Without Borders and Yale law students then "pressured" the university and Bristol-Myers to come to an agreement that would either "sharply reduce prices or allow generic drugmakers to do so" (Warner, Philadelphia Inquirer, 3/15). A statement issued by Yale said that the university is "gratified that [its] efforts paved the way for the significant action announced by Bristol-Myers." The university added that it "will continue to encourage all pharmaceutical companies to make their AIDS drugs affordable and widely available in Africa" (Yale release, 3/15). Yale law students were also pleased with the outcome of the issue. "I hope this shows that Yale did some good work on this," Amy Kapczynski, a Yale law student who campaigned to change the Yale/Bristol-Myers contract, said (Philadelphia Inquirer, 3/15). Other than Zerit, Bristol-Myers has "no other patent rights in Africa that could prevent AIDS therapies from being distributed," the Associated Press reports (Associated Press, 3/15). South Africa is the only country in which Bristol-Myers holds the patent for Zerit (Wall Street Journal, 3/15).
A Step Forward
Many AIDS activists have applauded Bristol-Myers' move as a step toward increasing access to antiretrovirals for poorer nations. UNAIDS "welcomed" the action, stating that the effort suggests that "pharmaceutical companies are now very seriously seeking to improve further the affordability of their medicines." A spokesperson for the South African AIDS group Treatment Action Campaign added, "HIV/AIDS activists have won a major victory" (DeYoung/Brubaker, Washington Post, 3/15). Kate Kraus, a member of ACT UP/Philadelphia, added that the company's "groundbreaking" move to forsake its patent rights in South Africa marks "the first time that a U.S. drug company has acknowledged that generic drugs are the key to saving lives" (Petersen/McNeil, New York Times, 3/15). Some activists, however, have said that the effort does not go far enough, as the cheaper prices will apply only to countries in sub-Saharan Africa. "Why did they pick sub-Saharan Africa? Why is that more important than ... a place like El Salvador," Daniel Berman, coordinator for Doctors Without Borders' Access to Essential Medicines Campaign, said (Washington Post, 3/15). Others are "question[ing]" why Bristol-Myers has not agreed to pull out of a lawsuit it filed with 38 other drug firms against South Africa over a law that allows the country bypass patents to acquire cheaper AIDS drugs through parallel importing and compulsory licensing. Bristol-Myers officials replied that "the lawsuit was still important because it was aimed at protecting their rights to all prescription drugs, not just AIDS drugs" (New York Times, 3/15).
Is it Enough?
While Bristol-Myers' plan would make Zerit and Videx available at a cost of $365 per patient per year -- much less than the drugs' current U.S. price of $10,000 per patient per year -- the reduced cost may still be "far beyond the reach" of most Africans, the Washington Post reports (Washington Post, 3/15). The drugs would still need to be combined with a third drug to complete the triple-drug combination. Either of Merck's AIDS drugs Crixivan, which the company has agreed to sell for $600 per patient per year to developing nations, or Stocrin, which the firm has discounted to $500 per person per year, could be added. The drugs could also be combined with Boehringer-Ingelheim's Viramune, which has been discounted to $438 per year. However, the annual cost of the three-drug therapy, even with the newly discounted prices, would still be at minimum $803, a cost that many Africans cannot afford. The cost is also higher than the $600 price tag generic drug maker Cipla Ltd. has attached to its triple-drug therapy offer for governments and large non-governmental organizations (Wall Street Journal, 3/15). Some activists have questioned whether Bristol-Myers has discounted its drugs as much as it could have, or whether the new prices include other costs, such as those for research and advertising (Washington Post, 3/15). In addition, other drug firms may not be ready to offer discounted AIDS drugs. John Wecker, a program coordinator for Boehringer-Ingelheim's drug access program, said that his company "doesn't plan further [price] cuts" for Viramune (Wall Street Journal, 3/15). A spokesperson for Hoffmann-LaRoche said that the company was "reviewing" Bristol-Myers' actions but had not decided on a course of action yet. Nancy Pekarek, a spokesperson for GlaxoSmithKline, said that her company was not planning to follow Bristol-Myers' efforts. She added that the company has "already reduced the prices of its drugs enough in Africa that there is little need for generic drug makers to make cheap versions." She added, "The drugs are more affordable than they have ever been" (New York Times, 3/15).