Brazil’s Generic AIDS Drug Laboratory Serves as ‘Bargaining Tool’ for Lower Prices
Brazil's state-run generic drug manufacturing program has "set a new standard for excellence in the developing world," the Wall Street Journal reports. Generic drug maker Far-Manguinhos more than 40 years ago began to develop and produce drugs no longer made by multinational drug companies to treat "diseases of the poor," such as malaria and leprosy, and is now in the "international spotlight," as it supplies low-cost drugs to Brazil's AIDS program, a state-run effort that has helped the nation "contain the spread" of HIV/AIDS "better than any other" developing nation, the Journal reports. In 1998, as part of Brazil's "dual program of prevention and treatment," the government asked Far-Manguinhos Director Eloan Pinheiro to "analyze brand-name [AIDS] drugs and develop generic forms of them." Far-Manguinhos now manufactures eight of 12 AIDS medications that the government distributes to HIV/AIDS patients free of charge and is "expected" to start supplying other countries with "competitively priced" medications after a $4 million renovation and expansion of the lab is complete. The program has also expanded from two researchers two years ago to 33 today, and the plant now operates in three shifts to accommodate the demand for the AIDS medications. Pinheiro, who spent 14 years with international drug companies before coming to Far-Manguinhos, called her lab's purpose "special." She added, "The price of a drug cannot determine whether one lives or dies. We will do all the research necessary to ensure that drug prices are fair."
Seeking Lower Prices
The lab's success has become a bargaining tool for Brazil in the country's efforts to obtain the remaining AIDS drugs it does not self-manufacture at lower costs. Brazil recently secured a lower price on the drug efavirenz from Merck & Co., which might otherwise have been impossible without the "pressure supplied by Far-Manguinhos." The lab is "our instrument of price regulation," Platao Puhler, the Health Ministry official who negotiates with the pharmaceutical companies, said. The lab "play[ed] a critical role" in negotiations, he added. The government told Merck it would authorize Far-Manguinhos to begin manufacturing efavirenz unless the company "substantially reduced" its price. Merck lowered the price of efavirenz and another AIDS drug that the lab already manufactures by two-thirds. Brazil is still negotiating with Roche Holding for a lower price for the drug nelfinavir, which accounted for 28% ($85 million) of the country's total AIDS drug expenditures last year. Roche is expected to release a new price within the next two weeks, a company spokesperson said. Despite the lower prices, Brazil is "determined" to continue pursuing generic versions of both drugs to "make sure we have the know-how to manufacture them" in case the companies "reneg[e]" on their promises, Pinheiro said (Jordan, Wall Street Journal, 4/27).