High Drug Costs Could Jeopardize Brazil’s No-Cost Antiretroviral Program
The rising cost of new antiretroviral drugs could jeopardize Brazil's program that provides the drugs to HIV-positive people in the country at no cost, the Boston Globe reports. As tens of thousands of people living with HIV/AIDS become resistant to older generic antiretrovirals, the higher cost of new drugs has increased the country's spending on HIV/AIDS by 75% over the past two years. Although the government receives antiretrovirals at the lowest prices outside Africa following negotiations with pharmaceutical companies, new antiretrovirals in Brazil can cost up to $17,000 per patient annually, compared with hundreds of dollars per patient annually for older generic drugs. The increasing costs have "sparked a national debate" among HIV/AIDS advocates, health officials and drug companies over how to sustain the program and over whether Brazil has the right to begin producing generic versions of newer drugs, the Globe reports.
Advocates Push for Production of Generics
AIDS advocates and leaders of the country's drug industry are urging the government to reduce antiretroviral prices by producing generic drugs that are still under patent (Lakshmanan, Boston Globe, 1/3). Under the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights, developing countries can issue compulsory licenses to import generic drugs for diseases such as HIV/AIDS if a country confirms that it cannot manufacture them domestically. In addition, governments can approve the domestic production of generic versions of patented drugs during emergency public health situations if they fail to reach an agreement with the patent holder (Kaiser Daily HIV/AIDS Report, 11/14/06). However, large pharmaceutical companies are trying to avoid compulsory licensing, which involves a government paying royalties to a pharmaceutical company to reproduce a drug. Although many African countries have used compulsory licenses, international drug companies say that Brazil is a middle-income country that can afford to pay full prices. In addition, the Brazilian government has been reluctant to use licensing because of concerns over reprisals from pharmaceutical companies and the countries in which they are based. However, advocates are pushing for Brazil to begin producing generic drugs before they become too expensive. Veriano Terto, executive director of the Brazilian Interdisciplinary AIDS Association, said that if Brazil does not start producing generic drugs, rising costs could bankrupt the government's antiretroviral program. Eduardo de Azeredo Costa, director of a state-owned pharmaceutical company, said the government is obliged to taxpayers and people living with HIV/AIDS to allow Brazilian laboratories to produce generics and new drugs that could save the country money. Advocates also are seeking to prevent drug companies from renewing patents based on minor changes to drug formulas, and they also are pushing for parallel imports from countries that pay less for antiretrovirals or that make generic drugs (Boston Globe, 1/3).