d4T becomes 85% cheaper in Thailand

Stavudine - d4T is now produced generically in Thailand at US$ 0.54 - 0.76 per day (depending on body weight). This is more than 85% cheaper than the current brand name price in Thailand (and more than 90% below the US price).

Unfortunately Bristol-Myers Squibb has been engaged in heavy lobbying efforts over many months to prevent generic production.There is no patent on d4T in Thailand but d4T had market exclusivity based on a regulation that automatically gives market exclusivity during post marketing surveillance (here called Safety Monitoring Program). This arrangement was imposed on Thailand by the US Trade Representative when Thailand was under "special 301" review in 1993, i.e. before TRIPS was even signed. Market exclusivity for d4T expired last year with the completion of the Safety Monitoring Program but Bristol-Myers Squibb attempted to get further protection and has been trying to discredit the quality of generics.

These lobying efforts have to be seen in contrast to the recent press releases of the 5 drug companies (including Bristol-Myers Squibb) to reduce drug prices in cooperation with UNAIDS. At least for this particular company it shows that the reduction of drug prices (if it ever will take place) is not genuine but a response to generic competition and activist pressure. Total world wide sales of d4T (Zerit) had exceeded $ 1.1 billion by 1998. Mind that this is another drug that was not developed by the industry...

Tido von Schoen-Angerer, MD
Medecins sans frontieres Thailand
Email : msfdrugs@asianet.co.th

Govt aims to produce HIV drug d4T at 85% reduced price

BY MUKDAWAN SAKBOON

IN a bid to improve access to HIV/Aids drugs, the Government Pharmaceutical Organisation (GPO) will produce the drug stavudine and reduce the price by 85 per cent. People living with HIV/Aids together with non-governmental organisations welcomed the move yesterday.

Stavudine, better known as d4T, is now sold by US drug giant Bristol-Myers Squibb (BMS) at Bt100 and Bt104 per 30 and 40-milligram tablet respectively. Patients take two pills a day. The director of the GPO’s research-and-development department, Dr Krissana Kraisintu, said that with the cheaper cost of raw materials the GPO would be able to sell the drug at Bt11 to Bt15 per tablet. The monthly cost of the drug will thus be reduced to between Bt660 and Bt900, as opposed to the current Bt6,000 to Bt6,240. Production will start on Monday.

Paisal Tan-ud, chairman of the Network of People Living with HIV/Aids, said the price reduction of d4T would at least enable many people to start a combination of two HIV/Aids medicines. The combination of d4T with ddI, another Aids drug, would cost no more than Bt3,000 per month. Though a combination of three drugs is normally preferable in the treatment of HIV/Aids, bi-therapy can also be effective if patients start taking the drugs during the early stages of the virus.

BMS holds the patent for ddI, which costs Bt49 per 100mg tablet. Recently the GPO produced generic ddI in powdered form and cut the price by half. Nimit Tien-udom, director of the Aids Access Foundation, said the drug monopoly was inappropriate and should not exist. Production of affordable generic Aids drugs was vital for people living with HIV/Aids.

"The director-general of the Communicable Disease Control Department says he is negotiating with drug firms on the reduction [of cost] of HIV/Aids drugs," he said. He added that so far there had been no progress in the negotiations. No patent for d4T exists in Thailand, and the safety-monitoring period providing market exclusivity for d4T was completed last year. Because of this, BMS, which has been marketing d4T under the trade name Zerit, will have no right to monopolise sale of the drug here, said Dr Tido Von Schoen-Angerer from Medecins Sans Frontières (MSF) in Thailand.

He added that BMS had not developed d4T and that the patent for the drug in the United States was held by Yale University. His organisation has already ordered the first batch of d4T from the GPO for 100 patients over a one-year period.

BY MUKDAWAN SAKBOON
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