Patent war driving costs of HIV drugs

Although HIV drug prices have declined significantly, international humanitarian organisation, Medècins Sans Frontierés (MSF) has warned that future declines are under threat.

The lowest available price for first line HIV treatment has dropped by 26 percent since 2014, costing poorer countries, as well as South Africa, $100 (R1 420) per person a year for the one-pill-a-day combination (tenofovir, emtricitabine and efavirenz), according to an MSF report released yesterday at the 21st International AIDS Conference in Durban.

Second line treatment, which HIV patients need if they become resistant to first line drugs, has also dropped by 11 percent from two years ago - the lowest combination available costs $286, thanks to strong competition between generic manufacturers especially in India. This generic competition has driven the price of HIV treatment down by 99 percent since 2000 when a first line regimen cost $10 000 per person per year. But the lowest price for third line or "salvage treatment" - which contains newer HIV drugs on patent - is $1 859, almost 20 times the price of the cheapest first line regimen.

This is because drug companies have monopolies on patented products which block generic competition, often for decades. According to MSF's Claire Waterhouse, the number of people needing salvage treatment in South Africa is low - they estimate the figure to be close to 1 000. However, she said, as SA moves to test and treat (in September) and scale up viral load monitoring, these numbers are bound to increase and it is essential that we can access these medicines affordably. According to the report, India is "facing immense pressure to roll back its pro-health patent policies - which put people's lives over corporate profits - especially from the United States, backed by its pharmaceutical corporation lobby".

Waterhouse said this was an urgent threat for South Africa because it imports most of its generic medicines from India, which currently has a strong patent system protecting its generic pharmaceutical industry. So, she said, if they shut down the "pharmacy of the developing world" as India is now known, it will become much more difficult for SA to procure affordable medicines for our high disease burdens. It is essential that they stand strong against this pressure.

Health-e News Service, 22 July 2016