Drug company to sell AIDS drugs at less than cost price

BMJ 2001; 322 doi: (Published 24 March 2001) Cite this as: BMJ 2001;322:692
  1. Scott Gottlieb
  1. New York

    Bristol-Myers Squibb has raised the stakes in an effort to cut the prices of drugs to treat AIDS in Africa by announcing that it will sell two antiretroviral drugs in combination for $1 (66p) a day, just below the cost price. It is the first time that any drug manufacturer has made such a proposal.

    The move came a week after rival pharmaceutical company Merck unveiled its own round of new price cuts, and it is further evidence that the drug industry is bowing to international pressure to increase supplies of cheap medicines (17 March, p 635).

    Bristol-Myers said that didanosine (ddI), which is sold as Videx, and stavudine (d4T), which is sold as Zerit, would be made available at 85 cents and 15 cents a day respectively under a programme backed by the United Nations. So far the company has struck supply agreements with Senegal, Uganda, Rwanda, and the Cîte d'Ivoire. In the United States, by contrast, one day's dose of the two drugs costs $18, according to Bristol-Myers.

    Officials at Bristol-Myers also said that the company will not use its patent on stavudine in South Africa to block that country's efforts to buy less expensive versions of the drug from generic manufacturers in India. Bristol-Myers acknowledged that it has almost no patent protection for its AIDS drugs in sub-Saharan Africa. It claims a patent for stavudine only in South Africa, and it now has no patent for didanosine in any sub-Saharan country.

    This means that any nation or medical centre in the region could legally buy generic copies of those drugs if it chose to do so. The company is hoping that, at the lower prices, manufacturers of the generic drugs will not have an incentive to bootleg the company's medications.

    “Our goal here is to energise a groundswell of action that needs to be undertaken if we are going to do any good in fighting this terrible problem in Africa,” said John McGoldrick, executive vice president of Bristol-Myers.

    “This is groundbreaking,” said Kate Kraus, a member of Act-Up, a group that has led protests around the world against the big drug manufacturers. “This is the first time that a US drug company has acknowledged that generic drugs are the key to saving lives.”

    Britain's GlaxoSmithKline, the world's largest supplier of drugs for HIV and AIDS, pledged last month to widen its own access initiative by supplying drugs to a range of non-profitmaking organisations at discounts of more than 90%.

    But even at the newly reduced prices, doctors say that the drug therapy might remain far beyond the economic reach of most in Africa. Stavudine and didanosine must still be combined with a third drug to complete the AIDS regimen.

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