The New York Times - September 10, 2009
Duff Wilson

Merck won the highest grade and Abbott Laboratories flunked in a report card being issued Thursday by a prominent group of AIDS treatment activists after a yearlong study of the actions of nine major pharmaceutical companies to address the contagion in the United States.

Although advances in drug regimens since the 1990s have added nearly 20 years to the average life expectancy of a person with H.I.V./AIDS, the report card graded the drug makers overall with a below-average C-minus and recommended improvements.

"There's an opportunity now to kick it up a notch," said Bob Huff, antiretroviral treatment director of the Treatment Action Group in New York and a board member of the rating group.

Twenty-one members of the AIDS Treatment Activists Coalition, a nonprofit group formed in 2001, researched the drug companies, interviewed executives and assigned grades assessing performance over the last quarter century, Mr. Huff said. The companies were scored on research and development, pricing, patient assistance programs, marketing, and community relations.

More than one million people in the United States are infected with the human immunodeficiency virus, though only about half of them have been discovered and treated, the government says. Untreated, H.I.V./AIDS leaves people vulnerable to infections and cancers. While treatment reduces symptoms and extends life, there is no cure.

The report gave its highest grade, a B, to Merck, for producing Isentress, the first of a new class of AIDS drugs called integrase inhibitors. It also praised Merck for freezing prices for lower income users. Isentress, approved in 2007, is already used by 11 percent of the more than 550,000 people treated in the United States, Michael S. Seggev, a spokesman for Merck, said Wednesday.

"We're very pleased to have achieved the highest grade on the report card," he said. "They're the most respected and most representative coalition of H.I.V. community groups in the U.S., so their opinion is very meaningful."

The group gave an F to Abbott for raising the wholesale price of Norvir, the first drug proved to increase survival in AIDS patients, by 400 percent in 2003. Norvir is a key ingredient in most AIDS treatment cocktails. The price increaes provoked an outcry by many patients and others.

An Abbott spokesman, Dirk van Eeden, responded Wednesday, "The H.I.V. community is an important stakeholder for us, so yes, we do take notice of the comments they make." He added, "We really believe we've discovered important medicines and played our part in making sure the patients who need it can get it."

Other grades included a B for Tibotec Pharmaceuticals, owned by Johnson and Johnson as a separate company focusing on infectious diseases; C-plus for Pfizer, which announced in April a joint venture with GlaxoSmithKline to spin off a company focused on H.I.V.; C-plus for Gilead Sciences; C-minus grades for Bristol-Myers Squibb and GlaxoSmithKline, both criticized for high prices; a D-plus for Boehringer Ingelheim; and a D for Hoffman LaRoche, which the coalition said has the most expensive drug on the market.

Representatives for Pfizer, Gilead and Boehringer responded Wednesday that they valued the group's opinion and continued their work in AIDS. Bristol-Myers Squibb and GlaxoSmithKline officials each said they were "disappointed" and deserved better grades. Other companies did not respond immediately to requests for comment.

The coalition was to some degree biting the hand that feeds it. It receives all of its financing from drug companies, mostly for activists to travel to meetings with them. The executive director, Edward T. Rewolinski, disclosed specific amounts to The New York Times for the last two years. "None of our members has the wherewithal to afford this activity," he said.

"People like that would never be influenced by the flow of money," Jennifer Flynn, managing director of an unrelated AIDS group, Health GAP, in New York, said.

The top fund provider was Gilead with $100,000, followed by Pfizer, $63,000; Bristol-Myers Squibb, $50,000; Tibotec, $45,000; Merck, $15,000; and Boehringer, $5,000. Abbott gave no money.

Mr. Huff said the grading group was insulated from financing requests. "There's no sugarcoating," he said. "The membership feels that the pharmaceutical industry can be doing a much better job, whether it's innovation or pricing."

The coalition was formed in 2001 partly to coordinate contacts with drug companies instead of letting the industry decide whom to invite to meetings.

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