Voice of America - July 23, 2007
Joe De Capua
Washington

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The humanitarian group - Doctors Without Borders - has released a new report on prices of AIDS drugs. It says while there have been dramatic price reductions for some older medicines, newer, less toxic drugs may cost significantly more. The report was released Monday at the 4th International AIDS Society Conference in Sydney, Australia.

The report - entitled "Untangling the Web of Price Reductions" - looks at the cost of first-line and second-line antiretroviral drugs. First-line drugs are the initial combination of medicines given to someone with HIV, the AIDS virus. Second-line drugs are prescribed when the first drug cocktail loses its effectiveness.

Karen Day is a pharmacist with Doctors Without Borders' Campaign for Access to Essential Medicines. She says the report can help countries make informed decisions when buying the medicine.

"There were two main points that came out this year. Well, two most significant changes in these last 12 months is that the second line prices are finally starting to move and come down. And then in the first-line regime - well, the good news of the first-line is it's now available under $100 per year. On the flip side of that, though, is as WHO (World Health Organization) has recommended moving away from this regime to a less toxic one it looks like we're putting back the prices of the first-line regime to almost $400 or $500 (per year), which is putting us back about six years," she says.

Years of negotiations, legal battles and lobbying have brought the cost of current first-line medications below $100 a year in developing countries..

"The current first line that's used today predominantly in developing countries is a combination of three drugs - Lamivudine, Stevudine and Nevirapine. And it's three tablets in one pill. So it's a fixed-dose combination," she says.

Day says that the price of the first-line combo is rising because the World Health Organization has recommended replacing Stevudine with Tonofovir, which has fewer side effects. But before the price of newer drugs can come down, and before they're readily available in developing countries, issues such as patents, generic copies and availability must be resolved first.

The good news in the Doctors Without Borders report is that prices for second-line medicines are down sharply. One reason is that is they have been standardized and simplified by the WHO. Another is the effect of a compulsory license issued by Thailand in January. In certain situations, trade agreements allow a country to issue a compulsory license, which allows it to legally import or manufacture an AIDS drug locally. In effect, it bypasses some of the patent regulations.

"More competition. That's the best way we've seen to get prices coming down. With multiple producers, it's the best way to bring on the competition," she says.

Doctors Without Borders says, "Significant delays persist between when newer treatments become available in wealthy countries and when they become available in the developing world."

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