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[e-drug] MSF Comments on new GSK preferential prices

E-DRUG: MSF Comments on new GSK preferential prices

Dear e-Druggers,

We would like to briefly comment on the announcement of GSK on 5 September
2002 to "further reduce the not-for-profit preferential prices of its
HIV/AIDS medicines by up to 33%".

Practical aspects of the offer seem to have been lost in much of the media
coverage. We are concerned that three major aspects are not addressed by
GSK: equitable access for the largest possible population, a substantial
price reduction compared to the international market, and a strong concern
for paediatric patients.

GSK sets a preferential price for ARVs to least-developed countries (LDCs)
and sub-Saharan African countries, which together represent "a total of 63
countries".  While this offer may appear to cover a large number of
countries, these 49 LDCs (34 of which located in sub-Saharan Africa)
actually account for only 10.7% of the world-wide population, and limiting
the offer to LDCs excludes the entire Latin American continent and Central

In its public relation document "Facing the Challenge ? One Year On", GSK
writes that "We have concluded 95 arrangements covering 31 countries for
the supply of preferentially priced ARVs". However, only 23 of those 31
countries belong to the group of 63 eligible countries, which most probably
means that preferential prices in the other eight countries may not have
been concluded within the framework of the program, but following
case-by-case negotiations. To better evaluate the actual impact of the
offer, it would be also interesting to know how many patients are actually
benefiting from the differential price offer.

In its announcement, GSK declares that "the price reductions are the result
of a review of manufacturing costs and of increased economy of scale".
However, the price of Trizivir� (ABC/3TC/ZDV) has been reduced by 33% and
is now competitive with one generic equivalent, while the price of
Agenerase� (APV), for which there is no international offer from generic
competitors (and  which is not in the WHO Essential Medicines List, ) was
reduced by only 2%. That the price discounts offered by GSK are steepest
when there are other producers serves to underscore the importance of
generic competition.

GSK's offers are still much more expensive than quality generics. The price
of Epivir� (3TC) has not been reduced at all, and is still priced at $US234
per patient per year. There are already some generic alternatives of this
drug on the market, one of which has been prequalified by WHO and whose
best price is $US 100 per patient per year. The best price offered for
Retrovir�  (ZDV) is now $US 438 per patient per year for the countries
subject to the offer, while the best offers for WHO-prequalified generic
versions is less than $US 200 per patient per year.  Similarly, while the
best GSK offer for Combivir�  (ZDV+3TC) is now $US 621 per patient per
year, a WHO pre-qualified generic version is available at $US 265 per
patient per year.

Also of significant concern, there is no mention of paediatric formulations
in the GSK communication. This seems to reflect the general neglect toward
HIV positive pediatric patients in developing countries .

Raffaella Ravinetto, Pharmacist
M�decins Sans Fronti�re,
Campaign for Access to Essential Medicines

Contact: M�decins Sans Fronti�re, Campaign for Access to Essential
Medicines, access@geneva.msf.org

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