Cheaper HIV/AIDS treatments in developing nations

NEW YORK — Former US President Bill Clinton recently announced two important and complementary agreements to enable better, more affordable treatments for patients on second-line antiretroviral (ARV) therapy for HIV/AIDS in the developing world. 

For the first time, a second-line regimen of four ARVs will be available for under $500 annually. Additionally, the cost of a key drug for treating tuberculosis (TB) in patients using second-line ARVs has been reduced by 60 percent, to $1 per dose.

“Thanks to the work of my foundation’s HIV/AIDS Initiative, two million people living with HIV/AIDS are now able to access life-saving treatment,” Clinton said.

“But their continued survival depends on uninterrupted access to medicine and quality and affordable healthcare throughout their entire life. Today’s announcement will help ensure we can sustain treatment over a lifetime and better treat patients with both HIV and TB, two key steps in turning the tide of the global HIV/AIDS pandemic,” he added.

Addressing the need for more affordable second-line ARVs, Mylan and Matrix, a Mylan company, are making available all four drugs — atazanavir (ATV), ritonavir (RTV), tenofovir (TDF), and lamivudine (3TC) — needed to enable once-daily treatment of patients who have developed resistance to standard first-line ARVs.

The four drugs will be available in three pills, with tenofovir and lamivudine combined into a single pill. The three pills are being made available today as separate products, with a total price of less than $475 annually. 

Matrix will also sell the pills together in one package — a “second-line-in-a-box” — at $425 annually starting in 2010.

These new products and prices will be available to governments that are members of the Clinton Foundation’s Procurement Consortium across Africa, Asia, Latin America, and the Caribbean.

The TDF+3TC is FDA-approved, and ATV and RTV are pending approval by the World Health Organization (WHO).

Mylan chairman and chief executive officer Robert Coury said, “Ensuring sustainable access to effective treatments in the developing world is a critical element in the global fight against HIV/AIDS.”

“Mylan and Matrix are proud to continue our commitment of creating and introducing innovative and affordable pharmaceutical solutions. This includes our ‘second-line-in-a-box,’ which will reduce patient pill burden and facilitate patient compliance. Our affordable, heat-stable version of ritonavir also represents another advance in the development of products that can withstand environmental conditions in parts of the world where treatment is desperately needed,” he added.

Citing the importance of integrating HIV/AIDS and tuberculosis treatment, Clinton also announced an agreement with Pfizer to reduce the price and expand the availability of rifabutin, a drug used to treat tuberculosis in patients taking second-line ARVs. 

This marks the Clinton HIV/AIDS Initiative’s first pricing agreement with a research-based pharmaceutical company, as well as its first pricing agreement on tuberculosis.

Pfizer will sell the product at $1 per 150 mg dose or $90 for a full course of treatment over six months. This price will be available throughout the developing markets in Africa, Asia, Eastern Europe, Latin America, the Middle East, and the Caribbean. 

Tuberculosis is the leading cause of death among HIV-positive patients. The WHO reports that over one-third of all individuals living with HIV are also infected with tuberculosis, resulting in over 450,000 deaths in 2007.

Jeffrey Kindler, chairman and CEO of Pfizer, said, “Pfizer is pursuing numerous global health projects like this one with the Clinton HIV/AIDS Initiative to find new ways to connect people to the medicine they need.”

“We are working on innovative solutions to bring healthcare to customers who have often been neglected in the past and do this in a socially responsible, sustainable, and commercially viable way,” he said.