June 27, 2006

Activists Say New HIV Drug Price Encouraging

June 27, 2006 (AIDSmeds)—A coalition of United States HIV/AIDS treatment activists has given thumbs up to what it sees as an encouraging trend in HIV drug costs, based on the price announced for the recently approved protease inhibitor Prezista™ (darunavir). While one AIDS service organization criticized the price of Prezista and expressed concern about HIV drug price gouging, the AIDS Treatment Activist Coalition (ATAC) said that the drug's price may represent the end of an upward pricing trend seen in recent years.

According to Lynda Dee, a member of ATAC and a former co-chair of its Drug Development Committee, Tibotec has changed the pricing model by not charging a higher price than its predecessor Aptivus® (tipranavir) which, like Prezista, is specifically approved for people with HIV resistant to older medications. "If you review what's happened with new drug prices," Ms. Dee said, "you find that new, more effective drugs have always been priced higher than the preceding drug. The industry term for this is ‘new value benchmark.'"

Tibotec announced that the wholesale acquisition price (WAC) for Prezista, approved by the FDA on June 23, 2006 (see our previous story on this), will be $25 per day. According to Ms. Dee, this is approximately $4 less than Aptivus, approved in June 2005, and only 25¢ more than the daily cost of Reyataz® (atazanavir), approved in June 2003. Fuzeon® (enfuvirtide), an injectable fusion inhibitor prescribed for HIV-positive people with limited treatment options, carries an approximate daily WAC of $61.

Treatment advocates contend that Prezista is an important addition to the anti-HIV drug armamentarium given that it works for people who have HIV that is resistant to previous protease inhibitors. ATAC Steering Committee Chair Rey Candelaria commended Tibotec for its decision to stop the continuing escalation of drug prices. "This is the first time we can remember an HIV drug company pricing a new drug lower than the last FDA approved anti-HIV medication. This pricing decision is especially necessary in light of the lack of political will and misplaced spending priorities in Washington."

But according to a statement by Michael Weinstein, President of the AIDS Healthcare Foundation in Los Angeles, the daily $25 price tag is nothing to celebrate. "As with many AIDS drugs before it, we anticipate that the cost of Prezista will simply be out of the price range for most AIDS patients and threatens to further stress Medicaid and AIDS Drug Assistance Programs nationwide many of which already have waiting lists."

Mr. Weinstein contends that "AIDS drugs are priced at the maximum the market will bear, regardless of production costs. Other drug makers will follow suit with equally high prices, and access to care will be the casualty."

Ms. Dee disagrees. "[AIDS Health Foundation's] assertions that [Tibotec] priced their drug at what the market will bear is just not true," she said. "[Tibotec] started with a price higher than Aptivus and Fuzeon." After a letter was submitted to Tibotec in early June, requesting fair pricing for the drug and signed by 400 HIV-positive individuals, advocates, and organizations, Ms. Dee said that the manufacturer reduced its Prezista price to below that of Aptivus and Fuzeon.

According to ATAC, the price of prescription drugs has gone up radically over the last ten years. In 1996, when the first highly effective anti-HIV combination therapy became available, treatment for a single individual cost at least $12,000 to $15,000 a year per person for a typical three-drug regimen. Today, a single drug can cost this much or even twice this amount.

While Ms. Dee admits that she is not thrilled with Prezista's $25 daily sticker price, she expressed satisfaction with the current cost compared to the $34 price she says Tibotec was strongly considering. "I am elated that we have stopped this unconscionable drug pricing war and drawn a line in the sand. From here on out, we are declaring a war on any company that continues the upward spiral of pricing escalation on new drugs."