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."
If you don't understand one of the words in this article,
just double-click it. A window will open with a definition
from CancerWEB's On-line Medical Dictionary. If the double-click feature
doesn't work in your browser, you can enter the word below:
