[Ip-health] Brazil negotiates price of Kaletra again - Newspaper october 14th - late translation

[MSF Michel Lotrowska]

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Newspaper Tribuna da Imprensa =96 RJ

October 14th 2006



Aids: the Brazilian government tries to avoid increase in the price of
medicine



Geneva =96 A new battle has just started between the  Brazilian government
(headquarter in Bras=EDlia) and pharmaceutical companies. The government ai=
ms
to avoid the increase of Kaletra=92s price in 2007, an Abbott medicine used
for Aids treatment. According to Mari=E2ngela Sim=E3o, the National Aids Pr=
ogram
Director, the government has started a new negotiation with Abbott in order
to establish a new price for the next year.



In the next few months, Abbott will be launching a new formulation of the
ARV.  Today, Kaletra is sold as a capsule e must be taken three times a day=
.
The new formulation is a tablet to be taken only twice a day. For this
reason, the company want to increase the price of the medicine by 10%.



The tablet version of Kaletra was not (yet) approved for commercial use (in
Brazil) at the time the agreement was signed. Now, it is used in 22
countries. By the end of September, the Brazilian Drug Regulatory Agency
(ANVISA, acronyms of Ag=EAncia Nacional de Vigil=E2ncia Sanit=E1ria) will p=
robably
grant the market approval for this new version.

For this reason, the government wants to re-open the negotiations. =93We do
not want this increase=94, Mari=E2ngela Sim=E3o said in Geneva, during the
participation on debates related to financing the fight against AIDS. She
says that government spends R$35 millions annually only with Kaletra. She
wants the price to remain the same.


However, Abbott will not revise the price. According to the Abbott
Communication Manager, Ana Paula Barboza, the new version of Kaletra is par=
t
of the agreement signed with the Brazilian government in October 2005. It i=
s
established that the new formulation could be sold at a price 10% higher: U=
$
1.500 US$ to treat one patient per year. "We will do what is established in
the agreement. Currently, there are no chances to discuss about price
reduction=94, said Ana Paula. She says that Kaletra has the lowest price in
Brazil among others from the same therapeutical class (protease inhibitors)=
.



Furthermore, according to Ana Paula, the price would be one of the lowest i=
n
the world: low-income countries pay U$ 2.200 to treat one patient during on=
e
year with the new medicine. However, the Brazilian price is three times
higher than those paid by African countries. The treatment for one patient
during one year costs US$ 500.


Several specialists expected this dispute to happen now. At the time when
the agreement was signed between the government and Abbott, everybody said
that the price agreed upon would have short term benefit, until the new
version of Kaletra would be launched on the market. After that, government
would have to pay 10% more, which is a calculation that should have been
done at that time.



However, the criticisms were not heard. At that time, the medical and
patients communities were confused  with difficulties during negotiations.
The government and the company started a battle in the beginning of 2005,
with the threat of issuing a compulsory license and also with the
declaration of public interest of the medicine. This last act was done
together with the Brazilian President Luiz Inacio Lula da Silva. After all
these efforts were done, the government gave up going any further in the
process.

The main argument put forward was that Farmanguinhos =96 the public laborat=
ory
responsible to produce the medicine =96 would take 2 years to produce a
generic version and cover the whole Brazilian market.  During this period,
Brazil would have to import the generic version from India.  Finally, the
government agreed to pay a price 50% lower than the one Abbott initially
proposed. The agreement also included that government would purchase Kaletr=
a
directly from Abbott until 2011 with the same price and not considering tha=
t
the number of patient would increase across time.





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