[Pharm-policy] Merck Drops Prices in Central America

[James Love]

-------- Original Message --------
Subject: Merck Drops Prices in Central America!
Date: Fri, 30 Mar 2001 11:53:47 -0600 (CST)
From: rastern@sol.racsa.co.cr

(Version en Español  viene mas tarde)  
From: Richard Stern, Agua Buena

To:   those who have  signed the Merck petition (234 in total!)   and others....

Friday, 30 March, 20001


Dear Friends...

I have just received a phone call from the United States from  Gray  Warner,
Vice President in charge of Latin America, for Merck and Co.  In this call
Mr. Warner indicated to  me that Merck would be proceeding immediately to
offer price reductions in Central America, equal or similar to those offered
in Sub-Saharan Africa.

Specifically he told me that the price of  $600 per year for Crixivan would
be offered for Belize, Guatemala, Honduras, and Panamá.  The price of $500
per year for Stocrin will be offered for these same four countries.   This
is a price reduction of about 85%, and is the same price which Merck had
announced that it would offer to Sub-Saharan African countries on March 7th.

With respect to Costa Rica, El Salvador and Nicaragua, the price will be
$1029 per year for Criixivan, and $920 per year for Stocrin.


Why the difference, according to Merck in prices that are offered to
Guatemala, Honduras, Belize and Panamá, from that which is offered to Costa
Rica, El  Salvador and Nicaragua?


What Mr. Warner indicated is that   Merck used the  United Nations Human
Development Index to determine which countries are "low" in human
development and which are "medium."   In turns out that all Central American
countries are at "medium level" according to this index.   Then, Merck used
the index of incidence of AIDS in each country. Those countries which have
an incidence of AIDS (according to UNAIDS figures) of greater than  1%
received the larger discount and those which incidence of less and than 1%
(Costa Rica, Nicaragua, and El Salvador) received the smaller discount.  

I suggested  to him that Nicaragua and El Salvador are both countries which,
in my opinion should get the larger  discount, as well,  because 1)
Incidence of  AIDS is under-reported probably in all three countries   2) El
Salvador has recently suffered effects of a devasting earthquake 3)  In
Nicaragua and El Salvador, health care is not universal and the governments
there are still in very economically vulnerable positions and may or may not
be able to provide triple therapy, even when there are substantial discounts.

Costa Rica is already providing universal ARV therapy for People with AIDS,
and the Merck announcement reduces its costs for Merck's products  from
$1,4  million per year to about four hundred thousand dollars per year.  


I consider this announcment by Merck to be good news for the region. What
follows are  continued efforts to work on infrastructure and distribution,
as well as to pressure other companies  which    produce anti-retrovirals to
make similar discounts.  


Sincerely,


Richard 

Richard Stern
Agua Buena Human Rights Association
San José, Costa Rica
Tel/Fax 506-234-2411
rastern@sol.racsa.co.cr
www.aguabuena.org

PS: Thanks to Olaf Valverde of MSF Guatemala for valuable technical support
and advice, and to Laura Asturias of Guatemala for her efforts to promote
signatures for the petition.