April #69 : Geography Lessons - by Daniel Berman

POZ - Health, Life and HIV
Subscribe to:
POZ magazine
E-newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr MySpace
POZ Personals
Sign In / Join
Username:
Password:

Back to home » Archives » POZ Magazine issues




Table of Contents

Geography Lessons

Mo' Money, Mo' Trouble

Cold Sore Comfort

THE BIZ OF AID$

Living Large on Small Change

Living Large on Small Change

Living Large on Small Change

O Pioneer!

Going Dental

Vax Attack

¡La Emergencia!

Monette & Merrill

Normal, New Jersey

Briefs

Milestones

Quickies

Money Pit

Cryptic 'Script

Don't Meth Around

AAT Ease

Two Strikes

LTNP? UB2

Is N-9 Deep-Sixed?

Action Zero

Mary MAC'd

Murphy's Law Breaker

Editor's Letter

Mailbox

04.09.84 The Waters of Babylon

Conflicts in Pharmaland



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


email print

April 2001

Geography Lessons

by Daniel Berman

With AIDS meds costing all the tea in China, why are they so cheap in India? Fluconazole's no fluke.


If companies could patent, and so fix global prices for food, the price of bread would be twice as high in a Guatemalan pueblo as in a Beverly Hills bakery. Ridiculous...right? Well, so it is with Pfizer's fluconazole (Diflucan), the most egregious example of the madness of global AIDS drug pricing. For many of the 95 percent of the world's PWAs without access to HAART, the price of Diflucan is a matter of life and death.

Fluconazole, an anti-fungal commonly used against thrush, is also the main treatment -- effective but lifelong -- for cryptococcal meningitis, which, if untreated, can kill the immune-suppressed in less than a month. Many doctors with Médecins sans Frontières (MSF) must helplessly watch their patients in developing countries die for lack of the drug. So last June, MSF, where I manage the Access to Essential Medicines Campaign, conducted a study of the drug's price in eight countries, looking at generics as well as Pfizer's brand-name version.

The results were striking. A Thai PWA can buy generic fluconazole for 29 cents per capsule, while a Guatemalan pays $27.60 for the same dose of Diflucan. The crucial difference: whether or not the drug is patented in each country. (Even the brand-name price dips in places that produce a generic.) If AIDS-ravaged South Africa were to import the Thai generic, the cost of a year's treatment would drop from $2,970 to $104 -- boosting drug access.

Pfizer's pricing policy has worked badly for PWAs but well for the company: Worldwide sales of Diflucan surpassed $1 billion in 1999. For 12 years, Pfizer has enjoyed a monopoly on the drug in many countries that recognize drug patents. Its patent won't expire until 2004 in the U.S. and even later elsewhere. So far, Pfizer has refused to slash Diflucan's price or grant licenses to developing nations to produce or import generics, though it did offer South Africa a drug donation. "We don't believe reducing the price will mean that the medication will get to large numbers of people," a Pfizer manager told The Wall Street Journal.

MSF has called on Pfizer to lower the price of Diflucan to generic levels in developing nations. But limited deals with drug-makers are only the beginning. In a public health emergency, national governments can negotiate prices based on global price comparisons, register generic producers and issue compulsory licenses to override patents. Despite the risk of sanctions, MSF urges them to do so now.

This article was adapted from a report that appeared in The Lancet, 12.16.00.


Wholesale prices of a 200 mg daily dose of fluconazole, June 2000:

Spain
$10.57 Pfizer
$6.29 Vita (local generic)

USA
$12.20 Pfizer

Guatemala
$27.60 Pfizer
$11.84* Pfizer
$3* Bussie (Colombian generic)

India
$0.64 Cipla (local generic)

Kenya
$10.50 Pfizer

Thailand
$6.20 Pfizer
$0.29 Biolab (local generic)

South Africa
$8.25 Pfizer

*Reduced bulk price




[Go to top]

Join POZ Facebook Twitter Google+ MySpace YouTube Tumblr Flickr
Quick Links
Current Issue

HIV Testing
Safer Sex
Find a Date
Newly Diagnosed
HIV 101
Disclosing Your Status
Starting Treatment
Help Paying for Meds
Search for the Cure
POZ Stories
POZ Opinion
POZ Exclusives
Read the Blogs
Visit the Forums
Job Listings
Events Calendar


    Drew949
    South Orange County
    California


    juliar33
    brooklyn
    New York


    jimmy807
    San Antonio
    Texas


    kmfdm221
    Arcata
    California
Click here to join POZ Personals!
Ask POZ Pharmacist

Talk to Us
Poll
Survey
Pop Watch

more surveys
Contact Us
We welcome your comments!
[ about Smart + Strong | about POZ | POZ advisory board | partner links | advertising policy | advertise/contact us | site map]
© 2014 Smart + Strong. All Rights Reserved. Terms of use and Your privacy.
Smart + Strong® is a registered trademark of CDM Publishing, LLC.