January 23, 2008

The Fair Pricing Coalition AIDS Activist Group Reacts to Pricing of AIDS Drugs

POZ speaks to pharmaceutical companies and advocates about how the pricing of AIDS meds impacts the community’s ability to access lifesaving treatment

The Fair Pricing Coalition (FPC), a nonprofit advocacy group of leading AIDS activists from across the nation that seeks to ensure fair pricing of HIV drugs, has issued a statement protesting HIV drug price increases announced last week by pharmaceutical company Bristol-Myers Squibb (BMS).

The increases, which range from 6.9 percent to 9 percent on all of BMS’ HIV products, are “well beyond any increases in the Consumer Price Index”—the universal standard for adjusting prices of consumer products based on inflation rates—“and above the increases taken by any other company,” said Martin Delaney of the FPC and Project Inform in the FPC press statement, issued January 14. “These drugs have been on the market for several years, and their development costs have long been recovered. There is no justification for this kind of increase.”

Sonia Choi, a spokesperson for BMS, told POZ that the company’s price hikes were instituted to enable BMS “to continue [its] significant investment in innovative therapies for the HIV community and to allow [it] to invest in all compounds in the BMS pipeline.”

The FPC statement says, however, that BMS, which currently markets five HIV drugs—Zerit, Sustiva, Atripla (produced in conjunction with pharmaceutical company Gilead Sciences), Videx and Reyataz—is doing “very little if any further research in HIV.” FPC member Lynda Dee, of AIDS Action Baltimore, said in the press release, “Considering how little this company has spent developing its portfolio of HIV drugs, especially in recent years, and how well their products are selling, it's unconscionable for BMS to do this. They've got a lot of nerve pushing the limits with these annual price increases.”

Regarding compounds in the BMS pipeline, Choi said, “We have a very strong R&D program in HIV and hepatitis that is focused on addressing the unmet medical needs that still exist in these disease areas. We are developing several innovative HIV therapies with novel mechanisms of action, and we are pursuing multiple targets to develop novel oral compounds for hepatitis C. We also continue to invest in the development of our currently approved medicines through clinical trials [to pursue options like] dosing simplification [like the one-pill, once-daily formulations of Reyataz and Sustiva].”

Choi continued: “Pricing for all Bristol-Myers Squibb medicines are based on the cost to develop, manufacture and bring them to market; their scientific innovation; and the value that they bring to patients and healthcare providers. In HIV, for example, price increases enabled us to invest in efforts to reduce pill burden and simplify therapy for patients. Through this work, we developed one-pill, once-daily formulations of Reyataz and Sustiva, and developed Atripla as a complete HAART regimen with Gilead.”

When asked why BMS raised its prices at this particular moment, Choi told POZ, “We periodically review pricing of our medicines to continue our substantial investment in research to deliver breakthrough therapies for the future.”

The FPC said it would like to see BMS reconsider their price increases. “Our first demand is for [BMS] to roll back the entire price increase, and, if they are unwilling to do that, we’re asking that they at least roll it back to no more than what is warranted by the level of the Consumer Price Index,” said Paul Dalton, director of treatment information and advocacy for Project Inform and a member of the Fair Pricing Coalition, in the January 14 FPC press release.

Founded in 1998, the FPC aims to meet with pharmaceutical companies and help them set drug prices that it considers fair and reasonable for HIV/AIDS and hepatitis treatment. For example, in 2006, after a series of meetings with Tibotec Therapeutics concerning the pricing of one of its new HIV drugs, Prezista, the FPC announced that the company had priced Prezista “responsibly,” calling it a “particularly thoughtful move on the company's part since it recognizes the crisis in funding faced by payers in and out of government.” Dalton told POZ that he believes that setting manageable prices for AIDS medications is essential to ensure that the greatest number of people who need them can afford to buy them. “Drug price plays a big role in deciding which medications to take—both on the part of the prescriber and the patient,” he said to POZ.

According to Dalton, Prezista’s price point allowed the drug to be placed immediately on California’s AIDS Drug Assistance Program (ADAP) formulary list, offering immediate access through ADAP to those who needed the medication. Meanwhile, other higher-priced drugs are not immediately placed on certain ADAP formulary lists, keeping the meds from some members of the HIV community who need them but can’t afford them.

Tibotec announced the launch of another new drug—Intelence—on Friday, January 18. The FPC was also involved in setting the price for Intelence. In a press release issued January 18 by Tibotec Therapeutics, Delaney said: “Tibotec…continues to demonstrate real leadership in the pharmaceutical industry by pricing Intelence fairly and responsibly. We…expect to see the drug quickly accepted on all formularies.” In a press statement issued January 21 by the FPC, Delaney said, “[The pricing of Intelence] shows a real sensitivity to the otherwise growing problem of high drug prices. We’ve been arguing for years that this escalation in drug prices is unjustified and has to stop. The overall cost of health care skyrockets annually and is causing more and more people to go without health insurance. While drug prices are only part of the problem, they are one of the parts we can do something about. We applaud Tibotec for…realizing that fair pricing is also good business.”

In that release, Dee said, “People with resistant virus now have a number of good choices, but for the first time they also have the ability to choose a very good drug that costs less than the alternatives. We hope that the market rewards Tibotec for making this smart strategic move. We hear all the time from drug companies that ‘payers don’t care about drug prices.’ We think that is false and believe that companies that set fair prices will get a larger share of the market. While we are pleased with Tibotec’s price today, we wish it were even lower. We have requested that [Tibotec] make further reductions in the price it charges government payers.” Pam Van Houten, director of communications for Tibotec, told POZ: "We believe Intelence is priced fairly for the value it brings to patients. We are committed to continuing to work with the community on access issues."

Dalton said to POZ that the potential impact of higher drug prices is higher co-pays for HIV-positive people. “When private insurers look at co-pays for individual drugs, the primary factor in how high that co-pay is going to end up being will be the cost of the drug,” he said, adding, “Drugs that are less expensive tend to have smaller co-pays.” Dalton said that the higher prices could cause a domino effect, influencing other drug companies to raise their prices as well: “The last thing we need right now is a round of excessive price increases for these drugs, which are already extremely expensive and burdening the health care system.”

In addition to asking BMS to scale back its price increases, the activists are recommending that BMS open up its communications with the FPC, the AIDS Treatment Activist Coalition (ATAC), community-based organizations and national and international patient groups to discuss fair pricing of its HIV drugs. “We meet with other companies before any new drug is priced and we talk with them prior to any significant prices increases,” said Delaney in the January 14 FPC release.

The FPC says that BMS has been unwilling to have open discussions with the HIV community—and the FPC members say they are as outraged by BMS’ unwillingness to discuss the pricing of their HIV medicines as they are about the price hikes themselves. According to Choi, however, BMS has “consistently met with the FPC in advance of…product launches,” adding that the company last met with the FPC in June 2006, before the approval of its HIV drug Atripla in July of the same year. She also told POZ that, “BMS hopes to meet with the Fair Pricing Coalition and other community leaders again in the near future to ensure a healthy dialogue and understanding of each other’s perspectives moving forward.”

Choi told POZ, "The HIV advocacy community is an important partner in our efforts to advance HIV patient care. We have worked collaboratively to help meet the needs of patients for the past 15 years, and we are committed to continuing to work closely with our community partners in the future.” She said that BMS is “committed to ensuring that patients who need our medicines are able to access them through the discounts we provide to federal- and state-funded access program, our participation in the pharmaceutical industry's Together RX Access Program, and through the free medicines that we provide via our patient assistance program.”

Said Dalton, “It boils down to ensuring that everyone in the U.S. has access to the drugs they need. If the HIV drugs weren’t as expensive as they are, there never would have been ADAP waiting lists, and people would not be dying from a lack of access to care.”

NEW! Scroll down to comment on this story.

Previous Comments:

Neil, , 2008-01-27 18:00:31
Gee, I was shocked when the pharmacy called me and said that they couldn't refill my script for Atripla this month due to the fact they now need "prior authorization" from my HC provider due to the price increase, im lucky, I have Rx coverage. I feel guilty having it sometimes. Gee its funny we dont hear a WORD about HIV/AIDS in the Presidential debates from anybody, the Dem's or the Repub's. We are swept under the rug. Its not a hot topic anymore.

Steve, New Jersey, 2008-01-26 17:26:45
I've just been dumped into Medicare Part D. I don't qualify for ADAP (close but no cigar). My annual out of pocket drug costs will now exceed $5,000 because of the doughnut hole. I have no idea how I will come up with this amount every year since I can't work. There are no generic options, and costs will go up even more if I ever have to switch drug cocktails. It's immoral to be denied access to life saving drugs because you can't afford them. More advocacy regarding this issue is needed.

James33624, Tampa, 2008-01-26 10:18:23
Well, the price of the drugs prescribed to me are Reyataz, Norvir and Epzicom, I don't get them because the cost to me is more than my monthly income. Therefore my health has gotten much worse since my health care company dropped me. I am with out drugs and have been full blown since 1991. In America we still are dying but because of not affording the drugs we need, just like third world countries.

Jack, Columbus, 2008-01-24 21:43:32
I would like to know what is FAIR about Sustiva costing $550.00 per month and Combivir costing $810.00 per month. I work with A Hospice organization and a 25 year old KID just DIED yesterday because he could not afford life sustaining drugs!!!

Jeff, new york city, 2008-01-24 12:14:57
I was really glad to hear that there are people advocating for lower prices...I am one of the few who has medicare part d but doesn't qualify for any help in the "doughnut hole". I currently spend around $4300.00 (true OUT OF POCKET) per year for my hiv cocktail, which thankfully continues to keep my viral load undetectable. I would love to hear more about this, or any other suggestions on how to lower my yearly costs.

Shawn, Springfield, 2008-01-24 11:51:53
They are in the business of making money. Even tho most of the cost to find these drugs were paid for already by the US Government. Raise the price on those that most likely cannot protect themselves or fight back. This is Trickle Up Greed Economics at its finest.