Thai Three-In-One Antiretroviral Pill Likely to ‘Reignite Debate’ Over Cost of Treating HIV/AIDS in Developing Countries

Thailand's plans to market next month a combination pill that contains three separate antiretroviral drugs -- at a cost well below the price of the drugs in developed nations -- has "reignit[ed] the debate" over patent protections and AIDS drug prices, the Wall Street Journal reports. The three-drug pill would include the antiretrovirals stavudine, lamivudine and nevirapine, the patents for which are held by GlaxoSmithKline, Bristol-Myers Squibb and Boehringer-Ingelheim, respectively. The combination pill would cost approximately 46 cents per dose, while one dose of stavudine, lamivudine or nevirapine can cost $4 each in the United States. The new pill is expected to cut the cost of antiretroviral treatment for Thai AIDS patients to approximately $27.66 per month, or $330 per year. The pill comes in two strengths, and Thai researchers have studied it for safety and compatibility in patients.

Patent Protections
Thailand's Government Pharmaceutical Organization plans to sell the combination pill only in Thailand, where the three drug makers do not hold patents on the individual antiretrovirals. However, Medecins San Frontieres and health officials from several African nations have expressed interest in purchasing the drug and distributing it to AIDS patients in other nations where the drugs may be protected by patent law. Officials from GlaxoSmithKline and Bristol-Myers Squibb said that they would "look at any patent infringement on a case-by-case basis." But AIDS activists praised the arrival of the new pill as "another step toward greater access to critical medicines." James Love, director of the consumer project on technology at Consumer Action, said the "simplicity" of a combination pill will likely result in greater treatment compliance, thus lessening the risk of drug-resistant HIV. He added that the patent quarrels that will likely arise in developing nations where the three drugs are patented will put pressure on some governments to enact emergency import or licensing laws that could "override" patent protections. Krisana Kraisintu, one of the scientists involved with the development of the pill, said that any exports of the combination drug would likely start with other Southeast Asian countries, including Cambodia, Vietnam, Myanmar and Laos. Krisana added that she has already received inquiries from officials in Nigeria, Uganda and other countries expressing interest in purchasing the pill (Zimmerman/Frank, Wall Street Journal, 3/29).