Brazil Threatens To Break Patents, Produce Antiretroviral Drugs If Companies Do Not Reduce Prices

Brazil has threatened to break the patents on three antiretroviral drugs and begin producing generic versions of the medicines if drug makers Abbott Laboratories, Roche and Merck do not cut their prices by 50%, according to the AP/Las Vegas Sun. Brazilian Health Minister Humberto Costa issued an "ultimatum" to the companies, saying that if the companies do not offer an "acceptable" plan by tomorrow, Brazil will explore making generic versions of the drugs or consider importing them, according to the AP/Sun. The drugs in question -- lopinavir, made by Abbot; nelfinavir, produced by Roche; and efavirenz, made by Merck -- represent 63% of Brazil's $172 million annual budget for antiretroviral drugs, according to the AP/Sun. The companies responded to Costa's threat by saying that they already offer Brazil reduced prices on the drugs. Abbott offered to reduce the price of lopinavir by 1.3% to $1.48 per dose. Roche sells nelfinavir to Brazil for 53 cents per dose, and Merck supplies efavirenz for $2.10 per dose. However, Marcia Lage, a spokesperson for the Brazil's National STD/AIDS Programme of the Ministry of Health, said that the government can produce individual doses of the drugs for 25 cents, 27 cents and 87 cents per dose, respectively. Abbott in a statement said that it is "hopeful of a positive end to the current negotiations." Merck spokesperson Anita Larsen said that the company is waiting for a "specific price cut proposal" from Brazil, according to the AP/Sun. Both Abbott and Merck say that they offer Brazil the lowest price on their antiretroviral drugs outside of the prices offered to African nations and other countries designated as least developed by the United Nations. Roche said that it also offers the drugs to Brazil at reduced prices.

Importation Possible
Brazil adopted a law in 1997 that allows the government to break drug company patents and make generic versions if the firms are charging "abusive" prices, according to the AP/Sun. Lage said that a health ministry team will travel to India today to determine if the drugs can be purchased from Indian generic drug makers at a lower cost than they can be made in Brazil. In order to import the drugs from India, a new law would have to be passed; Lage said that Costa's office is drafting such a proposal, the AP/Sun reports. Brazil has one of the "most successful" HIV/AIDS programs in the world, offering free antiretroviral drugs to all who need them, according to the AP/Sun. There are approximately 143,000 Brazilians with HIV/AIDS and about 70,000 of them receive antiretrovirals, according to the AP/Sun (Clendenning, AP/Las Vegas Sun, 8/28).

Additional information on AIDS in Brazil is available online through kaisernetwork.org's Issue Spotlight on AIDS.