AHF urges all AIDS drug manufacturers to reduce medication cost by 20%

AIDS Healthcare Foundation (AHF)Feb 4 2011

As part of its ongoing advocacy to lower drug prices and increase access to lifesaving medications AIDS Healthcare Foundation (AHF), the largest global AIDS organization, today urged all AIDS drug manufacturers to reduce the cost of their medications by 20% for cash-strapped state AIDS Drug Assistance Programs (ADAPs)—the federally-funded, state-run program to provide HIV/AIDS drugs to low-income Americans. AHF made the request in formal letters to each of the major AIDS drug makers: Abbott Labs, Boehringer Ingelheim, Bristol-Myers Squibb, Genentech, Gilead, Merck, Tibotec and ViiV.

In the letter, AHF's President Michael Weinstein states: "On behalf of the thousands of Americans whose access to life saving care is threatened, AIDS Healthcare Foundation (AHF) requests that you reduce drug prices for AIDS Drug Assistance Programs. At a time when states and the Federal Government are under a strict mandate to reduce spending, the additional funding needed to end this crisis, at least $260 million through FY 2012, is not available or likely to be in the near future. The only available recourse to ensure people with AIDS get the lifesaving treatment they need is to rein in the cost of AIDS drugs."

Due to a perfect storm of state budget cuts, increased demand, and rising drug prices, AIDS Drug Assistance Programs can no longer provide treatment to all of the people who need it. More than 5,500 people are on ADAP waiting lists to receive treatment, with an additional 2,500 at risk of being dropped from the program altogether. This crisis is quickly becoming worse as many larger ADAP programs are being forced to stop providing treatment to new patients. For example, Florida, which has the third highest HIV population in the country, recently instituted a waiting list that has 2,700 people on it. In addition, California (and its 40,000 ADAP clients) has proposed cuts intended to force many patients off the program.

While funding reductions have continued, drug costs have exploded. Since 1996, drug spending by ADAPs has increased by over 617%, more than twice the rate of ADAP patient growth over the same period. For example, Tibotec's key AIDS drug Prezista costs over $13,200 per patient per year; BMS' drug Reyataz costs over $12,900 per patient per year; and, Merck's Isentress costs over $13,400 per patient per year.

"Year in and year out, rising drug prices have eaten away at ADAP budgets limiting the number of people who can be served using existing funds. For example, in California (the nation's largest ADAP program) since 2000 AIDS drug spending has increased 257%, more than three times the rate of client growth over this same period. This sharp increase is a result of skyrocketing prices for newer AIDS drugs."

In the letter, Mr. Weinstein proposes a 20% price reduction on all AIDS drugs for state ADAPs and makes the case that the companies' bottom lines will not be adversely affected. The only result would be more patients treated with the same amount of funding.

The letter concludes: "A 20% price reduction (or rebate in applicable states) will enable ADAPs to provide lifesaving treatment to all those who need it. Moreover, this discount will have negligible impact on your company's revenue from the ADAP program. ADAP budgets for purchasing drugs are fixed- as evidenced by the waiting lists - which means that drug companies will receive all of the money available to the program regardless of pricing. The only question is, given the cost of drugs, how many people ADAPs will be able to serve with this set pot of funds.

"Without the assistance provided by ADAPs, the people affected by this crisis have very few (if any) available options to get their treatment. These programs are the only real safety net for people with AIDS. Patient assistance and other programs, such as Heinz-Welvista, cannot provide help to everyone who needs it. ADAPs were set up for this purpose and, as long as they are protected from increasing drug costs, ensure that patients don't slip through the cracks."

There are numerous public health reasons to ensure that patients can access lifesaving treatment through state ADAPs. Lack of access to AIDS treatment impedes the public health community's ability to combat the epidemic. When not properly treated with antiretroviral medication, AIDS patients quickly become increasingly sick and expensive to care for. The opportunistic infections that develop in patients due to their weakened immune system are more costly than treating AIDS correctly, and typically lead to more expensive inpatient care. Moreover, advanced antiretroviral treatment for those patients experiencing treatment failure - because they can't obtain their medication - is not only more toxic and intolerable, but costs thousands of dollars more than standard therapy.

AIDS treatment is also one of the most effective tools to prevent new infections. People who are successful on treatment have less of the HIV virus in their bodies, which means they are less infectious and less able to infect others. This crisis has already caused a decline in testing. The best medical model to combat the spread of the virus is to test as many people as possible and treat those who test positive. People at risk for HIV are less likely to get tested if they cannot receive treatment for their diagnosis. They would just rather not know.