Cost of AIDS drug slashed in Brazil

The Swiss pharmaceutical giant Hoffman-La Roche has agreed to reduce the price of its AIDS drug, Viracept, by 40% after pressure from the Brazilian government. The agreement comes after the government said that it would declare AIDS a “national emergency,” triggering a law that would allow domestic production of cheaper, generic versions of drugs when the government judges that a manufacturer’s prices are unobtainable.

Viracept, known generically as nelfinavir, is one of about a dozen drugs that make up the drug cocktail that patients with AIDS take to try to control the disease. Its price would fall from US$1.07 (26p) to 64 cents a pill, saving Brazil $35.4m a year. The $88mspenton nelfinavir every year accounts for 29% of Brazil’s $303m anti-AIDS budget and the annual number of deaths from AIDS has fallen from 11 024 to 4136 in four years.

If Brazil had carried out its threat to ignore Roche’s patent on Viracept a host of other developing countries might have followed its lead and begun manufacturing patented drugs for AIDS and other diseases. The big drug companies are fighting hard to avoid such a situation. In March, for instance, Merck & Company decided to cut the prices on two other drugs in the AIDS cocktail for use in Brazil by 60% rather than face possible competition from generics. Earlier this year the United States filed a claim against Brazil with the World Trade Organisation over its intention to produce generic versions of patented AIDS drugs, arguing that it was a violation of the international patent law. It later dropped the complaint.

Brazil has the highest number of patients with AIDS in Latin America and it was among the first developing countries to deal with the epidemic. Its programme includes producing generic AIDS drugs at a state owned laboratory at lower prices and providing the drug cocktails free to patients



studentBMJ 2001;09:357-398 October ISSN 0966-6494