Bangkok: Thailand plans to buy more generic AIDS drugs from India to cut the cost of treating its poorest patients after failing to win large enough discounts from drug makers including Merck & Co. and Abbott Laboratories.
Public health minister, Mongkol Na Songkhla, said he will order more copies of Merck’s Stocrin from Matrix Laboratories Ltd, a unit of US-based Mylan Laboratories Inc., and plans to buy generic versions of two other life-saving drugs from India.
“Negotiations didn’t come out as good as we expected,” Mongkol said. “If their prices aren’t more than 5% above the generic drugs, we won’t hesitate to buy from them. Now, their prices are 20% higher.”
Thailand says copying the drugs will allow the government to provide free medicine to a larger share of the country’s poorest citizens, including its 220,000 HIV sufferers.
The Pharmaceutical Research and Manufacturers of America, a drug industry trade group, says taking that step would remove the incentive for companies to invest in research, and that its members would retaliate by not introducing new drugs in Thailand.
“I’m not afraid of having no drugs to treat people,” Mongkol said on 20 June in Bangkok. “If there aren’t any patented drugs registered in Thailand, it’s more convenient for us to import generic drugs from other countries.”
The country, Southeast Asia’s second-largest economy, will place a second order with Matrix for the AIDS drug efavirenz, Mongkol said.
The patented version is marketed as Stocrin by Merck and as Sustiva by Bristol-Myers Squibb Co.
The Thai government is also “in the process” of ordering Matrix’s copies of AIDS drugs Kaletra and its updated version Aluvia, made by Abbott, and clopidogrel, the heart medicine sold under the name Plavix by Bristol-Myers and France’s Sanofi- Aventis SA, he said.
Thailand’s Food and Drug Administration director-general Siriwat Thiptharadol, is meeting “about twice a week” with pharmaceutical companies to continue price negotiations, he said. Thailand has to order the three drugs from India as its stocks of the patented versions are running out, Mongkol said. The discounted medicines will only be provided to patients who can’t afford the patented drugs, he said.
The World Bank in August recommended that Thailand consider issuing so-called compulsory licenses under a World Trade Organization provision that allows governments to permit generic-drug production without the patent owners’ consent in some cases.
Two committees are examining whether to issue compulsory licenses on cancer medicines to treat poor Thai patients suffering from breast and blood cancer, Mongkol said. He declined to name any drugs under consideration.
“We have to look at which diseases are killing our people because they can’t access the drugs,” he said. “Cancer creates the third-highest death toll for Thai people, after AIDS and clogged arteries.”
Sanofi offered to sell Plavix at 27 baht (78 cents) per tablet, with an added incentive of supplying 3.4 million tablets for the same cost as one million, Siriwat said on 6 June. Merck offered to sell its AIDS medicine for 726 baht per patient per month, and to supply a free liquid form of the drug for 2,500 HIV-infected children a year. Merck also offered to cover their diagnosis costs and train health workers in treating youngsters.
Abbott has maintained its offer to supply Aluvia at $1,000 per patient per year, Siriwat said. Abbott has cut the price from $2,200, spokeswoman Jennifer Smoter said.
“The price is not cheap enough,” Mongkol said. The additional incentives on offer are “not what we want, we want lower prices.”
Demand for Kaletra, a drug often used as a second line of defense in the treatment of HIV, is growing because of increased resistance to cheaper first-line treatments and liver-related side effects, according to Doctors Without Borders, a medical aid group.
Thailand this year joined China and 10 other nations on the US government’s list of the world’s worst infringers of intellectual property rights, which could make it easier for aggrieved US industries to argue the Southeast Asian nation should lose some trade privileges.
Mongkol met with US commerce secretary Carlos Gutierrez, and deputy US trade representative John K. Veroneau, last month in an effort to avoid trade retaliation. He said then that the US government didn’t relent on their opposition to the compulsory licensing plan.