Living + Magazine Issue 1 - Positive Living BC

Glen Hillson, BCPWA
Chairperson, holds placard
during the protest against
DuPont Pharma’s high price
of Sustiva, at the Canadian
HIV/AIDS Research
Conference. Other activists
(pictured on previous page)
protesting included BCPWA
Vice-Chair Tom McAulay, and
BCPWA’s Treatment
Information Program Leader,
Tom Mountford.
fully expect these needs will
continue to be addressed over
time with incremental improvements
in the newer drugs
that come along. As this happens we are likely to see more
companies trying to charge whatever they think they can get
away with using any argument that is convenient at the time.
That is why it is so important for other stakeholders - consumers,
physicians, governments and other third party payers
to draw a line in the sand now.
B.C. Centre says “no thanks”
The government of B.C. has been one of the most progressive
third party providers of HIV drugs anywhere in the world.
Through the drug treatment program of the B.C. Centre for
Excellence in HIV/AIDS standard triple combinations, and
rescue therapy combinations of up to nine drugs are provided
to those in need free of charge. The annual cost of the
program is $32 million. Officials at the Centre, after unsuccessful
negotiations with DuPont for a lower price, have decided
to only provide efavirenz to those who are already taking
the drug through the expanded access program or in
other special circumstances (see article below from the BC
Centre for Excellence).
Where are the federal regulators?
In Canada, the Patent Medicines Prices Review Board
(PMPRB) has the power to review and regulate the prices of
patent medicines. The PMPRB is an agency of the federal
government. CTAC and the B.C. Centre for Excellence in
HIV/AIDS have both been asking for meetings with the
PMPRB for several months, in order to bring forward our
concerns, but these requests have only recently been granted.
At the same time, knowing there is widespread dissatisfaction,
the PMPRB has given a “go ahead” to DuPont to price
their drug outside of the range for NNRTIs and in the range
of PIs!
In addition to the poor judgment exercised by the PMPRB,
their lack of transparency and accountability has also made
them a target for AIDS activists. CTAC is planning future strategies
for fair drug pricing that will be aimed both at manufacturers
and the PMPRB.
• New or breakthrough medicines
• Medicines that offer little or no
therapeutic advantage over comparable
medicines.
Once a drug is slotted into Category
3 further analysis slots the drug
into therapeutic subclasses, (for
example protease inhibitors, NNRTIs
and RTIs). The PMPRB advice to
Dupont Pharma was that for the
purposes of price they could use both
the protease inhibitors and NNRTIs in
their price comparison. Dupont has
chosen to take advantage of this and
has offered Sustiva at 50% higher
price than other NNRT1s.
The Centre plans to make a formal
representation to the PMPRB to
demonstrate using best available
scientific evidence that it is inappropriate
to compare NNRTIs to protease
inhibitors for the purposes of price.
Dupont Pharma’s price
As a result of the PMPBR the decision
Dupont Pharma has, as indicated
above, sought a price for Sustiva at
50% higher than other NNRTIs,
Nevirapine and Delavirdine. The BC
Centre for Excellence in HIV/AIDS has
requested a budget increase of over
$7 million from the B.C. Ministry of
Health (over a 30% increase for the
fiscal year 1999/2000). We did not
make provision to pay for Sustiva at
this price and we do not have funds
allocated to this fiscal year to do so.
Since it’s inception, the BC Centre
for Excellence in HIV/AIDS has
worked collaboratively with industry
to bring the best available patient
care in the HIV/AIDS area to residents
of BC. However, as the sole payer for
these medications in the province we
operate under a capped budget. This
higher price is especially troubling, as
we are not aware of any data indicating
Sustiva is superior to Nevirapine
or Delavirdine. We have had successful
experience with NNRTIs at a much
lower price than Dupont is offering
and we will continue our efforts
through the PMPRB to ensure that
HIV drugs are appropriately classified,
the price of HIV drugs are appropriately
recognized, and we will continue
to bargain hard with Dupont
for a more acceptable price. If you
require any further information
please contact the Centre.
JULY/AUGUST 1999 • LIVING + 23