[e-drug] Availability and cost of ribavirin injection

E-DRUG: Availability and cost of ribavirin injection
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We read with interest the correspondence by Guy Antony Richards to the
Lancet on 14th of February 2009 on the 'availability of drugs for
formidable communicable diseases'. [posted on e-drug 16 February, titled 'Availability and cost of a patented life-saving medicine'. Moderator]

In fact, the issue of availability and affordability of ribavirin injection
is not something new. Medecins Sans Frontieres (MSF), a medical
humanitarian organisation has been using ribavirin injection produced by
Valeant Pharmaceuticals since 2001 to treat endemic Lassa fever in Liberia,
Sierra Leone and to a lesser extent Crimean-Congo Haemorrhagic Fever
(CCHF). Lassa fever is probably the most frequent haemorrhagic fever seen
in Africa and it has high mortality if not treated in its early stages. At
present ribavirin is the only drug with a demonstrated efficacy in reducing
mortality in Lassa fever patients. Most of the sporadic cases in endemic
countries spanning West Africa are simply neglected by lack of diagnosis
and treatment capacities.

We experience the same difficulty assessing an affordable validated source
of ribavirin injection. MSF purchased ribavirin injection from Valeant at
prices between US$ 20 and US$ 250 per vial, and prices up to US$ 450 were
quoted to us by Valeant's representatives.

On 26th of January 2009, we have written to Mr. J. Michael Pearson, the
Chairman and Chief Executive Officer of Valeant Pharmaceuticals
International to explain the situation and to request for a preferential
price for ribavirin injection at US$ 20 per vial for use by MSF and other
humanitarian actors both in ongoing diagnosis and treatment programmes and
in the case of outbreaks. To the best of our knowledge, the lowest Valeant
worldwide price for Ribavirin injection is US$ 20 per vial. We are still
waiting for a reply. We believe the best long term solution is to have a
validated generic source because the drug is no longer patented. Due to the
limited market for this drug, there is a need for affected countries and
WHO to come up with a joint strategy for supply.

Kind regards,
Janice S.F Lee
Pharmacist
Medecins Sans Frontieres
Campaign for Access to Essential Medicines
Phone: +41 22 84 98 407
www.msfaccess.org