E-drug: Cost of Antiretrovirals
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Not unnaturally, we are seeing increasingly common calls for action to
provide wider access to antiretroviral drugs for treatment of HIV.
Among solutions proposed is that of transfer of technology, allowing
pharmaceutical companies in developing countries to produce these
drugs with a reduction or waiving of royalties to the patent holder.
It would help me to understand the feasibility of such calls if I had a
better feel for the investment which might be needed to support this.
I have four questions:
1. What investment would be needed to set up production lines to
produce sufficient of two RTIs (say AZT and 3TC) plus one PI (say
Fortovase) to provide triple combination therapy to (say) 100,000
PLWHAs? This would be specific investment, assuming the normal
infrastructure, including buildings, etc. and 'generic' facilities such as
that required for packaging, was available.
2. How specific would this investment be? If research identified a much
improved therapy, how much of the investment made to produce the
old drug would have to be written off? (I.e. what is the risk involved
in the investment?)
3. How quickly could such a facility be constructed, assuming the basic
infrastructure was available? A secondary question would be to ask if
this assumption is reasonable; would the infrastructure for production
be readily available in the countries concerned? If not, what impact
would this have on cost and time to production?
4. At world prices (if such exist), what would be the cost of the raw
materials required to produce this regimen for 100,000 people?
I recognise that these questions are very general and rather
open-ended. But I'm not looking for exact figures, just orders of
magnitude. Would anyone be willing to stick their neck out to hazard a
guess--or perhaps tell me I'm asking the wrong questions?
Chris W. Green
Jakarta, Indonesia
Tel: +62-21 846-3029 Fax: +62-21 846-1247
e-mail: chrisg@rad.net.id
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