No change in drug price

Meningitis-fighting medication sold at higher rates than promised

PHARMACEUTICAL corporation Gilead Sciences had failed to deliver on promises to make an important drug available to people suffering from a life-threatening HIV-related infection, the medical humanitarian organisation Doctors Without Borders (MSF) said.

Nearly one year ago, Gilead announced its “access initiative”, promising lower prices for liposomal amphotericin B (L-AmB) in 116 developing countries, but to date, the drug largely remains inaccessible.

Gilead has registered the drug in only six of the 116 countries, and even where it is registered, the drug is unavailable at an affordable price, for MSF and others.

L-AmB is highly effective when used in combination with other medicines to treat cryptococcal meningitis, which is the second-biggest killer of people living with HIV, after TB.

Cryptococcal meningitis is an infection of the brain, which if left untreated, results in an agonising death for people living with HIV.

Just over a year ago, the drug was recommended by the World Health Organisation (WHO) as the preferred treatment over a suboptimal, more toxic treatment (AmB deoxycholate), as the safety benefits and fewer sideeffects associated with L-AmB could improve treatment outcomes and management in low-resource settings where most cases of cryptococcal meningitis occur.

WHO, however, recognised that high prices and a lack of registration of L-AmB created major barriers to people accessing this drug in developing countries.

Although Gilead publicised their pledge to reduce the price of the drug to a “no-profit” price of $16.25 (R200) per vial in September 2018, L-AmB continues to be priced out of reach in many developing countries.

For example, in South Africa, the drug is priced as high as $200 per vial (at least $4200 per full treatment course).

National programmes and treatment providers are still unable to purchase the drug at the corporation’s promised price.

“We are outraged that Gilead’s announcement to provide this lifesaving drug at a supposed “no profit” price and expedite its registration appears to have been nothing more than a public relations stunt,” said Jessica Burry, MSF Access Campaign pharmacist.

Cryptococcal meningitis kills more than 180000 people every year, 75% of whom live in sub-Saharan Africa. It especially affects people living with HIV whose immune systems are severely suppressed, leaving them vulnerable to such deadly opportunistic infections. MSF treats the infection in all its HIV programmes, including in Democratic Republic of Congo, India, Malawi, Myanmar and South Africa.

The Cape Times contacted the company for a response, but it had not responded by the time of going to print.

Gilead has registered the drug in only six of the 116 countries Gilead Pharmaceutical company