The international medical humanitarian organization Médecins Sans Frontières (MSF) today denounced Abbott Laboratories' decision not to market its new medicines in Thailand.
The Chicago-based multinational pharmaceutical company has cited Thailand's use of compulsory licenses as a reason for taking the drastic measures. MSF notes that the use of compulsory licenses to improve access to essential medicines is consistent with international laws, and is concerned that patients will bear the brunt of Abbott's harsh decision.
Among the drugs the company is refusing to sell in Thailand is the new, heat-stable version of the medicine lopinavir/ritonavir (LPV/r), marketed by Abbott as Kaletra. The drug is a vital component of treatment for a growing number of people living with HIV/AIDS who no longer respond to their first set of medications.
In the US, Abbott no longer sells the old version of the drug, which requires refrigeration. The company will continue to sell it in Thailand, though, where tropical temperatures make it highly impractical to use.
"Our patients in Thailand, who still use the old version of the medicine, have been waiting for this new version for a very long time," said Dr. David Wilson, of MSF in Thailand. "The drug was registered in the US in October 2005, but still cannot be used in Thailand and many other countries where it is desperately needed. Refusing to sell the drug here is a major betrayal to patients."
MSF currently provides treatment to more than 80,000 people living with HIV/AIDS in over 30 countries. In one MSF project in Khayelitsha, South Africa, 20 per cent of patients needed to be switched to a second-line regimen after being on treatment for five years. While the needs for second-line regimens are likely to increase in the coming years, medicines used for second-line therapy are mostly unavailable or unaffordable in developing countries.
Since November 2006, Thailand has issued compulsory licenses for three medicines, including the AIDS drugs efavirenz and lopinavir/ritonavir. The director of the World Health Organisation (WHO), Margaret Chan, and the director of UNAIDS, Peter Piot have both spoken in favor of governments using all flexibilities of the World Trade Organization's agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS). MSF is calling on WHO, UNAIDS, governments, and other international bodies to denounce Abbott's move.
"Thailand's move to issue compulsory licenses is an important way to help bring prices down and increase availability of medicines," said Ellen 't Hoen, Policy Director at MSF's Campaign for Access to Essential Medicines. "In light of this, Abbott's move is appalling."
Nearly one year ago, Abbott announced a price of US$500 per patient per year for Africa and least-developed countries. In August 2006, the company announced a price of US$2,200 per patient per year in low-income and low-middle income countries, such as Thailand, which far exceeds what people can afford. Today's standard three-in-one first line AIDS treatment in developing countries is currently available for US$140 per patient per year.
Abbott has failed to provide any information in response to MSF's repeated requests for a registration status update. MSF and other groups have consistently been calling upon the company to register the new version of the drug in developing countries, so that it can be used by patients in resource-poor settings.
"These discounted prices from Abbott exist only on paper, because the company has been dragging its feet about registering the product in many countries," said Dr. Tido von Schoen-Angerer, Director of MSF's Campaign for Access to Essential Medicines. "And now they have gone even further by withdrawing registration from Thailand, a tactic that effectively holds patients hostage."