Abbott situation worsens in Thailand

In the last issue of HTB we reported the ongoing issue of access to drugs produced by the US manufacturer Abbott Laboratories for patients in Thailand. [1]

The discussions between the Abbott and the Thai government had failed to resolve a price agreement suitable for both parties, and the Thai government announced that it would issue a compulsory license, applicable under the TRIPS trade agreement, to manufacture a generic version of the Meltrex formulation of lopinavir/r (Kaletra). In response, Abbott announced that they would not sell Maltrex Kaletra in Thailand.

This generated criticism against the companys decision, including from Medecins sans Frontiers (MSF) in a press release issued on 15 March. [2]

An editorial comment in the 24 March issue of the Lancet reported the case, and criticised WHOs Director-General, Margaret Chan for her comments that sided with the pharmaceutical industry (although followed by a swift retraction) rather than supporting the critical importance of generic antiretrovirals in treating the majority of people affected by HIV globally. [3]

Thailand is both in need of second-generation regimens for treatment experienced patients, and heat stable non-refrigerated options, as temperatures are commonly over 40 degrees C.

The situation has now escalated with Abbott deciding to restrict access to a wider range of its other medicines by withdrawing all pending drug registration applications in Thailand.

In response, the Thai network of people living with HIV/AIDS (TNP+) in solidarity with a broad alliance of other NGOs and HIV/AIDS activists have called on a global boycott of Abbott products (where alternatives are available), and for other action around the world.

Comment

The Thai government can probably afford to settle at a higher price and Abbott can certainly afford to settle at a lower price (the latest figure of $2000 US per year is still significantly higher than the lowest price of $500 per year for the worlds poorest countries). This issue is likely to continue to run with the health of HIV-positive people held in the balance.

It is difficult to understand why Abbott will not take a similar approach to other pharmaceutical companies involved in access to HIV medicines by agreeing licenses for generic production of its drugs in countries where HIV is a leading health issue.

Currently over 100,000 HIV-positive people receive treatment in Thailand using the governments fixed dose generic combination of d4T/3TC/nevirapine, approximately 20% of who are now in need of a second-line combination.