Wall Street Journal examines reason Abbott increased price of ritonavir

Previously undisclosed documents and e-mails reviewed by the Wall Street Journal indicate that executives at Abbott Laboratories attempted to “diminish the attraction” of the company’s antiretroviral drug ritonavir (Norvir) by increasing the price of the drug.

Ritonavir is used in combination therapies that include drugs manufactured by pharmaceutical companies other than Abbott. According to the documents and e-mails, in the Autumn of 2003 the company “grew worried about new competition to” its antiretroviral Kaletra, and the company’s executives began discussing ways to decrease the popularity of ritonavir with the “goal of forcing” HIV-positive people “to drop the rival drugs and turn to Kaletra”.

In December 2003, Abbott quadrupled the per-patient wholesale price of ritonavir in the US, which is used primarily as a booster for other protease inhibitors, such as atazanavir, saquinavir, fosamprenavir and indinavir. Abbott exempted US Medicaid, Medicare and state AIDS Drug Assistance Programs from the price increase, and the company announced that it would expand its patient assistance program. Institutions, such as state prisons, were not exempt from the price increase.

The cost of ritonavir increased from $51.30 to $257.10 for 30 100mg capsules, or by $5,000 more annually, which made Kaletra – costing $7,000 annually – the less expensive option for HIV-positive people residing in the U.S., according to the Journal. The increase “created a huge price discrepancy” between Kaletra and rival drugs, according to David Wohl, an associate professor at the University of North Carolina who also works with HIV-positive prison inmates. Abbott has said that it did not increase the price of ritonavir to promote Kaletra and that the increase did not affect other drug companies. According to Abbott, the price increase was intended to better show ritonavir’s medical value, the Journal reports.

According to the Journal, the price increase “triggered an uproar” among some HIV/AIDS advocates and physicians. After a May 2004 hearing to consider authorisation of a cheaper generic version of ritonavir before its patent expired, NIH stated that it did not have the authority to determine if a drug’s price was too high and ruled against a generic. The public “outcry faded” over time and “[private health insurers took a bigger blow but had little leverage, because they could hardly deny patients a lifesaving drug”.

Illinois Attorney General Lisa Madigan has been investigating ritonavir’s price increase for three years and has said that it might violate the state’s consumer fraud law. In addition, a lawsuit filed in U.S. district court in Oakland, Calif., by two HIV-positive people and the Service Employees International Union’s Health and Welfare Fund is scheduled to go to trial in early 2008, the Journal reports.

Source: Kaiser Daily News: Wall Street Journal examines reason Abbott increased price of antiretroviral Norvir (Jan 03, 2007)

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