Demand for two originator ARVs could soon exceed supply

People living with AIDS in developing countries that currently use d4T manufactured by BMS, may face a shortage. This was recently communicated to MSF by BMS, and was confirmed in the Wall Street Journal last week (“Demand for Two AIDS Treatments Could Soon Exceed Supply”, e-drug March 9th). In the article Paul Lalvani, procurement manager for the Global Fund in Geneva, said that some developing countries “have not been able to access the product”.

Considering the shortage of the BMS product it is important to note that on March 1st, WHO published a new edition of the prequalification list that included stavudine, and the combination stavudine/lamivudine from the Indian manufacturer Strides (both 40 mg). The other prequalified option is Cipla’s Triomune, stavudine/lamivudine/nevirapine (both 30 and 40 mg). The annual prices for these generic drugs are $51, $142 and $221 respectively (USD). They can be found in the MSF document “Untangling the web of price reductions: a pricing guide for the purchase of ARVs for developing countries”, 7th edition, February 2005.

This case illustrates the importance of having several sources of a drug available to face shortages and production problems. The originator companies alone do not have either the financial interest or the capacity of production to assure supply to developing countries.

Comment

It has been clear for a long time that no single company has the manufacturing capacity or capability to meet the World demand for ARV treatment – even if funding and infrastucture were immediately in place.

This story highlights these concerns and the critical importance of both brand and generic manufacturers supplying HIV medications