The most common and often deadly epidemic in developing countries — AIDS — could be shrunken.
That’s thanks to the big pharma company Merck. The company’s got a new HIV-fighting drug, called telaprevir, which is said to work not only on viral load but also on virus phenotype — the biological appearance of the virus that determine how it’s activated.
This new pill is much different from the pills we’re used to taking. Until this year, Merck’s telaprevir was developed and sold under the name Gilead’s triple-tablet that claimed a whopping 40 percent market share in the United States.
The healthcare industry is paying attention, too. Merck plans to share its formula with a range of poor countries in Africa and Asia for free.
“It’s a huge advantage to get it developed for these countries,” said Peter Piot, the executive director of UNAIDS, an HIV/AIDS advocacy group. “All you have to do is ask for it.”
Here’s the way they plan to spin it: Merck’s generic version of its dual pill will be made in a low-cost facility in Brazil, India and Indonesia. When the drug becomes available in those countries, the Brazil-Indonesia plant will be joined by a new one in Zambia, which will be added by 2014. The two plants should be able to churn out as many as 500 million pills a year.
Like the 3G, 4G, 3G model with which Americans are familiar, the Afghan, Nigerian and Bangladeshi pharmaceutical companies will then make the product on the same scale, at a lower cost, and market it to the rest of the world.
The plan sounds like a win-win for the poor and the developing world — except for the trade issues. One big concern is that the new access to Merck’s product will mean the people in developing countries could save a few dollars on their HIV drugs instead of getting new ones at discounted prices.
“Nobody wants to see a generic version of Gilead. We all want affordable AIDS care. But the basic problem is that Gilead sets the price. No one else can change it,” said Andrew Montagnier, who leads a campaign called the Combating AIDS Partnership from Redirecting and HIV Prevention in Africa, or CAMP HOPE, a Washington, D.C., nonprofit group.
Still, activists and poor countries are open to the Merck plan, thanks to the development of a generic-style advantage. The terms Merck has offered its partner in Mozambique, for example, include royalties and an opportunity to promote their product when Merck’s product goes out of production.
I emailed one Mozambican government official to ask about the pros and cons of Merck’s product and have yet to hear back. But the original agreement that allowed Merck to export its drug — called Essential Medicines Lists in the developing world — didn’t let it be cheap enough to do business in other countries.
“I think we’re the only ones who beat Merck to the punch,” said Montagnier.
Piot, the UNAIDS boss, compares the Merck moment to the iPhone, noting it’s been clear for some time that we’re going to have to find a way to save these medications to prevent them from going out of the market. So these big pharma companies may have been like original iPhone suppliers at the launch.
“Without a doubt it’s such a big cost now that it’s impossible to lose. At least not now. They’re doing it,” he said.