Advocacy in Ukraine results in drastic price reduction for HIV drug, raltegravir

The All-Ukrainian Network of People Living with HIV/AIDS (the Network) has received an official letter from Merck, dated 15 March 2019, confirming a price reduction for essential medicine, raltegravir.

The reduction will take the cost per pill to approximately $2.75 (USD), down from approximately $5.50 per pill. This successful negotiation means that currently this is the cheapest price for raltegravir across the Eastern Europe and Central Asia region. 

Raltegravir is on the World Health Organization’s (WHO) list of essential medicines, recommended for pregnant women and in second-line regimens in accordance with WHO treatment guidelines.

Changing things for the long-term

The price reduction is result of long-term negotiations with patent holder Merck, which started several years ago.

The first result of the Network’s advocacy was Merck’s decision to drop the patent protection on a HIV combination drug, tenofovir/emtricitabine/efavirenz, branded as Atripla in Ukraine.

When generic versions of the combination entered the country, the price of treatment fell from $354 per person per year, to less than $95. Annual savings for the health budget were estimated to be as much as $318,400, which would allow nearly an additional 3,000 people to be treated per year.

Following this success the Network turned its attention to raltegravir.  “We made the point to Merck that one of its aims must be to close the treatment gap as soon as possible,” says Mykyta Trofymenko, the Network’s Intellectual Property (IP) expert. “Considering the transition facing Ukraine, moving from donor funding to 100 per cent state funding in the next few years, all efforts must be made to decrease the price essential medicines in order for the health ministry to procure treatment for everyone who needs it and achieve universal access. As a result the company agreed a 50% decrease price for the medicine.”

Ultimate goal

“We welcome this decision,” says Trofymenko. “Any socially responsible company should have a price policy which aims to cover the largest number of patients possible. However, even though the price for Merck’s product is now the lowest in the region there is no getting away from the fact that the generic price is much lower even in comparison with the new, reduced price. Therefore we will continue our work, with the ultimate goal of securing cheaper, generic alternatives.”

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