Geneva - Starting in April last year, Médecins Sans Frontières (MSF) has been urging pharmaceutical company Roche to reduce its price for nelfinavir (brand-name Viracept‚), a crucial second-line AIDS drug that was priced out of reach of most patients in developing countries.

Roche's announcement today that they will sell nelfinavir with significant reductions in poor countries is a welcome result of this long campaign. "We are very pleased with this price reduction, and glad to see that Roche acknowledges that their pricing policy was flawed," explains Daniel Berman, from MSF's Campaign for Access to Essential Medicines.

"The long struggle to reduce the price of this Roche drug is proof of the limitations of a fully voluntary system. For new drugs, there needs to be an internationally-supported enforceable system that reduces prices to affordable levels in developing countries." Generic competition remains the most effective means to push prices down. However, for newer drugs for which no generic equivalents are available, a system of affordable prices from originator companies is critical.

The case of nelfinavir

While other AIDS drug producers taking part in the UN Accelerating Access Initiative had long ago set up a differential pricing system for poor countries and were offering drugs at 87-92% off Swiss prices, Roche was only offering a 40-50% discount.

In fact, nelfinavir was significantly more expensive in Guatemala (US$8,358 per patient per year) and the Ukraine (US$7,110) than in Switzerland (US$6,169). With this new discount, Roche will now charge approximately US$900 per patient per year for least developed countries and sub-Saharan Africa, down from US$3,171.

At just over 85% off Swiss prices, this discount is equivalent to those offered by other multinational pharmaceutical companies. Roche has also established a price of just under US$3,000 per patient per year for middle-income countries, unfortunately only 48% off Swiss prices. It is also important to note that Roche's published prices are "ex-factory": additional fees for freight and insurance will be added to the drug price, raising the price by around 20% for the customer. Published prices by other pharmaceutical companies such as Merck and Bristol-Myers Squibb already include these charges.

For many years, MSF has been caring for people living with HIV/AIDS in developing countries.

Medical projects include prevention efforts, voluntary counselling and testing, psychosocial support, prophylaxis and treatment of opportunistic infections. MSF started providing antiretroviral treatment to patients with HIV/AIDS in 2001.

MSF now treats 2,500 patients in Cambodia, Cameroon, Guatemala, Honduras, Kenya, Laos, Malawi, Mozambique, South Africa, Thailand, Uganda and Ukraine. This year, MSF will double its intake of patients in existing projects, and will open new projects in Burkina Faso, Burma, DRC, Ethiopia, Guinea, Indonesia, Nigeria, Peru, Rwanda, Zambia, and Zimbabwe.