Federal officials, HIV/AIDS groups and consumer advocates on Wednesday at a hearing focusing on drug reimportation plan to discuss the pricing of Abbott Laboratories' antiretroviral drug Norvir, which has "quite suddenly become a touchstone in these swirling debates," the New York Times reports (Harris, New York Times, 4/14). In December 2003, Abbott increased by 400% -- from $54 per month to $265 per month -- the per-patient wholesale price of Norvir, which is known generically as ritonavir. Norvir is used primarily as a booster for other protease inhibitors, such as Bristol-Myers Squibb's Reyataz and Merck's Crixivan. On Feb. 6, Illinois Attorney General Lisa Madigan (D) announced that her office had opened an investigation into whether the price increase of Norvir was designed to increase the price of antiretroviral drug combinations that use Norvir as a booster and steer patients toward Abbott's newer antiretroviral drug Kaletra. Kaletra, which does not need a booster for other protease inhibitors because it includes ritonavir, costs about $18.78 per patient per day, or $563.40 per patient per month, and has a longer patent life (Kaiser Daily HIV/AIDS Report, 3/19). Currently, consumers at a drugstore in the United States would pay $715 for a one-month supply of 200 mg Norvir pills, compared with $540 from the Web site Drugstore.com and $59 at a drugstore in Canada, the Times reports. Dr. John Leonard, Abbott's vice president of drug development, said, "To continue the work in HIV and other therapeutic areas, we decided the appropriate thing to do to resource our program was to make up our losses with the price increase" (New York Times, 4/14).

"Unexpected Urgency"
The HHS Drug Importation Task Force on Wednesday at the NIH campus in Bethesda, Md., will consider the "safety and feasibility of allowing drug importation from Canada," according to the AP/St. Paul Pioneer Press (Ross, AP/St. Paul Pioneer Press, 4/14). According to the Times, the "escalating protest" over the Norvir price increase has given the reimportation issue "unexpected urgency." Although some federal officials have said that imported drugs do not have the same consumer protections against "dangerous counterfeits" or any of the "safeguards" that come with drugs approved for use in the United States, supporters of reimportation say that it could be the "only way to make medicines affordable," the Times reports. Sen. Charles Schumer (D-N.Y.) said, "Norvir is sort of a nexus of all the bad practices that all the drug companies use. Abbott should understand that what they're doing invites scrutiny and change." Alan Holmer, president of the Pharmaceutical Research and Manufacturers of America, said, "The cost of AIDS medicines today is what funds the research for the better treatments and cures for tomorrow. It's true that other developed countries are free-riding on American research and we need to address that, particularly in trade agreements" (New York Times, 4/14). AIDS Healthcare Foundation President Michael Weinstein said, "We welcome both government and public scrutiny of Abbott's actions," adding that "[o]ne possible silver lining in this debacle is the fact that Abbott's greed has put a newfound focus on ... the movement to legalize the importation of less costly Canadian drugs" (AHF release, 4/14).

"Reasonable" Price
In cases involving drugs that were developed with federal funding -- as Norvir was -- the government reserves the right to demand "reasonable" prices from the drug maker, although it has never done so, the Times reports. Federal health authorities fear that any effort to control drug prices could discourage drug companies from collaborating on research with federal agencies, according to the Times. However, James Love, director of the Consumer Project on Technology, which advocates for lower drug prices, said, "The taxpayers already paid for this invention, so if anything [Norvir] should be cheaper in the United States." Love has petitioned NIH to insist on a reasonable price for Norvir, and six House members -- including Reps. Sherrod Brown (D-Ohio) and Henry Waxman (D-Calif.) -- recently sent a letter to HHS Secretary Tommy Thompson asking him to support the move, according to the Times. In addition, NIH is planning to convene a hearing that has yet to be scheduled on whether the government should allow generic versions of Norvir to be manufactured before Abbott's patents expire, the Times reports. NIH spokesperson John Burklow said that the agency wanted to "provide a venue for public input on this issue" (New York Times, 4/14).

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