The HIV Medicine Association (HIVMA) today called on Abbott Laboratories to rescind its recent 500 percent price hike of ritonavir (Norvir®), a drug necessary to the success of virtually all protease inhibitor combinations for treating HIV infection.
Although ritonavir has little anti-HIV activity of its own at currently used doses, it has become an essential part of many protease inhibitor combinations because it enhances the effect of other anti-HIV drugs. The new pricing means that ritonavir-boosted drug combinations will likely become substantially more expensive.
"While we recognize the value of ritonavir, we are alarmed by your decision to raise the cost of protease inhibitor regimens to the point where many people who need these life-saving drug combinations will struggle to pay for them or won't have access to them at all," said Paul Volberding, M.D., chairman, and Daniel Kuritzkes, M.D., vice-chairman, of the HIVMA Board of Directors, in a letter to Abbott. "In addition to our particular concern about the price increase for ritonavir, we are generally concerned about continuing upward pressure on prices as each new HIV drug is approved."
The letter acknowledges the important role Abbott played in developing "boosted" protease inhibitor regimens, but asks the drug manufacturer to consider the following detrimental effects of the price hike:
The decision increases the Average Wholesale Price of ritonavir to $8.55 for 100 mg, which equates to a monthly total of $260 for patients who take 100 mg daily as part of an ATV/RTV regimen. Previously, the monthly price was $45.
This much higher cost will likely raise insurance premiums and increase the amount of individuals' co-payments for ritonavir -- co-payments that most people with HIV/AIDS can ill afford.
The dramatic increase in price could cause payors to impose restrictions on available HIV/AIDS therapies.
AIDS Drug Assistance Programs (ADAPs) may have to pay more. The price increase will result in higher profits to the pharmacy and wholesaler, which will translate into higher costs to ADAPs, if the reimbursement rate used for pharmacies is indexed to the Average Wholesale Price.
The price hike may create budget problems for ADAPs, since the lag time between payments to pharmacies and receipt of rebates from the manufacturer can be as long as six months.
"This increase comes at a time when public programs that provide access to HIV treatment are struggling to keep costs down, and numerous ADAPs have been forced to impose eligibility and formulary restrictions and/or waiting lists," the HIVMA letter concludes. "We are deeply disappointed that Abbott has taken a step that will increase costs to these vital safety net programs. On behalf of our members and their patients, we urge you to rescind the price increase for ritonavir."
The HIV Medicine Association (HIVMA) is the professional home for more than 2,600 physicians, scientists and other health care professionals dedicated to the field of HIV/AIDS, not only those trained in infectious diseases. The Association promotes quality in HIV care and advocates for policies that ensure a comprehensive and humane response to the AIDS pandemic informed by science and social justice.
HIVMA's letter to Abbott is available on the HIVMA Web site.