Friday, December 2, 2011

World AIDS Day: Harvard Med Students Advocate For HIV Patent Pool

As a metaphor for joining the patent pool, some Harvard med students and undergrads showed up in swimsuits, carrying an inflatable pool. They more than playfully urged Whitehouse Station to make its HIV and auto-immune disorder intellectual property available -- on a non-exclusive basis -- to the non-profit researchers looking to combat AIDS in the less-developed world. Several other large pharma concerns have nobly agreed to do so (J&J among them). For its part, Merck has said it is still studying the idea. After nearly two years of "study," is time for Merck to decide: is it in -- or out -- of the pool?

Some media coverage, per this morning's online edition of the Harvard Crimson -- do go read it all -- but here is a bit:

. . . ."Merck knows about our campaign," said Yamamoto, adding that she thought Merck held "internal conversations" about the previous demonstrations carried out by Harvard AIDS activists. Yamamoto added that after sustained pressure from the coalition, Merck agreed to meet with them in January 2012.

Harvard AIDS activists said they hope the meeting will increase pressure on Merck to relinquish patents on several of its HIV/AIDS drugs to the Medicines Patent Pool. The Pool opens up patented drugs to generic producers for sale in developing countries and compensates the original patent holders with royalties. . . .

". . .[T]here is a special role for these drug owners because drug prices in the developing world directly impact the availability of critical medicines," said protester Nathan T. Georgette ’13, who wore swim trunks over his khaki slacks and sports coat.

Organizers planned Thursday’s protest to fall on World Aids Day, observed every year on Dec. 1.

"Typically, World Aids Day is a day of remembrance and mourning,” said Yamamoto. “We want to make sure it also sounds a call for action."

Protesters maintained that Merck’s participation in the patent pool would have a dramatic impact on reducing AIDS mortality in developing countries.

"Lots of people throw around the term ‘life-saving’, but these medications literally save lives," said Arjun A. Suri ’08, a Harvard Medical School student who sported a lab coat, stethoscope, and swim trunks. "They turn HIV from a death sentence into a manageable chronic illness. . . ."

In the United States, Merck's Isentress® costs as much as $12,864 per patient per year -- that is more than an average African could hope to earn over two decades. Significantly, Isentress is literally the difference between life -- and death -- it is a miraculous, life-saving wonder.

The largely-admirable United States-only Isentress price subsidy programs offered by Merck (and depicted at right) only apply to those patients with health insurance here, and even if such a discount were offered in the developing world, it wouldn't begin to make a meaningful dent -- the annual cost, even discounted -- is too far out of reach to be of any real use.

Time to decide, Merck.


Anonymous said...

A small blurb from the 3Q11 Crain's revenue round up:

"Prescription drug sales totaled $10.35 billion, led by strong sales of Singulair, Januvia and combination diabetes drug Janumet, the HIV drug Isentress and the Gardasil and Zostavax vaccines.

Read more:"

With #1 in revenue about to fall into the valley of generics, numbers 2 and 3 cannabalizing each other and heading for a merge to be one drug or two less profitable drugs, that brings us to one of the larger cash cows in the stable, Isentress. I admire the Harvard lot and their pressures but I don't see Merck bowing to them.

Letting loose the IP that supports your 3rd or 4th largest seller is dangerous business. We all know how small the world has become and it likely wouldn't be too much of a trick to get the IP freed drug anywhere once it was available somewhere.

But I'm sure Merck will come up with a scheme to help the developing world and keep the IP. If I had to guess they will 'donate' it to the developing world but maintain control of its IP.

Condor said...

Exactly right, Anon. -- the concept is to donate the Isentress tech to a generic manufacturer. It would be trivial to -- by contract -- make the generic version both readily traceable, and visually disinguishable, from the developed-world branded Isentress.

Moreover, Merck really loses very little by letting it be made nearly for free (if that can be acheived at all) in Africa, as there will never be a market for the (ultra-premium priced) branded form of Isentress, there.

No, Meck's game is to get the insured, developed world to pay $13,000 to $17,000 per year. There is effectively only maybe $20 to $40 million to be had -- in all of Africa -- continent wide (if the considerable Mount Kilamajaro of making it VERY cheaply can be summited).

Merck's gloabl revenue is nearly $50 billion a year, now. That less than one percent (generic Isentress in Africa) -- all the continental economy could possible afford to pay(!), even in a perfect world -- where it gets done cheaply -- just isn't really worth chasing, for Merck. It would have to build special plants, locally, and on and on. . .

But the lives all those Africans trying to live with HIV should certainly be worth saving. Think of it -- the patent pool idea -- as an "orphan economy" application, as opposed to an "orphan drug" application.

Namaste, and do stop back!