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ARV price hikes linked to private healthcare - Govt
PLUS News
September 29, 2006

http://www.plusnews.org/AIDSreport.asp?ReportID=6418

JOHANNESBURG - Zimbabwean Minister of Health David Pariyenyatwa said on Friday he was not aware that prices of anti-AIDS drugs had been hiked, but pointed out that steep private healthcare costs were pushing more HIV-positive patients to use public healthcare.

Pariyenyatwa was responding to reports by the official Herald newspaper earlier this week that the cost of antiretrovirals (ARVs) had gone up by between 50 percent and 65 percent - from US$62 in July to $103 currently - for a month's supply of ARVs, putting the drugs beyond the reach of many.

"If anything, the report might be pointing to prices in the private health sector, as we [government] get our ARVs cheaply from Varichem [the local manufacturer of generic ARVs] and then distribute them to the public at no cost," the minister told PlusNews.

Patients obtaining the drugs from the government scheme were expected to pay a mandatory hospital administration fee of Z$0.50 (less than US$0.01) but received the medication free of charge.

Varichem became the sole local manufacturer of generic ARVs in 2004, using raw materials imported from Europe and Asia to make ARVs affordable to Zimbabweans living with HIV/AIDS.

A source in the pharmaceutical industry suggested that the confusion about prices might be caused by wholesalers and retailers who received medicines at discounted prices and then added huge mark-ups.

For example, Varichem's Stanalev-30 tablet - a three-in-one ARV comprising Stavudine, Lamivudine and Nevirapine - was sold to wholesalers at the current price Z$11,958.71 (US$49), but was marked up to Z$16,610.00 (US$69) before the pharmacy dispensing fee of Z$170.00 (U$0.07) was added.

"At least 6,000 HIV-positive people get treatment from private healthcare facilities, but those numbers are dwindling because these people realise that they can get treatment for free with the government," Pariyenyatwa said. The government programme caters for only 42,000 of the estimated 600,000 people in need of ARVs.

Although no information was available on the number of private patients moving into the public healthcare sector, Amon Mpofu, evaluation and monitoring manager at the National AIDS Council (NAC), said a new strategic framework for making larger quantities of ARVs available in the government programme was being drawn up.

Local AIDS activists had meanwhile warned of a myriad of far-reaching consequences that could result from the price-hikes.

Lynde Francis, founder of The Centre, an NGO providing treatment, care and counselling for HIV-positive people, said: "Among these concerns are ARV treatment interruptions for scores of middle-income earners who would no longer be able to afford the drugs."

She expressed concern that such pricing hurdles might also result in the sharing of drugs between two or more infected members of a particular family unit, and ultimately to resistance being developed by these patients to their daily regimens.

Francis suggested that the government should already now start looking at ways of addressing such a scenario, if one occurred.

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