RPT-Buyers clubs for cheaper drugs help fight hepatitis and HIV

(Repeats with no changes)

* Patients using unofficial channels to access pricey drugs

* New data suggest buyers clubs’ medicines working well

* Generics bought online cost fraction of branded products

By Ben Hirschler

LONDON, Nov 6 Frustrated by the high price of
antiviral drugs, thousands of patients from London to Moscow to
Sydney are turning to a new wave of online “buyers clubs” to get
cheap generic medicines to cure hepatitis C and protect against
HIV infection.

While regulators warn that buying drugs online is risky,
scientific data presented at a recent medical conference suggest
that treatment arranged through buyers club can be just as
effective as through conventional channels.

Will Nutland, who supports a drug-buying network in London
and takes Indian-made generic drugs that are not available
through the health service to prevent HIV infection, thinks the
latest research will build confidence in such schemes.

“This new data shows that so far we’ve got it right,” the
HIV activist said. “It gives us a boost in confidence in the
types of drugs that are available online.”

The buyers clubs’ websites act as middlemen by providing
details of trusted online pharmacies and drug manufacturers,
exploiting a loophole in World Trade Organization patent rules
that allows small-scale imports of medicines for personal use.

Like Ron Woodroof, the 1980s AIDS patient in the movie
‘Dallas Buyers Club’, the sponsors of today’s drug clubs aim to
help patients who can’t get the drugs they want through local
healthcare systems by bringing in medicines from abroad.

But while Woodroof had to smuggle drugs in bulk across the
Mexican border, users of modern-day clubs can, in many
countries, tap orders into their computers quite legally.

Savings can be huge. A month’s generic supply of the
pre-exposure prophylaxis (PrEP) HIV drugs emtricitabine and
tenofovir costs about 45 pounds ($56) online in Britain, around
a tenth of Gilead Sciences’ branded version Truvada.

A Indian-made course of treatment for the liver-destroying
disease hepatitis C, meanwhile, can be had for around 1,000
pounds against a list price for branded drugs of around 35,000.

Gilead is also a leading producer of patented hepatitis C
drugs, along with Merck and AbbVie.

BRAVE ENOUGH TO TRY

“Resorting to a buyers club is clearly not conventional
medicine but it is something some people have been brave enough
to try and it seems to be working,” said Andrew Hill of London’s
Chelsea and Westminster Hospital.

Data presented at the Oct. 23-26 HIV Glasgow conference
showed generic drugs bought via buyers clubs in Australia,
Britain, Russia and South-East Asia by a total of 900 patients
delivered hepatitis C cure rates of around 95 percent. That is
similar to outcomes in clinical trials using the original
brands.

Another piece of research involving more than 200 gay men in
London taking generic PrEP bought through a buyers club found
that their drugs, mostly made by India’s Cipla, were
both safe and effective at preventing HIV infection.

Such observational studies do not have the rigour of
full-scale clinical trials but they do provide reassurance.

“What this sort of data does is give doctors and patients
some faith that this isn’t an act of complete lunacy that is
going to cause patient harm,” said James Freeman, a Tasmanian
doctor behind a hepatitis C drug-buying club.

For Freeman and other critics of the pharmaceuticals
industry, the advent of today’s buyers clubs is just the latest
chapter in an ongoing war over drug prices, with parallels to
the battle over getting cheap HIV drugs into Africa.

In the 1990s, HIV drugs costing more than $10,000 per
patient a year were simply out of reach for millions of people
in the developing world. Today, thanks to cheap generics, the
cost for the poor has been slashed to around $100.

Still, there are obstacles. In a number of European
countries, including Germany, medicines cannot be sent in the
post, prompting some people to collect supplies from friends in
countries like Britain where it is permitted.

Some online pharmacies demand a doctor’s prescription to
fulfil an order, although many do not, and people using buyers
clubs still require blood tests to ensure the drugs they are on
are working properly, without serious side effects.

The need for those laboratory tests is controversial, since
it costs money to test people taking medicines that were not
prescribed by the official healthcare system in the first place.

But Nneka Nwokolo, who presented the data on PrEP in
Glasgow, believes it makes sense, given the proven efficacy of
PrEP in several clinical trials. She works at a National Health
Service (NHS) sexual health clinic in London’s Soho that has
been offering blood tests for generic PrEP users since February.

“HIV rates among gay men are not going down, despite all our
interventions, including promoting condom use. But we know PrEP
works and it has been shown to make a significant difference to
HIV acquisition,” she said.

Clinical trials have shown PrEP cuts the risk of catching
the virus during sex by more than 90 percent.

PATCHY ACCESS

Across Europe and around the world access to PrEP remains
patchy. In Britain, routine use is stalled by a funding row, as
well as doubts over cost-effectiveness, based on the high price
of branded Truvada.

Access to hepatitis C drugs faces similar budget constraints
in many countries, given the high cost of brand-name products.
Gilead’s Sovaldi initially cost $1,000 a pill in the United
States, although competition has since pushed prices down.

Gilead said in a statement that it worked “to ensure broad
access to its medicines through dialogue and efforts with payers
and other stakeholders, including governments.”

But HIV activist Nutland, who is also a research fellow at
the London School of Hygiene and Tropical Medicine, believes
drugmakers must do more to make their products affordable.

“It’s an absolute scandal that the prices are so high that
even wealthy national services are saying they cannot afford the
costs of these drugs.”
($1 = 0.8015 pounds)

(Editing by Anna Willard)

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