The petition
Consensus Statement to Abbott Laboratories from the HIV Community Regarding Pricing of the New Norvir (Meltrex) Formulation
June , 2009
Miles White
CEO and Chairman
Abbott Laboratories
Dear Mr. White:
The undersigned represent organizations, coalitions, researchers, physicians and individuals working on behalf of people living with HIV/AIDS; many of us are living with HIV/AIDS. We are gravely concerned about your pricing intentions for the new Norvir (Meltrex formulation), and urge you not only to not increase the price over the current formulation, but to decrease the price to the 2003 Norvir price. We know you are aware of the controversy, ill will, and hardship in the community as a result of the 400% 2003 price increase. At a time when the nation is in an economic crisis, and healthcare costs have become unsupportively high, the cost of the new Norvir could have a profound impact on public and private payers and most importantly, on people living with HIV.
Any additional Meltrex price hike will set a detrimental precedent and will have serious long-term consequences for insurance premiums and patient co-payments. Third party payers may refuse to include the Meltrex formulation on formularies. Even if Abbott continues to offer a patient assistance program (PAP), no PAP can address the added burden this price hike will put on healthcare financing as a whole.
We also have no guarantee that the unrestricted PAP will continue. Further, Abbott has not publically agreed to include Norvir in its patient co-pay program and has threatened to discontinue production of the presently marketed Norvir.
Because of critical cuts and shortfalls in healthcare financing, we urge Abbott to agree to hold Medicaid and AIDS Drug Assistance Programs (ADAPs) cost neutral with respect to the Meltrex formulation. Due to the complexity of holding a drug cost neutral for programs that use rebates and retail pharmacy networks, we are requesting detailed assurances that all public payers will be treated equally under any agreement.
Abbott's past decisions have limited current and future treatment options for people with HIV. While the price of Abbott's own Norvir-boosted protease inhibitor Kaletra did not change in 2003, the average wholesale price of a one-month supply of a 100mg boosting dose of Norvir was increased from $130 to $650. Protease inhibitors, such as Prezista, Reyataz and Lexiva that use Norvir now cost up to twice as much. Abbott has already effectively dealt people living with HIV and their third party payers an ultimatum: switch to Kaletra or add thousands of dollars to your prescription drug costs. A Meltrex price increase will only exacerbate this problem.
Any new price hike will be particularly devastating to those who are treatment experienced or on salvage regimens. Their future treatment options may be dangerously limited by exorbitant costs. Abbott has thus far failed to co-formulate Norvir with other compounds, severely limiting the many possible anti-HIV co-formulated regimens that are being produced generically in the developing world. Again, it is unconscionable that taxpaying United States citizens who paid for most of Norvir's development do not have access to these budding co-formulations because of Abbott's refusal to cooperate with other HIV companies in this regard. It is also a very shortsighted business practice on Abbott's part.
The HIV community is again mobilizing around your anticipated Meltrex price hike and increased prices to government payers. The undersigned members of the HIV community will not tolerate yet another profit grab that will limit treatment options and hold people with HIV hostage to price gouging. We intend to rally HIV medical groups, researchers and physicians to terminate their relationships with Abbott including meeting with sales representatives, serving on Abbott boards, working as Abbott consultants and attending Abbott functions. We will also request that physicians boycott Kaletra when in their best judgment other antiviral therapies are medically indicated and to avoid other Abbott products when it is medically possible to do so without harming patients. We also intend to alert the press and relevant governmental officials that Abbott has taken yet another Norvir related price hike.
We urge Abbott to:
Roll back the price of Norvir and the new Meltrex formulation to the pre-December 1, 2003 Norvir price,
Not to increase the burden on public payers such as 340B, ADAP and Medicaid
Not to discontinue currently marketed Norvir, and
Include both Norvir and the Meltrex formulation on its patient co-pay program.
Signed,
cc: John Leonard, M.D., Senior V. P., Abbott Laboratories
Richard Klein, Office of Special Health Issues, U.S. FDA
Lisa Madigan, Attorney General of Illinois
Andrew M. Cuomo, Attorney General of New York
Christine A. Varney, DOJ, Antitrust Division
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