Thanks to a licensing agreement with Viiv Healthcare (part of the USA’s GlaxoSmithKline group), an apparent monopoly over the sale of the highly effective HIV drug dolutegravir is arising in India. Dolutegravir is considered to be the best in HIV drugs, quickly reducing virus levels and with a higher barrier to resistance than other available drugs.
Having only received Indian drug control approval last month, it is the latest in innovative HIV treatment. The drug works by blocking an HIV enzyme called integrase, preventing its replication and thereby reducing the amount of HIV in the blood. The speed at which this particular drug works is considered almost revolutionary, and has the potential to significantly reduce the risk of further transmission of the virus.
The Indian monopoly will be held by Indian drugs company Emcure, who hold the licensing agreement with Viiv Healthcare. Other drugs companies, including Cipla, Aurobindo Pharma, Hetero and Strides Arcolab are licensed to sell the drug in around 50 other low and middle income countries. These companies are able to sell the drug on the public market and through NGOs in India, but the private market is restricted to Emcure.
Activists, including a number of eminent doctors in the field of HIV care, are concerned that this lack of private market competition could drive prices up. As a result, many patients would be unable to access what is currently the best HIV drug on the market. With India having the third largest HIV epidemic in the world, it is a significant market for the drug company holding the license for dolutegravir.
Those who have raised concerns are fighting for the rights of access to proper medical care of an estimated 2.1 million people suffering from HIV in India. HIV sufferers are largely reliant on private markets for up-to-date drug access, as patients have found the National AIDS Control Organisation (NACO) to be lagging behind in utilizing new treatments. Antiretroviral treatment (ART) is currently available free to HIV patients, and has been so since 2004.
In an attempt to counteract the Emcure monopoly, both doctors and other organizations have challenged the Competition Commission of India and the price regulator to ensure fair practice.
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