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AIDS treatment provider says the high price of Merck's Isentress is limiting patient access. Merck says banning its reps is what limits access. While Mom and Dad are fighting, does the patient lose out?
AIDS Healthcare Foundation (AHF) centers won’t be seeing Merck reps again anytime soon. AHF released a statement Monday banning reps from its US clinics, citing what foundation President Michael Weinstein calls the “reprehensible” high cost of the company’s first line treatment Isentress (raltegravir).
According to AHF, the average annual wholesale price of Isentress-first introduced in 2007 as a salvage therapy-is $12,868 per patient. Merck officially cites the wholesale acquisition cost as $10,895. The monkey wrench: State AIDS Drug Assistance Programs (ADAP) budget only $8,088 for each patient.
Merck defends Isentress’ pricing, saying it’s comparable to other drugs with similar mechanisms, and that they froze the cost from 2008 until the end of 2010. But AHF says that price reflects Isentress’ status as a salvage drug.
The company says it shares AHF’s goal of access, and keeping Merck reps away only impedes that goal. “We have our own support program that has people dedicated to helping patients navigate the coverage arena,” said Merck spokeswoman Amy Rose. “And if they aren’t covered for the drug their physician prescribes, and it’s a Merck drug, we make it available to them for free.”
Rose added that while the company doesn’t speculate on future pricing, post-freeze prices are “certainly under discussion.”
AHF director of communications Ged Kenslea pointed out that the Foundation supports Isentress as a product, and says exiling the Merck reps is a symbolic gesture that will not have a direct impact on patients. “We hope it’s more than just a slap on the wrist,” he said. “[Pricing] is something we feel very strongly about.”
In fact, AHF has targeted other companies’ pricing policies in the past. “It was Merck’s turn, because they have the highest priced antiretroviral in the US. Someone had to be the beauty queen,” said Kenslea.
He added that Merck’s Isentress patient assistance program is not enough. “North Carolina instituted a waiting list for ADAP yesterday,” he said. “Five hundred forty people in nine other states are also on waiting lists. Even one person on a waiting list for this is an embarrassment.”