The price for an annual course of triple therapy consisting of AZT, 3TC and Nevirapine in South Africa would cost around R20 000 (around R1 700 per month) before VAT and the chemist’€™s mark-up is added. In contrast, the same course of generic ARVs would cost around R3 300 year (or R275 a month).

The huge profit margins of the drug companies forms the basis of a complaint lodged last year at the Competition Commission by a group of people living openly with HIV/AIDS, health workers, labour and civil society.

The Congress of SA Trade Unions and the Treatment Action Campaign have added their weight to the complaint.

Presenting to Parliament’€™s portfolio committee on health, Jonathan Berger of the AIDS Law Project accused drug companies of charging the private sector excessive prices for ARVs to the detriment of consumers.

The accused companies are GlaxoSmithKline (GSK) South Africa, its head office in the United Kingdom, Boehringer Ingelheim (BI), Ingelheim Pharmaceuticals and its office in Germany as well as any other related companies.

The drugs forming part of the complaint include the capsules, tablets and paediatric solutions of AZT, 3TC, Combivir and Nevirapine.

Berger said the commission had called for further complaints to be sent before a February 4 deadline this year.

‘€œIn terms of the Act they have up to a year to investigate a complaint before publishing their findings,’€ he said.

The complaint was lodged on September 19 last year and the complainants have urged the commission to treat the charges as a matter of urgency, to use its full powers of investigation (search, seize and summons) and to refer the matter to the Competition Tribunal.

It has further requested the Competition Tribunal to order the companies to stop charging excessive prices and to impose substantial administrative penalties (up to 10% of total turnover in South Africa). Such a move could see a company such as GlaxoSmithKline Pharmaceuticals having to fork out up to 10% of their annual turnover, logged at R650-million.

‘€œThis figure excludes their turnover on their non-pharmaceutical products such as Horlicks, Lucozade and Tobasco,’€ Berger pointed out.

Key to the complaint is laying out how these prices limit access for people who either pay for their own treatment, those in workplace treatment programmes, on clinical trials or community programmes and those on medical schemes.

Berger pointed out that for those forced to pay for their own treatment the choices often lay between settling for no treatment or substandard treatment. For example a patient may use the public sector facilities to have their tests done or to treat their opportunistic infections, but are forced to turn to the private sector for their drugs. They often opt for drugs and regimens according to price (what they can afford). This forces people to take drugs that cause side-effects or that are not as effective (two drug regimen as opposed to triple combination).

Those on workplace programmes or clinical trials access the treatment for a limited time (while they work at the company or until the trial ends). In the case of the workplace the programme is also limited to the employee and not his/her dependents.

People on medical schemes are faced with limited coverage and capped medication cover. Berger reported that some medical schemes were lowering the annual limit as the drug prices came down.

He said there was also concern over the sustainability of medical schemes in the long run.

The AIDS Law Project was set up in 1993 to legally protect and advance the rights of people living with HIV/AIDS.

 ANNUAL COST PER PATIENT PER DRUG (EXCLUSIVE OF VAT AND MARKUP)