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Stavudine and efavirenz in short supply for developing world, say manufacturers
Keith Alcorn, Thursday, March 10, 2005
The antiretrovirals stavudine and efavirenz may be in short supply in the coming months because their manufacturers cannot keep up with demand in the developing world, according to a report in the Wall Street Journal.

Manufacturers Bristol Myers Squibb and Merck, who make stavudine (Zerit) and efavirenz (Stocrin) respectively for the developing world market confirmed to the Wall Street Journal that they may experience `temporary` difficulties in meeting demand in months to come because of a growing volume of orders for the drugs from treatment programmes funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) and Global Fund to Fight AIDS TB and Malaria.

The supply bottleneck is being exacerbated by a shortage of generic stavudine manufactured in India following the withdrawal of several stavudine-containing products from the WHO list of prequalified antiretrovirals in the second half of 2004.

Although manufacturers say the problem is short-term, some warn that longer term bottlenecks in supply and price increases could emerge as a result of changes in Indian patent law. Prices could also rise due to the shortage of raw materials or fluctuations in the dollar exchange rate, limiting the number of patients who can be treated in developing countries.