Merck announces 20% cut in efavirenz price for low and middle-income countries

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Merck Sharp and Dohme (MSD) is to reduce the price of efavirenz (Sustiva) by 20% in least-developed countries and other middle income countries with severe HIV epidemics, the company announced today. The reduction will take the annual cost of treatment with the 600mg tablet formulation of the drug down to $277.40 in sub-Saharan Africa.

MSD is lowering the price of its formulation of efavirenz due to new efficiencies and cost savings resulting from improved manufacturing processes, the company said today. By the end of 2005, nearly 500,000 patients in 76 developing countries were being treated with antiretroviral regimens containing either of MSD’s two current HIV/AIDS medicines, Stocrin (efavirenz) and Crixivan (indinavir sulfate), the company said in a press release today. Merck shares marketing rights for efavirenz with Bristol Myers Squibb, which markets the drug as Sustiva in North America and the largest western European countries.

Merck’s price reduction brings the price of its product close to the price level agreed for generic versions of efavirenz in a deal announced by the Clinton Foundation in January, which promised a ceiling price of $240 a year subject to a minimum volume of orders. It is not known whether any country has yet taken advantage of this offer.



The physical form in which a drug is manufactured or administered. Examples of formulations include tablets, capsules, powders, and oral and injectable solutions. A drug may be available in multiple formulations.

middle income countries

The World Bank classifies countries according to their income: low, lower-middle, upper-middle and high. There are around 50 lower-middle income countries (mostly in Africa and Asia) and around 60 upper-middle income countries (in Africa, Eastern Europe, Asia, Latin America and the Caribbean).


In relation to medicines, a drug manufactured and sold without a brand name, in situations where the original manufacturer’s patent has expired or is not enforced. Generic drugs contain the same active ingredients as branded drugs, and have comparable strength, safety, efficacy and quality.

For countries that fall in the medium Human Development Index and that have an HIV prevalence above 1%, the price of Stocrin will also be reduced to $277.40. This group includes all countries in sub-Saharan Africa, as well as several countries in Asia (e.g., Thailand, Cambodia), Latin America (e.g., Dominican Republic, Guyana, Haiti, Guatemala, Honduras), and Eastern Europe.

In medium HDI countries with HIV prevalence below 1% MSD is reducing the price of the 600mg tablet formulation to $697 a year. This category includes Bolivia, Colombia, Ecuador, El Salvador, Nicaragua, Peru, and Venezuela in Latin America. Other countries in this category include Egypt and Morocco in Africa, and Malaysia in the Asia/Pacific region.