Clinton Foundation to Announce Deal Reducing Price of Viral Load, CD4+ Tests for Developing Countries

The William J. Clinton Presidential Foundation on Wednesday plans to announce a deal with Beckman Coulter, Becton, Dickinson & Co., Roche Diagnostics, Bayer HealthCare and bioMerieux that will cut the prices of viral load and CD4+ T cell diagnostic tests in developing nations, the Wall Street Journal reports. Although HIV diagnostics have failed to receive the same media attention as antiretroviral drugs, they are a "big part" of the cost of HIV/AIDS treatment, according to the Journal. The prices of the tests are prohibitively expensive in some developing nations, leading doctors to stop administering viral load tests and making limited use of CD4+ tests. The tests -- which are standard in the United States -- help doctors determine when to begin administering antiretroviral drugs and whether the drugs are working. Under the new deal, the companies will offer developing countries special pricing on a package including the tests, the machines for running them, training, maintenance and repair of the machines, chemical reagents and other supplies. The countries will receive the equipment without any downpayments and will instead "pay as they go" using a per-test fee, according to the Journal. Per-test charges for the CD4+ tests will range from $3 to $5, down from an average price in some African nations of $8 to $10. In one South African clinic, the test costs $15. However, the companies say that the nature of the package deal makes such comparisons misleading. For example, the vast majority of Becton Dickinson's African customers purchase the test kits separately from the expensive machines used to process them, the company said. Under the agreement, the pricing of the viral load tests is confidential.

Sustainability
In order to ensure the sustainability of the program, the Clinton Foundation priced the tests at a level that would allow the companies to make a "modest profit," according to the Journal. The companies see the proposed program as a "market maker," offering predictability and high demand, the Journal reports. Ira Magaziner, a long-time Clinton aide and head of the foundation's AIDS initiative, and a team of management consultants and AIDS experts visited the companies' manufacturing plants and helped the companies develop ways to cut costs (Schoofs, Wall Street Journal, 1/14). The foundation used a similar tactic last year to secure a deal with Ranbaxy Laboratories, Cipla, Matrix Laboratories and Aspen Pharmacare that reduced the prices of commonly used three-drug antiretroviral regimens to 38 cents per patient per day, down from the already discounted price of 55 cents per patient per day; the lowest available price of the same three-drug regimen using brand-name antiretrovirals is $1.54 per patient per day (Kaiser Daily HIV/AIDS Report, 11/21/03). The diagnostic tests price cuts will be available immediately in countries that the Clinton Foundation is currently working with, including South Africa, Tanzania, Mozambique, Rwanda, Haiti, the Dominican Republic and several other nations in the Caribbean. Magaziner said that the foundation hopes to expand the deal to as many nations as possible (Wall Street Journal, 1/14).

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