As expected, former President Bill Clinton on Wednesday at a press conference in New York announced a deal between the William J. Clinton Presidential Foundation and five medical technology companies -- Beckman Coulter, Becton, Dickinson & Co., Roche Molecular Diagnostics, Bayer HealthCare and bioMerieux -- that will cut the prices of viral load and CD4+ T cell diagnostic tests in developing nations by as much as 80%, Reuters/Washington Post reports (Reuters/Washington Post, 1/15). Although HIV diagnostics have not received the same media attention as antiretroviral drugs, they are a significant part of the cost of HIV/AIDS treatment and limited funding has lead doctors in some developing nations to stop administering viral load tests and to make 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 (Kaiser Daily HIV/AIDS Report, 1/14). Under the new agreements, the cost of CD4+ tests will drop from $8 to $10 per test to $3 to $5 per test, BD Chair and CEO Edward Ludwig said. Roche Molecular Diagnostics Vice President Robin Toft would not discuss in detail the price agreement on the more expensive viral load test but said that the price would be 20% lower than what the company is currently charging developing nations (Dugger, New York Times, 1/15). The companies will not require up-front payment for the expensive testing equipment and will delay payment collection until the system is in place and staff are trained, according to the Associated Press (Dobnik, Associated Press, 1/14).

Expanded Treatment Access
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 to help them develop ways to cut costs. The foundation used a similar tactic in October 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 (Kaiser Daily HIV/AIDS Report, 1/14). The new agreement, combined with the October agreement, will cut the cost of treating an HIV-positive person from $800 a year to $250 a year in the 13 developing nations where the foundation is operating, Clinton said (New York Times, 1/15). The foundation expects that the deal will allow five million more HIV-positive people to access treatment by 2008 (AFP/Yahoo! News, 1/14). South Africa will be the first to benefit from the plan and within two months is expected to finalize a deal that could save the country almost $300 million over the next five years, Lynn Margherio, executive vice president of the foundation's HIV/AIDS Initiative, said. Mozambique, the Bahamas, Tanzania and Rwanda are expected to be the next countries to benefit from the deal, according to Reuters/Post (Reuters/Washington Post, 1/15). The foundation is receiving private funding for its treatment project and has received pledges from several developed countries -- including Canada, Ireland, Norway and Sweden -- to contribute directly to programs in specific developing countries (Associated Press, 1/14).

Reaction
Company executives attending the press conference said that they planned to make up for lower profit margins with higher sales volume, the AP/Long Island Newsday reports (Dobnik, AP/Long Island Newsday, 1/14). "We are systematically changing the economics of AIDS treatment," Clinton said, adding that the companies had done an "astonishing service" by agreeing to the deal (Barber, Financial Times, 1/15). "By pushing down the price of HIV/AIDS medicine and laboratory tests, we are ramping up the ability of developing countries to treat millions of people, and to do so with the kind of quality of care that people with AIDS in the developed world usually receive," Clinton said (AFP/Yahoo! News, 1/14). Richard Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said that the Clinton Foundation "has made a major contribution to the fight against HIV/AIDS" (New York Times, 1/15).

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