Question

Hello, I am engaed to a lady in Thailand who is HIV+ and is taking a medication called GPO-VIR S30. I am HIV+ myself and have not heard of this particular medication. What can you tell me about its pharmocology and its effectiveness? I did some reading and know that it is used chiefly in Thailand and is very affordable by US standards. What I also dont understand is how such a medication can be so afforable while here in the US, HIV meds are so expensive. Thaks for your input. Rob

Answer

GPO-VIR S30 is a fixed dose combination of nevirapine (Viramune), lamivudine (Epivir), and stavudine (d4T, Zerit) which is produced I believe by the Government Pharmaceutical Organization in Thailand for about $30 dollars per month cost of treatment.

In the United States we have a quasi-free market pharmaceutical industry without a formal mechanism for price fixing. Since the U.S. is a relatively wealthy country medications are very expensive until they go off patent. These high prices produce a high motive for investment in innovative drugs to alleviate human suffering and make the world a better place. That's the sunny side of big pharma and it is true, every word of it.

But with this potential high profitability in of branded drugs also comes a strong motive for pharma companies to pour enormous sums into development and advertising for stuffy nose medications. These ads result in even more enormous profits when doctors comply with consumer request and write prescriptions for them. Hey, why the heck not, it is the insurance company picking up most of the bill. Another ridiculous expense involved in U.S. medicine are the legions (no, strike that, hordes actually) of pharmaceutical representatives that descend on doctors offices and hospitals to bring donuts, free food, pens, and other knick-knacks to gain entry to the inner sanctum. Once granted entry, these often attractive, well spoken young men and women make their best case to convince the doctor that their particular brand of extended-release 'colorful and shiny pill' is well worth the extra cost (a mere 10 fold higher) than the plain white chalky generic competition. There are about a dozen other reasons why meds are so expensive in the U.S., but time and space are limited.

Thailand should be applauded for their efforts to produce $30 per month life-saving generic antiretroviral combinations to save lives in their country. Likewise, the Pharmaceutical Industry researchers and scientists should be commended on their work and innovation that made these transformational breakthroughs possible. As for the marketing divisions that have seemingly gained control of this once proud industry I would simply say, "hey, very nice pen".