US pharmaceutical firm Gilead is not living up to its promise of supplying the life-saving anti-fungal drug liposomal amphotericin B (LAmB) at cheaper rates, the non-profit MSF (Médecins Sans Frontières, or Doctors Without Borders) has said.

Patient-support groups are therefore forced to acquire the drug at three times the initial price quoted by the company last year, MSF has pointed out.

Last September, Gilead had given an assurance that it would supply LAmB at a ‘no-profit’ price of $16.25 (approx ₹1,100) a vial. However, it continues to be priced at $45 (approx ₹3,109) a vial, with the full treatment costing $1,000 (around ₹70,000).

The Bihar government, along with MSF, provides treatment to patients in advanced stages of HIV. “Some of these patients are affected by cryptococcal meningitis, for which LAmB is crucial for treatment. We have been forced to acquire it at an expensive rate because Gilead is not instructing its distributor Mylan to reduce costs despite making announcements to help HIV patients last year,” said Leena Menghaney, Regional Head, Access Campaign, MSF. Cryptococcal meningitis, an infection of the brain, is the second biggest killer of people with HIV, after TB.

While Gilead is making LAmB available at a cheaper rate to the Union Health Ministry for the treatment of leishmaniasis (kala-azar), it is not extending such support to HIV patients suffering from cryptococcal meningitis, said Menghaney. “The government therefore does not procure LAmB for HIV patients but treats them with inferior drugs, like AmB deoxycholate, with substantial side-effects,” she added.

National programmes and treatment providers are also unable to purchase the drug at Gilead’s promised price.

Booming sales

“Meanwhile, Gilead continues to earn billions of dollars each year from global HIV drug sales — the corporation reported $14.6 billion in sales from global HIV drugs in 2018 alone,” said Menghaney. Gilead has a monopoly on LAmB.

Though the medicine is no longer under patent, the company has refused to license its technology to potential generic manufacturers.