The Swiss Pharmaceutical giant, Novartis, has announced further cuts in the price of its artemether-lumefantrine (AL) anti-malarial drug, CoartemÂ®. According to AFP, ” The new price of 37 cents (0.23 euros) for children’s doses will start from Friday which is World Malaria Day.” This reflects a 20% reduction in price. This announcement not only comes two before World malaria Day, but two days after Novartis announced for the first quarter of 2008 that, “Net income up 10% to USD 2.3 billion.”
The Novartis press release goes on to say that Coartem is “the only fixed-dose ACT that has been approved by a stringent, internationally-recognized health authority.” This refers to WHO’s pre-qualification efforts to ensure safe and effective medicines for major donor program use. The current list does now include other artemisinin-based combination therapy products such as artesunate-amodiaquine (AA) and artesunate-mefloquine, but WHO still favors Coartem and assists countries apply for Coartem at cost.
Ghana for one has chosen AA as its first line antimalarial drug, and is in the process of updating its national malaria drug policy and guidelines to reflect this and possibly include AL and atovaquone-proguanil as second line choices for people who may react to amodiaquine. Generally though, most countries are in lockstep with Coartem. While Novartis is optimistic about its “ability to satisfy Coartem production requirements in 2008 or the future,” it also issued a disclaimer about future uncertainties. It is just such uncertainties that require countries to consider alternatives, as in Ghana.
Ultimately if in the future donors do not persist in providing funding for buying anti-malarial drugs at cost, there needs to other mechanisms to bring costs in line with what countries can afford. Greater commercial availability of different types of malaria drugs that also bear WHO’s seal of approval will hopefully also bring down prices across the board for all such products and make it easier for countries to buy their own medicines as needed.