"We expect to receive offers of cheaper prices from the companies, ones that are cheaper than the prices offered at a previous meeting with us," FDA secretary general Dr Siriwat Thiptharadol said yesterday.

FDA officials have met with representatives of the three companies twice since Thailand began issuing compulsory licenses late last year to provide greater access to life-saving medicines.

The three drug companies are Merck's MSD (Thailand), Abbot Laboratories and Sanofi-Aventis, which produce Efavirenz, Kaletra and Plaviz respectively. The first two are Aids drugs and the third is for heart disease.

The first two rounds of talks failed.

"The FDA invited the companies to negotiate the royalty fee for their drug's patent," said Dr Jiraporn Limpananond, a lecturer in the Faculty of Pharmacy at Chulalongkorn University and one of Thailand's leading experts on access to medicine.

"But the companies declined to negotiate the royalty fee, and asked instead to negotiate prices," Jiraporn said. The FDA had offered a 0.5 per cent royalty on imported generic drugs to the patent holder.

"Their request to negotiate price reductions rather than royalty fees is a fight over 'principles' and shows their resistance to Thailand's CL policy," she said.

Sources at the FDA said it would maintain its stand in the third round of negotiations, which will also be about royal fees, but it would be open to an offer of lower prices from the three companies.

"If the companies offer to lower prices of the three drugs, the patients will benefit. If not, the FDA is still able to buy drugs from other sources by using CLs. Either way the patients will benefit," the source said.

Since the CL policy was announced, Efavirenz has been included in the national healthcare scheme.

The FDA used to buy the drug from MSD (Thailand) before switching to buy a generic copy from the Indian company Metrix after the CL was issued.

Recently, Merck offered to further cut price of Efavirenz from Bt700 to Bt540 per person per month.

Abbott has priced Kaletra out of the reach of all but a handful of Aids patients in Thailand. The FDA had tried to negotiate a lower price with Abbot but failed prior to the announcement that it would issue a CL.

Public Health Minister Mongkol na Songkhla last month negotiated a far cheaper price for a generic copy of the drug with Metrix. The company sells a generic version of the drug called Aluvia at US$850 (Bt30,000) per person per year and said it would reduce that price to $695 per person per year in Thailand.

For Plavix, Sanofi-Aventis is the only producer in Thailand today. However, Siriwat said yesterday that a Thai pharmaceutical company submitted a proposal to produce Clopidogrel, a generic copy of Plavix, and sell it to FDA at a much cheaper price.

"The general situation is positive," Siriwat said.

If today's talks fail again, the issue of royalties will be forwarded to the to Department of Intellectual Property Rights to settle the amount of royalty to be paid, Jiraporn said

Duangkamol   Sajirawattanakul

Kamol Sukin

The Nation