ABSTRACT
AIDS: Costa Rican AIDS activists seeking compassionate access to protease inhibitors reported recently that negotiations with both their government and Hoffmann-La Roche, the maker of the protease inhibitor saquinavir, have failed in part because of the drug's high cost. Currently, AZT is the only regularly available anti-HIV drug in the country, and it is prescribed only for pregnant women. A month's supply of saquinavir costs about $800, compared to an average salary of $250. In an attempt to combat this disparity, a coalition of 200 activists negotiating with the government to get antiretrovirals approved in the national health system also sought compassionate access from Hoffmann-La Roche for 50 patients. The company's director in Costa Rica, however, refused to provide the drug for free or at a significant discount, saying he did not have the power to make such a decision. Protease inhibitors are made cost-effective in other countries because they lower the cost of keeping patients in the hospital. The Costa Rican government, however, claims that saquinavir would cost up to four times more than the expense of hospitalization. The drug industry should share the responsibility for providing AIDS drugs to countries and to individuals who cannot afford them. This can be accomplished by distributing the drugs via international agencies, licensing countries to produce the drugs at affordable prices, or pricing AIDS medications so that they are affordable.^ieng
