Effective Dec. 1, Abbott Pharmaceuticals increased the price of Norvir, one of the most popular protease inhibitors for the treatment of HIV and AIDS, by 500 percent without warning to distributors. In turn, pharmacies were unable to warn their clients of the price mark-up, catching many people off guard and causing a significant change to their monthly budgets for HIV/AIDS medications.

A Norvir bottle with 120 100mg capsules that retailed for $257.17 before the price increase now costs $1,255.03, Jim Avedikian, R.Ph., reported in an article entitled “Abbot Labs points gun to heads of AIDS Patients: raises price of AIDS drug Norvir 500 percent.”

Monique Dechaine, executive vice president of sales and marketing for Priority Pharmacy in Hillcrest, had not had a chance to assess the exact percentage of the price increase, but confirmed that the price increase came as a surprise.

“Essentially… our experience with the price increase was, we had a patient come in — that has been a longtime patient — to refill their prescription, and we ran the prescription as we normally do, and when we did we noticed that there was a substantial increase in the co-payment that the patient would be responsible for,” Dechaine said. “Sometimes there are glitches in the computer system, so we said ‘well, this must be an error.’ That was our assumption at the time, so we went ahead and let the prescription go at the older pricing for the client. After the client left — because we wanted to take care of the client first — we did the research and we made a couple of phone calls to our vendor as well as to the manufacturer itself, and we became aware of the price increase and that it was confirmed that the pricing that was in our system was in fact accurate.”

Dechaine said that unannounced price increases are not standard practice for pharmaceutical manufacturers, but they do happen occasionally. She was not at liberty to disclose how many of their local clients will be affected by the price increase.

Introduced in the late 1990s, Norvir was one of the first drugs to increase the survival rate of those with HIV/AIDS. Because of its severe side effects in high doses, it was not widely prescribed for several years until scientists discovered that, in lower doses, Norvir boosted the effectiveness of other HIV/AIDS drugs. It has now become an essential part of some drug cocktails, allowing those that take it to stay at therapeutic levels of their medications for longer periods of time.

“The fact that less of a drug is needed should not increase its price so disproportionately from its original price” Avedikian wrote. “This has myself, other AIDS activists and HIV specialty physicians very concerned and worried.”

President Bush’s Medicare Prescription Drug Benefit, recently signed into law, does not require competitive bidding on the price of drugs sold for use in the Medicare program. Avedikian and other AIDS activists and HIV physicians began to worry that drug companies would jump on the opportunity to make a profit.

“As a concerned community pharmacist, I have been watching in horror over the price of prescription drugs in this country compared to Canada and Europe,” Avedikian wrote. “My fear was that this was going to set a dangerous precedent and lead to a series of unjustified price increases by the drug companies. It did not take long to see my worst fears realized.”

Because the state Medical program and AIDS Drug Assistance program have contracts with Abbot Laboratories that set the cost of Norvir until June 2004, people with HIV/AIDS who receive their medication through these programs will not see an increase for another six months. After that time, however, the contracts are open to price increases that could affect co-pay costs and limit insurance coverage for consumers.

Avedikian referred to a Dec. 11 Bay Area Reporter article that included comments by Lei Chou, Director of the AIDS Treatment Data Network in New York. “Primarily our major concern right now is that by taking this action, Abbott is putting a gun to the head of those people who are in a salvage situation, when they have been through different regimens already and need to use Norvir,” said Chou. “I don’t understand how they can justify a price increase on this scale.”

A price increase of this magnitude, according to Avedikian, may cause insurance companies looking to balance the increased cost to set restrictions on the use of Norvir, or cause a consumer to have to pay a $50 co-pay instead of a $15 one. Abbot Laboratories does offer Norvir free to uninsured eligible consumers, though the application process is complicated, involving extensive documentation and paperwork.

Avedikian urges concerned individuals and community groups to contact Abbot Laboratories directly at (800) 255-5162.