fizer and Mylan are to significantly cut their prices on medicines for patients with drug-resistant HIV in developing countries as part of deal with the foundation run by former US president Bil Clinton.

Mylan and its India-based Matrix unit are selling four second-line antiretrovirals –atazanavir, ritonavir, tenofovir and lamivudine – which will be available in three pills, with tenofovir and lamivudine combined into a single pill, for less than $475 a year. It also will sell the pills together in one package – a “second-line-in-a-box” – at $425, starting in 2010.

These products and prices will be available to governments that are members of Clinton Foundation's Procurement Consortium in Africa, Asia, Latin America and the Caribbean. Mylan chief executive Robert Coury said the ‘second-line-in-a-box' will reduce patient pill burden and facilitate compliance, adding that “our affordable, heat-stable version of ritonavir also represents another advance in the development of products that can withstand environmental conditions in parts of the world where treatment is desperately needed”.

President Clinton also announced an agreement with Pfizer to reduce the price and expand the availability of rifabutin, a drug used to treat tuberculosis in patients taking second-line antiretrovirals. The deal is the Clinton HIV/AIDS Initiative (CHAI)’s first pricing agreement with a research-based pharmaceutical company, he noted.

Pfizer will sell the off-patent product at $1 per 150 mg dose, or $90 for a full course of treatment over six months. This represents a 60% price reduction to $1 a dose, lower than current generic versions, and chief executive Jeffrey Kindler said these types of initiatives bring health care “to customers who have often been neglected in the past” and do so “in a socially responsible, sustainable and commercially viable way”.

The CHAI noted that if fully adopted the new products and prices could lead to cumulative cost savings of $400 million over the next five years compared with recent prices paid for alternative regimens. There were between 200,000 and 250,000 HIV drug-resistant patients across the developing world last year and that number is expected to double over the next three years.