Brazil may have struck a deal with Abbott Laboratories over Kaletra but a similar deal with Thailand still seems a long way off as the price for the US firm’s AIDS drug is still considered to be too high.

Abbott has just reached an agreement with the health authorities in Brazil which will see the firm sell a new version of Kaletra (lopinavir/ritonavir), called Aluvia, at a price discounted by around 30%, which fits with the company’s new policy, announced in April, of offering the drug to the governments of more than 40 low and low-middle income countries and to non-governmental organisations for $1,000 per patient per year.

At the time the offer was made, Abbott specifically noted that it applies to Thailand as well, despite the country saying that it was issuing a compulsory licence for Kaletra, which is still patent-protected. Thai authorities originally welcomed the offer but it seems that talks between state and drugmaker have failed as Vichai Chokevivat, chairman of Thailand’s state-owned drugmaker, the Government Pharmaceutical Organisation, said that the offer would not be taken up.

Dr Chokevivat was quoted in The Bangkok Post as saying “we understand that the Brazilian government has a reason to accept the deal. But we cannot do that. It's not the option we are hoping for''. The stumbling block would appear to be the price put on Aluvia, a formulation of Kaletra which requires fewer tablets per day and does not require refrigeration, and while Abbott has insisted on selling the drug at around 34,000 baht ($1,000) per year, Thailand’s Public Health Minister Mongkol na Songkhla recently said that the figure is still too high, especially as the price quoted by Indian generic specialists Matrix Laboratories for a copycat version of Aluvia is just over 24,000 baht ($695) per person per year.

Government looking to buy two million generic Plavix tablets

It is not only Abbott that is facing a tough time in Thailand as Mr Chokevivat noted that the GPO is looking to import some two million tablets from India of generic versions of Sanofi-Aventis and Bristol-Myers Squibb’s patent-protected anti-platelet agent Plavix (clopidogrel). The Thai government slapped a compulsory licence on the blockbuster at the beginning of the year after it rejected Sanofi’s offer to buy Plavix for 27 baht ($0.82) per tablet. The Franco-German drugmaker had also offered to supply 3.4 million tablets for the same price as one million, but Thailand again said that was too expensive.

The Health Ministry has drawn up a short list of four undisclosed Indian drug manufacturers to supply the two million tablets of clopidogrel, up from 500,000, and says that the price will be about 5.50 baht per tablet including tax and transportation costs. In Thailand, it is estimated that five million tablets of the medicine are needed to meet demand and the first batches should arrive around October. Sanofi is understandably dismayed and claims that the Thai authorities are only focusing on price and not the safety of patients.