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PERSPECTIVE ON AIDS : Private Sector Research Delivers : The administration wrongly scapegoats drug companies. Congress should extend the Ryan White aid program.

July 07, 1996|JAMES DRISCOLL | James Driscoll of San Francisco is national AIDS policy advisor to the Log Cabin Republicans

The 11th International AIDS Conference, which begins today in Vancouver, will tell the world about major breakthroughs in AIDS drug research. Already, reports abound of patients enjoying spectacular recoveries with the new protease drug regimens.

A few years ago at the seventh conference in San Francisco, activists were chanting: "Seven years, $2 billion and one lousy drug." In the last year alone, the Food and Drug Administration has approved five important new AIDS antivirals. Until recently, AIDS activists were demanding a "Manhattan Project" for AIDS research. Now they're demanding better access to the treatments the FDA has just approved.

Have those billions in government-funded, National Institutes of Health- directed research finally paid off? Surprise! The new protease drugs that are keeping patients alive were developed almost entirely by the private sector. Those perennial scapegoats, the "price gouging drug companies" led by three multinational giants--Abbott, Hoffmann-La Roche and Merck--are responsible for the breakthroughs.

The crucial protease mechanism for blocking viral reproduction was discovered at Merck. Rushing their separate protease research, Abbott, Hoffmann-La Roche and Merck developed new drugs in record time. They worked in fierce competition, each risking hundreds of millions of their stockholders' dollars. With AIDS activists clamoring for new drugs and a Republican Congress eager for regulatory reform, the FDA was prudent enough not stand in the way.

The protease drugs are a victory for and vindication of free enterprise. And that victory has a human face: that of each patient who owes his or her life to corporate research.

Linda Grinberg of Los Angeles had tried every approved drug and every promising underground treatment. Nothing worked long or well. By 1995, Grinberg, who was infected by her husband, had advanced AIDS. In failing health and without energy, she helplessly watched her life ebb away. Then Grinberg enrolled in a clinical trial for the new Merck protease drug. Her energy and weight increased and she resumed an active life. "I know I must sound like a drug company infomercial," she said at a recent FDA hearing, "but Merck's drug has given me back my life. I am deeply grateful to the company." Thousands of other patients receiving protease drugs from Merck, Hoffmann-La Roche and Abbott tell similar stories.

One might think that the administration and Congress would take a cue from Grinberg and be grateful to the drug companies for succeeding where government failed. Think again. The Clinton administration acts as if David Kessler's FDA deserves all the credit for not stalling the protease drugs, and it gripes about price gouging, although it knows that at current prices, the companies will not recoup their huge investments for many years.

The Republicans avoid pricing demagoguery and have a commendable record on supporting AIDS care and private sector research. But their good record is endangered by reluctance to fund adequately the Ryan White Drug Assistance Program, which provides AIDS drugs to uninsured patients. These patients will be left with three options, all devastating. They can do without treatment. They can quit their jobs and go on welfare to get the drugs from Medicaid. Or they can pressure the companies to slash prices and give away their drugs in indigent patient programs.

Experts on the Ryan White drug program estimate that during fiscal 1997, it will need at least $196 million in added federal funds. So far, Congress has offered $23 million. Such false economy will doom thousands of patients to substandard treatment. And it almost guarantees the companies meager profits, weakening their incentive to find the additional AIDS drugs needed to make the disease fully manageable. AIDS patients will remain at the mercy of NIH research, whose record is "12 years, $6 billion and one lousy drug." Perhaps we shouldn't expect more from an administration responsible for a monumental health care reform fiasco. But Republican champions of free enterprise ought to know better.

The Republicans have an opportunity to show leadership in AIDS where the administration has given us empty rhetoric and drift. Republicans need to uphold their tradition of supporting free enterprise. And maintaining the Ryan White Care Act costs much less than we spend on NIH research.

Before she got AIDS, Linda Grinberg was CEO and owner of an independent film library. Grinberg can easily afford the new drugs, yet she's fighting for more Ryan White reimbursement. "I want everyone to benefit as I have," she says, "but I've got a survival motive too. Though these drugs will give me extra years, eventually I'll need new drugs. If we undercut the incentive to develop more drugs, thousands of patients like myself will pay with their lives."

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