From humanitarian aid to preventive medicine, cheap drugs hold a big promise: For pennies and pennies a day, life can get better.
But those “naloxone” drugs or “pep-drugs” do cost more in the developing world, where lifesaving medical products and medical services are often rationed — even by the drug companies themselves.
That’s where Merck’s Compassionate Access program comes in. At the launch of a new experimental drug called modafinil in July, Merck announced the program it was starting to build drug companies’ capacity to sell poor people medication, for less than $2 a day, that will also make them less likely to get addicted.
“We’re trying to use a cost model that is not static,” Merck Chief Executive Kenneth Frazier said in an interview. “It is nimble and shifts with economics. It’s a way of thinking about diseases that is very, very cost effective, as well as affordable.”
Merck, which makes the drugs for addiction disorders in many of its vaccine and ophthalmic products, envisions a program for other emerging market drugmakers, Frazier said.
“This is important if they’re going to help us bring an affordable drug like modafinil to markets where it has low access,” he said.
A version of varenicline — sold under the brand name Vivitrol — is already available for some of the most common causes of withdrawal from prescription drugs, including prescription medications, weight loss aids and alcoholics. That drug goes for as little as $1 a day, and can save an average family $40 a month, the company says.
The potential value of such drugs for healthier and less prone people is hard to quantify. Merck officials estimate, for example, that if the company can cut the cost of a pill to pennies a day, the global market for the drug could top $1 billion a year.
Instead of being sold as a replacement, though, as much of the payer market demands, modafinil, combined with no-cost counseling, could be used in the community, Frazier said.
“You’re taking some of the cost out of the equation, but you’re helping people who are already using the product,” he said. “You’re helping them control their addiction.”
To help develop the company’s pilot model, the company signed a partnership with the Bill & Melinda Gates Foundation. So far, money from the pilot program is flowing to Bangladesh, where Merck, with support from Microsoft co-founder Bill Gates, is sponsoring the promotion of medication programs in 13 of the country’s poorest districts.
Merck is now partnering with a pharmaceutical manufacturer to start scaling up the program, with commitments from the Gates Foundation of $3 million over the next three years.
The company plans to increase its output of the drug, which is approved for marketing in 120 countries, and to treat the program as an economic model, asking drug companies to make a point of participating and to provide a market for cheaper medications.