AIDS Coalition To Unleash Power

CONTACT: Paul Davis, ACT UP/Phila 215.731.1844
Kate Krauss, ACT UP/Golden Gate 415.252.9200,
Mark Milano, ACT UP/NY 212.475.4889
James Learned, PWA Health Group, NY 212.255.0520


ACT UP/Golden Gate, ACT UP/New York, ACT UP/Philadelphia and the PWA Health Group have forced Stadtlanders mail order pharmacy to offer a 19.5% cash discount on the retail price of Crixivan, a powerful new AIDS drug manufactured by Merck & Co. of Blue Bell, PA. Stadtlanders, based in Pittsburgh, is the sole commercial distributor of the drug.

Stadtlanders had been charging a 37% markup on Crixivan for uninsured persons and for many insured people who must pay a percentage of their prescription costs. The average industry markup ranges between 6% and 17%. In the face of activist pressure, the company lowered its markup to 10%.

Four members of ACT UP/New York were arrested the night before Stadtlanders capitulated. The activists plastered the company's showcase New York City store with signs denouncing the company's "price gouging" and "AIDS profiteering."

Commented ACT UP New York member Mark Milano, "We wanted to bring the message home to New York City that Stadtlanders wouldn't get away with price gouging people with AIDS."

Stadtlanders will offer to enroll People with AIDS (PWAs) who are paying out of pocket for Crixivan in a discount program. The drug will be available for a contract price of $398 per month. The discount program has an enrollment fee of $18.00 per year, and buyers who have already paid cash for the drug will be offered a refund based on the discounted price. People paying cash will save about $100 per month; those paying a 20% insurance co-payment will save about $20 per month under the new plan.

"The price of Crixivan is still too high, and we want to send a message to Abbott Labs, Merck, and Hoffman-La Roche that we will not tolerate price gouging," commented ACT UP/Golden Gate's Bill Thorne. "Those companies are next."

All three companies manufacture powerful new AIDS drugs called protease inhibitors, and all have come under scrutiny for the extremely high price of their drugs. The price of Abbott's protease inhibitor is $8,500 a year. In addition, most PWAs must take several expensive therapies concurrently.

AIDS activists have also called on Merck to expand the eligibility criteria for the its patient assistance program. The program is intended to provide Crixivan to people in need who do not have insurance and are unable to pay full price. The company has stipulated that patients earning more than $20,000 per year will be ineligible for patient assistance. Crixivan will cost about $6,000 under the program, and patients generally require at least two other costly medications. "The $20,000 income cap is ludicrous," commented ACT UP Golden Gate's Edward Zold. "A person's drugs alone can easily cost $20,000. Thousands of people with AIDS will be left out in the cold. Merck must raise the maximum income cap to a minimum of $30,000 per year, more for couples and families."

The activists stated that they will closely monitor Stadtlanders over the next weeks to ensure that the new discount program is well promoted and running smoothly. "This drug has meant new hope for a lot of individuals with HIV," said ACT UP/Philadelphia member Steven Parmer. "We will continue fighting to make certain that Stadtlanders meets the needs of people with AIDS."

Patients interested in obtaining Crixivan can contact Stadtlanders' hotline at 1-800-238-1548.

Voices From the Front:
Mark Milano on being one of the Stadtlander's Four

On Thursday morning at 2 am, I was arrested, along with other ACT UP/NY members for "unlawful postering" of the Stadtlanders pharmacy on 8th Ave. in Manhattan.

The front of the store was completely covered with posters reading, "Price Gouger" and "Profiteers," and large sheets detailing the obscene 37.5% markup Stadtlanders is charging those individuals who purchase Crixivan (indinavir) retail.

Apparently, the Chelsea Bar across the street called police and alerted them of the situation, and we were arrested a few blocks from the scene. We spent the next 28 hours in group holding cells, being denied any phone calls or access to our medications, which several of our members needed.

Stadtlanders issued a press release on Thursday reading in part,

"On Thursday April 18th, Stadtlanders conducted a scheduled nationwide teleconference to address and propose solutions to the issues being protested. Stadtlanders would prefer continued intelligent discussion ofthe issues, as opposed to suffering further late night vandalism."

If Stadtlanders is sincere in their promises to lower their markup and provide refunds to those already paying for the drug, the time we spent in jail will most certainly be worth it, since I hope our arrest played a part in demonstrating the community's outrage at the price of this drug.

Now, on to protests about the wholesale price of all the protease inhibitors: Merck, Abbot and Roche! I urge all activists to gear up for strong steps to lower the outrageous price of these drugs. We CAN make a difference!



ACT UP and people with AIDS across the US are outraged by Stadtlanders Pharmacy's exclusive deal to distribute indinavir (Crixivan), a powerful new drug for people with AIDS. Under the plan, Stadtlanders will receive a 37% markup on the price of indinavir, and thousands of people with AIDS will be unable to obtain the drug at all. Merck has already set the price at $358 per month; it will retail for $495 per month with the markup, far beyond the means of most people with AIDS. ACT UP is currently considering whether to initiate a nationwide boycott of Stadlanders, excluding indinavir.

Commented ACT UP Golden Gate's Virge Parks, "If Merck knew about this huge
markup when they chose Stadtlanders, it means that their initial price, lower than the other protease inhibitors, was a lie. Even if they didn't know, they have formed an alliance with a company that is price gouging sick people." Under the current terms of the contract, Stadtlanders may gross more than $20 million. ACT UP 's lawyers are looking into the legality of the arrangement.

There are many other restrictions on who can receive indinavir. Most drug companies operate indigent programs, but Merck's consists of restrictions apparently designed to exclude people who cannot afford the drug. The company has stated that it will not provide indinavir to patients who have been denied coverage by their insurance companies. (Insurers are reluctant to provide coverage due to the high cost of indinavir.) In addition, the program will bar people with AIDS from receiving the drug if they live in a state where indinavir has not been added to the AIDS Drug Assistance Program. New York is one of many states currently unable to afford protease inhibitors for its AIDS Drug Assistance Program.

The company has further stipulated that patients earning more than $20,000
per year will be ineligible for patient assistance. (Indinavir will cost about
$6,000 under the program, and patients generally require at least two other
very costly drugs.)

1. That Stadtlanders immediately reduce its markup on Crixivan to no more than 15%, in keeping with industry norms. A 37% markup is price gouging people with AIDS. It should be illegal.

2. A compassionate patient assistance program that offers drug to people who cannot afford it otherwise, especially those who are unable to obtain the drug through their insurer or a public program. The program should include a realistic income cap of at least $30,000 for a single person, more for couples and families. Merck stands to gain many millions of dollars from PWAs. It can afford to help the indigent.

3. Deep discounts for public programs such as the AIDS Drug Assistance