Tamar Kahn
26 February 2008
Cape Town — Africa's biggest generic drug maker, Aspen Pharmacare, cast the spotlight on the health department's battle to keep tabs on AIDS patients, as CEO Stephen Saad revealed figures yesterday suggesting one in six people enrolled on the government's free treatment programme is unaccounted for.
Saad said Aspen, a key supplier of generic antiretroviral medicines to the state, estimated there were 340000 to 350000 patients on treatment. The figure is markedly lower than the treasury's figure last week, which showed 418000 HIV patients had been initiated on treatment at 316 sites since the programme began four years ago.
Treasury's director for health policy Mark Bletcher was unable to say how many patients had died, switched drugs due to side-effects, or quit treatment altogether, and referred queries to the health department.
Yesterday the health department's spokesman Sibane Mngadi said he was unable to confirm Aspen's snapshot of the number of patients on treatment, but said it was to be expected that the company's figures would be lower than the cumulative total enrolled on the treatment programme. The department would comment later on the reasons for patient drop-out, he said.
However, last August health director-general Thami Mseleku told reporters his department did not have an adequate monitoring system for AIDS patients. Doctors failed to report adverse reactions to AIDS drugs, it was hard to track patients who moved between health facilities, and researchers were not providing clinic data to a central authority, he said.
Aspen provides state hospitals and clinics with five generic anti-retrovirals -- stavudine, lamivudine, didanosine, zidovudine and nevirapine -- which are used to help slow the progression of HIV.
Saad said Aspen had used sales of lamivudine to gauge the size of the patient pool, as the drug was provided to almost all HIV patients on long-term treatment as part of a three-drug cocktail. Aspen was awarded 80% of the contract to supply lamivudine to the state, with the remainder going to GlaxoSmithKline.
Saad said Aspen estimated that no more than 500000 AIDS patients were likely to be on treatment within the next year, due to staff and infrastructure constraints in the public sector.
This means less than half the HIV patients in need of treatment will be getting life-prolonging antiretrovirals by mid-2009, according to the Actuarial Society's calculations, detailed in the latest Health Systems Trust Review.
Aspen yesterday reported a 24% increase in operating profit to R634m for the six months to December, driven by sales of AIDS drugs and strong performance in its domestic and offshore pharmaceutical divisions. But growth was tempered by a slump in sales of a ctive p harmaceutical i ngredients , as rival Adcock Ingram stopped buying Aspen's codeine phosphate (used in painkillers) in favour of imported supplies.
Aspen's bottom line was also knocked by reduced profits in its consumer division, as a 60% increase in the price of milk squeezed margins on its infant formula products.
Aspen Australia reported a 30% increase in earnings before interest, tax and amortisation (Ebitda) to R48m, while the South African business grew Ebitda 17% to R577m.
Saad said performance in Aspen's SA pharmaceutical business was slightly dampened by unexpected delays in getting new products approved by the Medicines Control Council. Aspen had 218 products awaiting registration, and estimated it took an average 27 months for its dossiers to be approved.
Aspen's share price fell 5,2%, or R1,70, to close at R31 yesterday.
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