January 20. 2004
Dr. John Leonard
Vice President, Global Pharmaceutical Development Abbott Laboratories
100 Abbott Park Road
Abbott Park, IL 60064-3500
Dear Dr. Leonard:
By now you are well aware of the widespread dissatisfaction that HIV
Healthcare providers nationwide have with your company regarding the
decision to increase the price of ritonavir by more than 400%. This
letter represents a collective unified agreement from all the
signatories about our position on this issue, and the initial measures
that we are currently undertaking until the ritonavir price is undone.
It is very obvious that the justifications outlined in your letter dated
December 23rd, 2003 are not the real reasons for the price increase. By
now, you have met with many HIV healthcare providers who effectively
argued with Abbott representatives about the lack of justifications for
this action. We believe that trying to continue to debate these
justifications is not worthy, because it is just going to distract us
from the main issue, which is the potential devastating consequences
that this price increase portends for the future of HIV care in the
We understand that the rules and regulations that govern pharmaceutical
pricing are complex. Abbott’s willingness to pay the initial high
penalties and governmental discounts for overpricing a drug so much
above WSP, if any, coupled with a profit increase due to high 3rd party
payer payments, leads us to believe there is a much deeper marketing
strategy; even if the final goal is to overprice a new future
formulation and to lose any current penalties. This action is going to
set precedents that will have unfortunate consequences in the pricing of
anti-HIV drugs in the future. As gatekeepers, who have been told for
the last 20 years that we are responsible for keeping medical costs
down, we cannot allow this to happen.
We also strongly believe in the importance of a profitable and healthy
pharmaceutical industry market that will stimulate pharmaceutical R&D
and ultimately will result in more and better drugs for our patients.
For that reason, we would be in favor of your company, and other HIV
committed companies, increasing their revenues. Unfortunately, we
believe that taking advantage of a monopolistic situation, where your
product is the only effective protease inhibitor boosting agent , will
result in a much worse consequences in the future.
We want to make you aware that Abbott’s actions are perceived by many
healthcare workers and organizations as a way to force the use of one
drug over another. It is also seen as an outrageous behavior, extremely
disappointing from a company that was at the vanguard during the early
stages of the HAART era. For the reasons stated above, we all have
formally joined a nationwide boycott against Abbott Laboratories. The
actions we are currently taking are:
1. We resign as members of all Abbott advisory boards and lecture
2. Abbott representatives, commercial or medical, are currently banned
from our offices.
3. We will no longer attend any Abbott-sponsored lectures or advisory
4. We will not participate in any new Abbott-sponsored clinical trials.
5. We will continue to prescribe lopinavir/ritonavir or other boosted
PI’s in the best interest of our patients, but we will actively consider
other treatment options, when medically appropriate.
6. We will extend this boycott to other branches of Abbott Laboratories,
such as antibiotic, gastrointestinal and cardiovascular drugs,
nutritional supplements, diagnostics and any other Abbott-related
products. When other treatment alternatives are available for our
patients we will avoid the use of the following products: Biaxin,
Erythromycin PCE, Omnicef, Prevacid, Tricor, Depakote, Flumax, Hytrin,
Mavik, OraQuick, Advera, Ensure, Glucerna, Pro-sure, and Pulmocare.
7. We are actively encouraging other physicians and organizations to
join us in these actions.
Nobody will argue about the value of Norvir and Kaletra in current
treatment paradigms. We are also most appreciative of Abbott’s
collaboration on the HIV field. We feel that many of Abbott’s
representatives are among the most genuine, hard working and dedicated
people in the pharmaceutical field. Many of your representatives have
certainly gone beyond the call of duty to serve the HIV community
directly. It is for those reasons that we will be looking forward the
reestablishment of our relationship with your company, once the
ritonavir price is rolled back.
HIV Healthcare Providers
Dorothy E. Bulgin-Coleman
Luis Marquez Babilonia
Cissy van den Berg-Wolf