Fluconazole in Nicaragua and Pfizer's "Special Discount"
by Richard Stern

Nicaraguans living with AIDS continue to die from opportunistic infections that have been treatable for many years. According to Willford Lopez, of the Nicaraguan National Association of People Living with AIDS, (ASONVIH/SIDA), Fluconazole, used to treat candidiasis and toxoplasmosis continues to be priced out of the reach of most People with AIDS in his country.

Says Lopez "fluconazole (a generic version) costs $4 per day. When Juan Antonio, Vice President of our Association, was sick two weeks ago, it tooks several days to raise the money to buy him two weeks worth of fluconazole," said Lopez. With per capita income in Nicaragua at less than $100 per month it is unlikely that People already sick with AIDS would be able to afford fluconazole, and the government does not provide it because it is not on the list of "essential medicines." "In fact it was on the list, and was removed a few years ago," said Lopez.

Fluconazole is made by Pfizer. Generic versions of Fluconazole are available for as little as .25 U.S.(less than 10 percent of the cheapest generic version in Nicaragua) in countries such as Thailand because of efforts made by the national government and supported by regional health associations. But, in Central America costs vary greatly and there has been no regional effort to provide generic fluconazole at prices similar to those available in other parts of the world.

Consulted October 8th about the price Fluconazole in Nicaragua, a Pfizer representative offered a "special discount" of $16.80 per 200 milligram capsule, if a not for profit association was buying the pills to donate them to People living with AIDS. The regular over the counter price for Pfizer's product in Nicaragua was quoted by this representative as $23.60 per capsule, more than five times higher than the price of the generic version in Nicaragua and approximately 90 times the price of the generic version in Thailand.

Nicaraguans also receive assistance from Salvadoran brothers and sisters who are willing to smuggle generic fluconazole into the country

CPT Home IP and Healthcare CPT page on Fluconazole