Merck Pricing Policy for HIV Medicines in the Developing World

Merck instituted a differential pricing policy in March 2001, as part of its commitment to addressing HIV, with the goal of ensuring that its HIV antiretroviral medicines reach as many of those in need as possible. Merck's differential pricing facilitates access while allowing for sustainability and for investment in clinical and medical education programs in the countries with the greatest disease burden and allowing for an incentive to develop and market medicines in countries with a lower HIV disease burden and with a greater ability to finance healthcare.

ISENTRESS^® (raltegravir), STOCRIN^® (efavirenz), CRIXIVAN^® (indinavir)

As of January 1, 2011, pricing categories for Merck's HIV antiretroviral medicines has been based on World Bank country classification based on gross national income per capita (Atlas method) classification. Merck offers its lowest Access price for its HIV medicines to all countries in sub-Saharan Africa and Low Income countries, as defined by the World Bank. As of July 1, 2011, the Access prices for Merck's HIV medicines in sub-Saharan Africa and Low Income countries for eligible customers¹ are:

Countries classified as Low-Middle and Upper-Middle Income² by the World Bank are eligible for prices that are discounted from the prices in the developed High Income countries. These prices will vary based on country income, disease burden, and will be negotiated with each government.

For the High Income countries, Merck will make ISENTRESS available at competitive prices that take into account the innovation and value that ISENTRESS represents.

ATRIPLA^® (tenofovir, emtricitabine, efavirenz)

Merck sells ATRIPLA at $1.68 per day, or $613 per year in 98 access countries as defined by our agreement with Gilead.

Antiretroviral (ARV) Pricing

Merck is committed to reviewing the prices of our ARVs based on efficiencies in manufacturing and supply, and/or reductions in the costs of active ingredients.

Since 2000, Merck has lowered the access price of STOCRIN more than 95 percent from an introductory price of US $10/day in 1998, to US $.65/day. Since 1996 Merck has lowered the access price of CRIXIVAN by 84 percent, from an introductory price of US $12/day to US $1.64/day.

¹Customers eligible for public sector Access pricing in sub-Saharan Africa and Low-Income countries will include: governments and programs fully funded by governments and/or by multi- and bi-lateral donors (e.g., the Global Fund, PEPFAR or UNITAID), UN System Organizations, NGOs and other noncommercial providers of HIV treatment in Sub-Saharan Africa and World Bank defined Low-Income countries. Merck offers these products on DDU, CIP or CPT airport of destination (Incoterms, 2000) basis. Additional costs may include freight, insurance, customs handling, taxes and duties.

²Customers eligible for public sector pricing in Low-Middle and Upper-Middle Income countries will include: governments and programs fully funded by governments and/or by multi and bi-lateral donors (e.g., the Global Fund, PEPFAR or UNITAID), UN System Organizations and NGOs. Low- and Middle-Income countries that are members of the European Union are not eligible for pricing under this access program.