E-DRUG: WHO Bulletin paper on ARV prices
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[Important paper by Brenda Waning on ARV prices. Strongly recommended reading! WB]
Dear e-druggers,
I am pleased to announce the publication of a paper that examines the impact of 3 global strategies on prices for antiretroviral (ARV) medicines purchased with donor funds from 2002-2007.
http://www.who.int/bulletin/volumes/87/08-058925.pdf
Specifically, we looked at impacts of the following strategies on price:
1. purchase volume at country level (the number of tablets a country ordered for each procurement)
2. Clinton HIV/AIDS ARV price negotiation for generic ARVs on behalf of countries that comprise their consortium
3. Differential/tiered pricing schemes offered by originator companies for branded ARVs
Of most interest, perhaps, is the lack of a relationship between volumes purchased by countries and price. While conventional wisdom suggests "buy more, pay less", this over simplifies the complexities of ARV prices and market dynamics.
We hope this paper will facilitate a dialogue around other potential drivers of medicine prices, including barriers to generic entry at country and global levels, registration issues, financial inefficiencies (late payments to suppliers), supplier-client relationships, quantification challenges, production complexities, consolidation of demand, and intellectual property issues to name a few.
We found dramatic price reductions in ARV prices for the ARVs that comprise the original 1st line regimens recommended by WHO (e.g., lamivudine, nevirapine, stavudine, zidovudine); however, we drastically need new approaches to attain similar price reductions with ARVs that comprise the recent WHO-recommended 1st line regimens (e.g., tenofovir, abacavir, efavirenz, etc.).
Lastly, this paper demonstrates the value in transparency of medicines information. This paper was only possible because the Global Fund and WHO are both committed to transparency and post transactional data for medicines used to treat HIV/AIDS, TB, and malaria.
regards
Brenda Waning
Department of Family Medicine
Boston University School of Medicine
Boston, MA USA
email: bwaning@bu.edu
phone: +1 617 414-6318