AEGiS-15IAC: Determinants of prices of antiretroviral drugs for developing countries: An econometric analysis.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Determinants of prices of antiretroviral drugs for developing countries: An econometric analysis.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoOrD1033)

Moatti JP, Lucchini S, Cisse B, de Cenival M, Comiti C
GREQAM-EHESS, Marseille, France

Objectives: To analyze the determinants and long-term sustainability of a "differential pricing" mechanism for HIV/AIDS drugs in favor of developing countries. Data collection: Source prices of antiretroviral (ARV) drugs observed in real transactions that occurred in Brazil and 13 sub-Saharan African countries between 1998-2002. Current update of data collection to 20 additional countries and year 2003.

RESULTS: Preliminary analysis of 1,030 transactions reveals a linear declining price trend for ARVs between 1997-2000, an accelerated decrease in 2001, followed by a more limited decrease in 2002; a significant reduction in price differences between brand and generic drugs and between countries and a relationship between higher volumes per transaction and lower prices. Multiple linear regression shows that protease inhibitors (PIs), patent protection for the drug at country level, higher HIV prevalence, national guide-lines recommending PIs for first-intention treatment, and intervention of intermediary wholesalers were associated with higher prices. On the other hand, transactions in countries with organized public programmes for ARV delivery and in countries which participated in the Accelerated Access Initiative (AAI), the partnership that was launched in 2001 between UN organizations and six brand-name major pharmaceutical companies, were associated with lower prices. However, even after adjustment for th ese factors, the introduction of generic competition remains an essential factor for price decreases. This analysis will be extended to the new available prices data for 2003 and additional countries. Conclusion The sustainability of a lower differential pricing for HIV/AIDS drugs in developing countries implies that mechanisms of procurement continue to guarantee competitive decentralized negotiations with multiple suppliers including generic manufacturers. International agreements at the UN level, as well as pooling of drug purchasing between countries at regional level, may be helpful but only to the extent that they do not limit the emergence of effective markets for HIV drugs at national level.

Keywords: AEGIS, Developing Countries, Commerce, Pharmaceutical Preparations, Anti-HIV Agents, Research, Patents, Drugs, Generic, Costs and Cost Analysis, Marketing, Public Sector, Brazil, economics

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