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Abstract
Negotiating antiretroviral drug prices to increase access: challenges and opportunities
E.C. Seoane Vazquez1, R. Rodriguez-Monguio2
1Ohio State University, College of Pharmacy & School of Public Health, Columbus -OH, United States, 2Ohio State University, School of Public Health, Columbus -OH, United States
Issues: This study analyzes the impact of the Andean Countries negotiation (Lima 2003) of antiretroviral drug (ARVs) prices. The study objectives were: to assess the problems faced by the Andean countries during the negotiation process, to evaluate the impact of the negotiation on prices paid by public programs, and to identify factors that made it difficult for countries to purchase ARVs at the negotiated prices and standards.
Description: The Lima negotiation (2003) marked the first time generic companies participated in a multinational negotiation. The objectives of the negotiation were to reduce the cost of and expand access to HIV tests and ARVs. The Pan American Health Organization – World Health Organization provided technical support during the negotiation process.
The information derived from a bibliographic review and a survey of prices directed to the Andean countries ministries of health. Prices paid by public programs were analyzed by program, country and company. ARVs purchases were converted to common units and U.S. dollars.
Lessons learned: The negotiation achieved lower prices and higher quality standards. In general, public programs of the six countries analyzed did not purchase ARVs from the companies that participated in the negotiation, nor did they base purchases on the prices or quality and bioequivalence criteria established in the negotiation. Prices paid by the Andean countries’ public programs in 2004 ranged from 84.7% to 4477.8% of the average negotiated prices, with a weighted average of 165.4%.
Recommendations: Successful development and implementation of multinational price negotiations require that participant countries coordinate regulations and policies related to drug registration, quality and bioequivalence, international trade, intellectual property, and procurement. At the national level, more efficient use of resources could be achieved upon coordination of each country’s various health care programs; improvement of the countries’ epidemiological and information systems; and strengthening of the procurement and distribution systems.
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