Examining the production costs of antiretroviral drugs

Abstract

The availability of data on the cost of antiretroviral drug production and calculation of factory prices under a sustainable business model provide benchmarks that bulk purchasers of antiretroviral drugs could use to negotiate lower prices. While truly significant price decreases for antiretroviral drugs will depend largely on the future evolution of API prices, the present study demonstrates that for several antiretroviral drugs price reduction is currently possible. Whether or not these reductions materialize will depend on the magnitude of indirect cost and profit added by each supplier over the direct production costs. The ability to achieve price reductions in line with production costs will have critical implications for sustainable treatment for HIV/AIDS in the developing world.

Sustaining access to antiretroviral therapy in the less-developed world: lessons from Brazil and Thailand

“…At the same time, the government gave the patent holder, Abbott, 10 days to offer a reasonable price, but in fact negotiations were protracted over 4 months, and concluded with the government agreeing on a price of US$1380 per patient per year for the old version and US$1518 for the heatstable version. The discounted price obtained was still far higher than the best prices available internationally by Abbott (US$500 per patient/year), and production cost estimates published by the WHO (US$338 per patient/ year) [37]. In addition, the Brazilian government made a number of concessions demanded by Abbott, including restricting the use of the compulsory licence, and a moratorium on future price negotiations until 2011 [38].…”

“…Abbott responded by offering a price of US$2000 per patient per year (at the time a generic company was offering $1333 per patient/year). Given that the drug costs less than US$400 to manufacture [37] the MOPH proceeded with the compulsory licence. The company discounted the price again, to US$1000 per patient per year for both the old and the new version of the drug, and this offer was made available to 40 'middle-income' countries including Brazil.…”

Patentes farmacêuticas e saúde pública: desafios à política brasileira de acesso ao tratamento anti-retroviral

“…Deve-se considerar que, com a expansão do acesso ao tratamento contra HIV/AIDS nos países menos desenvolvidos, fruto da campanha internacional de acesso a anti-retrovirais, existe a possibilidade de escassez e, conseqüentemente, de encarecimento dos princípios ativos 65 . Mais preocupante ainda, a recente internalização da proteção patentária para o setor farmacêutico nas legislações de propriedade intelectual da China e da Índia implica, no médio prazo, sérias barreiras ao fornecimento de insumos para novos medicamentos.…”

How developing world concerns need to be part of drug development plans: a case study of four emerging antiretrovirals

“…Tibotec is developing rilpivirine for the treatment of antiretroviralnaïve patients in combination with other antiretrovirals [15]. However, on the basis of its in vitro virological profile and specific pharmacokinetics it is reasonable to expect excellent safety and efficacy in treatment-experienced patients.…”