Access to ARVs in low and middle income countries - Joseph Perriëns Coordinator HIV technology and commodities HIV dept. World Health Organization.

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Presentation transcript:

Access to ARVs in low and middle income countries - Joseph Perriëns Coordinator HIV technology and commodities HIV dept. World Health Organization

ARV price transparency DRV (600 mg)NA DRV (300 mg) ETV (100 mg) RAL (400 mg)NA Median price (US$ ppy) paid for third-line drugs by LMICs, Average price (US$ ppy) paid for first line treatment by LMICs, Median price (US$ ppy) paid for second line treatment regimens by LMICs, Source: Global Price Reporting Mechanism

Using price data… Median price and range (US$ ppy) of first line treatment regimens in LMIC, 2013 Source: Global Price Reporting Mechanism

Increasing supply security

Stock-outs require action in financing, supply planning and distribution

Regulatory approvals: a neglected area % of 139 countries with at least 1 registered supplier of: Adult formulations Paediatric formulations In 2012, WHO launched a collaborative procedure with national regulatory authorities to fast- track registration of prequalified medicines. 19 countries now participate.

Progress in intellectual property Geographic scope of voluntary licenses increased, and new drugs were licensed, e.g.: TDF: to 112 countries (Gilead via MPP) ATV: to 110 countries (BMS via MPP) Dolutegravir: to 144 countries (ViiV via MPP) RPV: to 112 countries (J&J, bilaterally) Countries with no access to voluntary licenses negotiated lower prices, and have at times resorted to compulsory licenses Newer drugs like DRV, RAL, EVG, RPV and TAF remain concerns

Concentration: a threat for competition and supply security Source: Global Price Reporting Mechanism

Acknowledgements Organizations (contributed data) CHAI, CPS/WHO, GFATM, IDA, JSI, MissionPharma, UNICEF, SCMS, SIAPS/MSH, UNAIDS,UNITAID, USAID. Companies (contributed data) Abbvie, Anhui Biochem United Pharm. Co., APIChem Chemical Technology Co. Arch Pharmalabs, Aurobindo Pharma, Aspen Pharmacare, Boehringer Ingelheim, Bristol-Myers-Squibb, CIPLA, Emcure Pharmaceuticals, Gilead Sciences, Glaxo-Smith-Kline, Hoffmann La Roche, Hetero, J&J, Lonzeal Pharmaceuticals, McLeod, Merck Sharp & Dohme, Microlabs, Mylan, Ranbaxy, Shandong Xinhua Pharm. Co., Shanghai Desano Chem. Pharm. Co, Strides Arcolab, Varichem, ViiV. People (helped write) Vincent Habiyambere (WHO), Boniface Dongmo- Nguimfack (WHO), Peter Beyer (WHO), Francis Aboageye-Nyame (SIAPS/MSH), Martin Autun (GFATM), Nathan Ford (WHO), Robert Matiru (UNITAID), David Jamieson (SCMS), Laurence Läser (WHO), Martina Penazzato (WHO), Chris Wright (JSI), Dominque Zwinkels (SCMS), G Hirnschall (WHO), Andrew Ball (WHO), Michel Beusenberg (WHO), Esteban Burone (MPP), Cees De Joncheere (WHO), Meg Doherty (WHO), Jane Galbao (UNITAID), Zafar Mirza (WHO), Taufiqur Rahman (UNITAID), Jaqueline Sawyer (WHO), Marco Vitoria (WHO), Gundo Weiler (WHO), colleagues in WIPO and WTO.