1. Marketing Group Presentation b b Cost Analysis by Anawat Pinisakul b b Intellectual Property Laws in Thailand by Phanit Ratasuk b b Health Insurance in Thailand by Chate Jaikunya b b FDA Thai by Manaswee Arayasiri b b Southeast Asia Market by Myat Htay Kyi b b HIV in China by Wang Xiaofeng

2. Cost and Financing Aspects of Providing Anti-Retroviral Therapy Marketing Group of AIDS Drug By Mr. Anawat PinisakulEVD998498 Advisor Dr. Maria Kartalou Dr. Suvit Loprasert

3. Today Presentation b b Introduction Introduction Background Treatment of AIDS by drug b b Contents Contents Cost and financing aspect Cost-saving and cost-effectiveness b b Conclusions Conclusions

4. Introduction b The HIV/AIDS was first recognized in the early 1980s. b Treatment options were limited. b AZT drug (Zidovudine) was approved by USA’s FDA in 1987. b This drug is now widely used in North America, Europe and Australia b Other anti-retrovirals (ARVs)

5. Introduction b In contrast, ARVs are not yet widely available in developing countries. AsiaAsia AfricaAfrica Latin AmericaLatin America b ARVs combination therapies Prolong lifeProlong life Prevent HIV-infected progressionPrevent HIV-infected progression Reduce transmission of HIV from mother to childrenReduce transmission of HIV from mother to children

6. Contents b b Cost of providing anti-retroviral therapy Cost of providing anti-retroviral therapy b b Total cost implication of providing anti-retroviral therapy Total cost implication of providing anti-retroviral therapy b b Total cost implications of providing anti-retroviral therapy in comparison with available resources Total cost implications of providing anti-retroviral therapy in comparison with available resources b b Cost-saving potential and cost-effectiveness of anti-retroviral therapy Cost-saving potential and cost-effectiveness of anti-retroviral therapy b b Financing anti-retroviral therapy Financing anti-retroviral therapy

7. Cost of providing anti-retroviral therapy b Three types of drug Nucleoside reverse transciptase inhibitorsNucleoside reverse transciptase inhibitors Protease inhibitorsProtease inhibitors Non- Nucleoside reverse transciptase inhibitorsNon- Nucleoside reverse transciptase inhibitors

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9. Cost of providing anti-retroviral therapy

10. Estimated Number of People Total cost implication of providing anti- retroviral therapy North AmericaOceania Latin America Sub-Saharan Africa Caribbean Eastern Europe SE Mediterranean Northeast Asia Southeast AsiaWestern Europe Geographic Region

11. Total cost implication of providing anti- retroviral therapy Estimated Cost ($billion) North America Western Europe Oceania Latin America Sub-Saharan Africa Caribbean Eastern Europe SE Mediterranean Northeast Asia Southeast Asia

12. Total cost implications of providing anti- retroviral therapy in comparison with available resources

13. b Number of patients b Cost of treatment GDPGDP Health expendituresHealth expenditures

14. Cost-saving potential and cost- effectiveness of anti-retroviral therapy b Cost-saving potential AZT therapyAZT therapy –Reduced health care costs in comparison with not receive drug Triple-combination therapiesTriple-combination therapies –Cost save in 4.6 times per capita income b Cost-effectiveness AZT therapyAZT therapy –Prolong life Triple-combination therapiesTriple-combination therapies –Reduce medical costs

15. Financing anti-retroviral therapy b High cost with ARV therapy Financing care may not be sufficientFinancing care may not be sufficient b Health care financing TaxationTaxation Social insurance systemSocial insurance system Private insurancePrivate insurance User feesUser fees Community financing schemesCommunity financing schemes

16. Financing anti-retroviral therapy b Private insurance companies Difficult for patient to receive helpingDifficult for patient to receive helping Employers in the USA try to exclude AIDS patients from group insurance policesEmployers in the USA try to exclude AIDS patients from group insurance polices b Public sector In Maryland, MedicaidIn Maryland, Medicaid 65% of AIDS patients65% of AIDS patients

17. Conclusions b ARV therapy does appear affordable and cost- effective in high-income countries b Consideration Number of HIV patientsNumber of HIV patients Income of populationIncome of population Type of drugType of drug Government sectionGovernment section

18. Thank You! b Dr. Maria Kartalou b Dr. Suvit Loprasert b MIT Staff b CRI Staff b Our Classes

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20. Some Words b GDP Gross Domestic ProductGross Domestic Product The value of all goods and services produced in one year.The value of all goods and services produced in one year. b GNP Gross National ProductGross National Product Sum of all personal and governmental expenditures on goods and services within a country, including the value of net exportsSum of all personal and governmental expenditures on goods and services within a country, including the value of net exports b GNP = GDP + Net income from outside country

21. Some Words b GDP Gross Domestic ProductGross Domestic Product The value of all goods and services produced in one year.The value of all goods and services produced in one year. b GNP Gross National ProductGross National Product The total domestic and foreign value added claimed by residents and is calculated without making deductions for depreciation.The total domestic and foreign value added claimed by residents and is calculated without making deductions for depreciation. b GNP = GDP + Net income from outside country

22. Some Words b b Caribbean The region of the Atlantic between the southern W. Indian islands and Central America. b b Mediterranean The almost land-locked sea separating southern Europe from Africa, connected with the Atlantic Ocean by the Strait of Gibraltar, with the Black Sea by the Bosphorus, and (now) with the Red Sea by the Suez Canal.

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