1 / 16

Access to ART in a context of increasing patent protection:

Access to ART in a context of increasing patent protection:. an analysis of ARV drug price evolution and determinants in Brazil C Meiners , L Sagaon - Teyssier , F Orsi , R Lopes, MP Carrieri , B Spire, L Hasenclever , JP Moatti AIDS 2010 Vienna. Presentation outline.

steel-vinson
Télécharger la présentation

Access to ART in a context of increasing patent protection:

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Access to ART in a context of increasing patent protection: an analysis of ARV drugpriceevolution and determinants in Brazil C Meiners, L Sagaon-Teyssier, F Orsi, R Lopes, MP Carrieri, B Spire, L Hasenclever, JP Moatti AIDS 2010 Vienna

  2. Presentation outline • Context • Issues and objectives • Data and methods • Results • Case analysis • Main conclusions

  3. Context HIV/AIDS & HAART in Brazil • PLWHA : 730 th (UNAIDS, 2008) • Prevalence: 0.61% since 2004 • Treatment coverage: almost 200 th patients • Free and universal access to HAART • Decentralized and individualized care • 2009: 19 ARVs and 1 FDC (32 formulations)

  4. Context ARV market structure • Demand-side: monopsony (MoH) • Supply-side: patented and off-patent drugs • Branded segment - 9 proprietor/licensed MNCs - 13 ARVs • Non-branded segment - Local production (6 gov & 1 priv lab) - 8 ARVs and one FDC (AZT+3TC)

  5. Context

  6. Issues and objectives • Local production + assertive pricenegotiations »»access to state-of –the-art HAART in Brazil • ↑drugresistance + toxicity »»↑ adoption of patenteddrugs • Objectives: • Study ARV priceevolution • Identify main price determinants

  7. Data and methods • Object: adult ARV transactions (2009 USD) • Analysedperiod: 1996 - 2009 • Data: transaction, drug and marketcharacteristics • Source: Dept of STD, AIDS and VH, MoH • Descriptive analysis: QYD and PYD evolution • Regression analyses: pricedeterminants (log PYD) • Variables: therapeutic class, log QYD, drug age, patent status, transaction year, patient weight

  8. Results Coverage and mean expenditure 5 100 1 350 N=607

  9. Results PYD according to supply type ↓52% 2 000

  10. Results ARV supply share (QYD) N=491 55% 20%

  11. Results Expenditure share (2009 USD) N=491 80% 80% 68%

  12. Results N=491 ^ ^ ^ * Significantat 10%; ** Significantat 5%; ***Significantat 1%

  13. Case analysis I. 1st-line NRTI PYD evolution 927 313 95

  14. Case analysis II. Compulsory license of EFV 1 163 ↓74%

  15. Main conclusions • ARV price decrease has been mainly pushed by non-branded drug competition; • Falling price trend came to a halt after 2004; • Patent protection, due to its effect on prices, constitutes an important obstacle to the access to new generation ARVs; • Increasing ARV costs help impose a double standard of HIV care in the world; • TRIPS flexibilities may provide an important means for decreasing costs, yet their full application faces important limits and high political pressure.

  16. Acknowlegments: ANRS, Sidaction, Dept. of STD, Aids and VHs (BMoH), UMR 912 Inserm & IE/UFRJ. Contact: constance.meiners@inserm.fr

More Related