Marseille 2007
| Abstract #51 - Evolution of prices for antiretroviral drugs in Senegal 1998 2006 | ||||
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Session: 19.5: Universal Access to care (Parallel) on Monday @ 14.00-16.00 in HC Chaired by Shirin Heidari, Jean-Paul Moatti Authors: Presenting Author: Mrs Mame Basty Kota - Centre rgioanl de Recherche et de Prise en Charge du VIH/sida, Senegal |
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| Additional Authors: Dr Karim Diop, Dr Bernard Taverne, | ||||
| Aim: Describe the evolution of prices for the different ARV molecules available in Senegal from 1998 to 2006, identify the main circumstances and causes for the price decrease and assess the impact of updating therapeutic recommendations (notably second-line regimens) on treatment costs. | ||||
| Method / Issue: Prices for ARV drugs available in Senegal were gathered from drug delivery orders provided by the National Supply Pharmacy (NSP) since 1998. The NSP is the only public structure authorized to import these drugs. Prices have been compared to those on the international market, as indicated in the Pricing Guide for the Purchase of ARVs for Developing Countries (9th edition, MSF, 2006). | ||||
| Results / Comments: In 2006, the following are available: 5 NRTI (AZT, ddI, 3TC, d4T, FTC [within the framework of a clinical trial]) and the combination AZT+3TC; 1 NtRTI (TDF); 2 NNRTIs (EFZ, NVP); 3 PIs (IDV, NFV, L/r). In 1998, the program began with brand-name drugs. The first generics were ordered in October 2002 and distributed in April 2003. Since 2003, supply went through a competitive process among suppliers on the international market. The first major price decreases occurred between 2000 and 2001 (access agreements with the industrial owners). The subsequent decreases are clearly due to supply from generic producers. The average cost of a first-line ARV treatment was $332/year/p in 2006. Only the TDF/ddI/L/r combination is available as a second-line therapy at a cost of $1885/year/p; whereas the lowest average price on the international market is $1317/year/p. | ||||
| Discussion: Therapeutic activism should be strengthened to obtain a significant decrease in the prices of second-line treatments. However, issues surrounding ARV drug supply cannot simply focus on the price of drugs; they must also consider (1) the continued rapidly evolving character of international recommendations (choice of adapted molecules), (2) product availability on the international market to avoid breaks in stock and (3) drug quality. | ||||
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