Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Nov 18;9 Suppl 1(Suppl 1):S6.
doi: 10.1186/1471-2458-9-S1-S6.

Factors influencing global antiretroviral procurement prices

Veronika J Wirtz  1 , Steven Forsythe, Atanacio Valencia-Mendoza, Sergio Bautista-Arredondo
Affiliations

Factors influencing global antiretroviral procurement prices

Veronika J Wirtz et al. BMC Public Health. .

Abstract

Background: Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs.

Methods: An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs.

Results: Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief.

Conclusion: One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this.

PubMed Disclaimer

References

    1. The Joint United Nations Program on AIDS. Countries. 2008. http://www.unaids.org/en/CountryResponses/Countries/default.asp
    1. The Joint United Nations Program on AIDS. Financial resources required to achieve universal access to HIV prevention, treatment, care and support. 2007. New York: The Joint United Nations Program on AIDS; p. 8.
    1. Médecins sans Frontières. Geneva, Switzerland. 11 2008. Campaign for Access to Essential Medicines. Untageling the web of antiretroviral price reduction.
    1. World Health Organization. Transaction Prices for Antiretroviral Medicines and HIV Diagnostics from 2004 to September 2008. A summary report from the Global Price Reporting Mechanism. Geneva, Switzerland. 2008. http://www.who.int/hiv/amds/gprm/en/ (accessed Dec 2008)
    1. Keiser O, Tweya H, Mc Phail P, Kumarasamy N, Nash D, Jahn A, Brinkhof MWG, Egger M, for the ART in Lower Income Countries Collaboration (ART-LINC) Determinants of switching to second-line therapy in resource-limited settings. http://www.iedea-sa.org/fileadmin/IeDEA/Posters/Poster_Malaga_final_Oliv... (accessed Jan 2009)

Publication types

Substances