This paper assesses the costs of antiretroviral drug (ARV) procurement and identifies policies that could help to lower costs, improve efficiency, and thereby ensure sustainable long-term access to ARVs by low and middle income countries.
An analysis of ARV price changes between 2005 and 2008 was carried out using data from the Global Price Reporting Mechanism (GPRM) of the World Health Organization (WHO). Linear regression models were used to identify factors associated with lower procurement prices. Additionally, logistic regression models were used to identify factors which influenced countries’ abilities to procure ARVs at close to production costs.
The findings show that there is a large ARV price variation across countries, even for those with similar per capita income and epidemiological status. The price reductions between 2005 and 2008 were greatest for those ARVs which had more suppliers. Three key factors appear to have an influence on a country’s ARV prices: (a) whether the product is generic or not; (b) whether the country is a low or middle income nation; (c) whether the country is a member of the Clinton HIV/AIDS Initiative (CHAI). Factors which did not influence prices were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or is a focus country of the United States President’s Emergency Plan for AIDS Relief (PEPFAR).
