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Strategies for price reduction of HIV medicines under a monopoly situation in Brazil
OBJECTIVE: To analyze Government strategies for reducing prices of antiretroviral medicines for HIV in Brazil. METHODS: Analysis of Ministry of Health purchases of antiretroviral medicines, from 2005 to 2013. Expenditures and costs of the treatment per year were analyzed and compared to internationa...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Faculdade de Saúde Pública da Universidade de São Paulo
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687827/ https://www.ncbi.nlm.nih.gov/pubmed/26759969 http://dx.doi.org/10.1590/S0034-8910.2015049005459 |
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author | Chaves, Gabriela Costa Hasenclever, Lia Osorio-de-Castro, Claudia Garcia Serpa Oliveira, Maria Auxiliadora |
author_facet | Chaves, Gabriela Costa Hasenclever, Lia Osorio-de-Castro, Claudia Garcia Serpa Oliveira, Maria Auxiliadora |
author_sort | Chaves, Gabriela Costa |
collection | PubMed |
description | OBJECTIVE: To analyze Government strategies for reducing prices of antiretroviral medicines for HIV in Brazil. METHODS: Analysis of Ministry of Health purchases of antiretroviral medicines, from 2005 to 2013. Expenditures and costs of the treatment per year were analyzed and compared to international prices of atazanavir. Price reductions were estimated based on the terms of a voluntary license of patent rights and technology transfer in the Partnership for Productive Development Agreement for atazanavir. RESULTS: Atazanavir, a patented medicine, represented a significant share of the expenditures on antiretrovirals purchased from the private sector. Prices in Brazil were higher than international references, and no evidence was found of a relationship between purchase volume and price paid by the Ministry of Health. Concerning the latest strategy to reduce prices, involving local production of the 200 mg capsule, the price reduction was greater than the estimated reduction. As for the 300 mg capsule, the amounts paid in the first two years after the Partnership for Productive Development Agreement were close to the estimated values. Prices in nominal values for both dosage forms remained virtually constant between 2011 (the signature of the Partnership for Productive Development Agreement), 2012 and 2013 (after the establishment of the Partnership). CONCLUSIONS: Price reduction of medicines is complex in limited-competition environments. The use of a Partnership for Productive Development Agreement as a strategy to increase the capacity of local production and to reduce prices raises issues regarding its effectiveness in reducing prices and to overcome patent barriers. Investments in research and development that can stimulate technological accumulation should be considered by the Government to strengthen its bargaining power to negotiate medicines prices under a monopoly situation. |
format | Online Article Text |
id | pubmed-4687827 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Faculdade de Saúde Pública da Universidade de São Paulo |
record_format | MEDLINE/PubMed |
spelling | pubmed-46878272015-12-29 Strategies for price reduction of HIV medicines under a monopoly situation in Brazil Chaves, Gabriela Costa Hasenclever, Lia Osorio-de-Castro, Claudia Garcia Serpa Oliveira, Maria Auxiliadora Rev Saude Publica Original Articles OBJECTIVE: To analyze Government strategies for reducing prices of antiretroviral medicines for HIV in Brazil. METHODS: Analysis of Ministry of Health purchases of antiretroviral medicines, from 2005 to 2013. Expenditures and costs of the treatment per year were analyzed and compared to international prices of atazanavir. Price reductions were estimated based on the terms of a voluntary license of patent rights and technology transfer in the Partnership for Productive Development Agreement for atazanavir. RESULTS: Atazanavir, a patented medicine, represented a significant share of the expenditures on antiretrovirals purchased from the private sector. Prices in Brazil were higher than international references, and no evidence was found of a relationship between purchase volume and price paid by the Ministry of Health. Concerning the latest strategy to reduce prices, involving local production of the 200 mg capsule, the price reduction was greater than the estimated reduction. As for the 300 mg capsule, the amounts paid in the first two years after the Partnership for Productive Development Agreement were close to the estimated values. Prices in nominal values for both dosage forms remained virtually constant between 2011 (the signature of the Partnership for Productive Development Agreement), 2012 and 2013 (after the establishment of the Partnership). CONCLUSIONS: Price reduction of medicines is complex in limited-competition environments. The use of a Partnership for Productive Development Agreement as a strategy to increase the capacity of local production and to reduce prices raises issues regarding its effectiveness in reducing prices and to overcome patent barriers. Investments in research and development that can stimulate technological accumulation should be considered by the Government to strengthen its bargaining power to negotiate medicines prices under a monopoly situation. Faculdade de Saúde Pública da Universidade de São Paulo 2016-03-01 /pmc/articles/PMC4687827/ /pubmed/26759969 http://dx.doi.org/10.1590/S0034-8910.2015049005459 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Chaves, Gabriela Costa Hasenclever, Lia Osorio-de-Castro, Claudia Garcia Serpa Oliveira, Maria Auxiliadora Strategies for price reduction of HIV medicines under a monopoly situation in Brazil |
title | Strategies for price reduction of HIV medicines under a monopoly situation in Brazil |
title_full | Strategies for price reduction of HIV medicines under a monopoly situation in Brazil |
title_fullStr | Strategies for price reduction of HIV medicines under a monopoly situation in Brazil |
title_full_unstemmed | Strategies for price reduction of HIV medicines under a monopoly situation in Brazil |
title_short | Strategies for price reduction of HIV medicines under a monopoly situation in Brazil |
title_sort | strategies for price reduction of hiv medicines under a monopoly situation in brazil |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687827/ https://www.ncbi.nlm.nih.gov/pubmed/26759969 http://dx.doi.org/10.1590/S0034-8910.2015049005459 |
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