|Sources and Prices of Selected Drugs and Diagnostics for People Living with HIV/AIDS (UNAIDS, 2001, 36 p.)|
The issue of how drug prices are determined is complex. Identical items produced by the same company may not only be marketed at different prices on the international market but within individual countries as well. While there is no generally accepted method for performing international price comparisons, this survey has been carried out in a way that takes into account: quality of product; sales volume; terms and conditions for payment; and issues relating to exchange rates.
The data collected during the surveys show that the majority of drugs are available as generics on the international market. Although prices vary widely, realistic indicative prices for bulk procurement can be estimated for many products. The limitations of these indicative prices are:
· The prices listed apply generally in the context of bulk procurement i.e. the working unit is one batch. Although batch sizes vary greatly among formulations and manufacturers, the following sizes are typical: capsules and tablets in batches of 100,000 to 500,000 (batches of over 1 million are not uncommon, but these are not minimum purchases); vials and bottles in batches of 5,000 to 20,000.
· Prices are ex-works (EXW) or free-on-board (FOB). They do not include the added cost of items such as freight, insurance, import duties or taxes. For this reason, the prices quoted in this report cannot be compared with consumer prices which are often much higher due to these add-on costs. Many countries continue to impose considerable import duties and taxes on the price of essential drugs. In addition, wholesale and retail mark-ups vary from one country to the other. As a result, the ex-works price is often less than half of the end-price to the consumer.
· The prices quoted do not reflect any contractual agreements or differential pricing which manufacturers may have negotiated with individual countries.
· Since exchange rates fluctuate over time, the survey can only reflect the situation at a given date. Both the price quoted and currency conversion rate used were established on the date at which the offer was made.
· The report does not include data on sources and prices of drugs for the treatment of tuberculosis. However, this information is available on the website of the International Price Indicator Guide 2000 (a joint publication of Management Sciences for Health and WHO) at www.msh.org.
The following information is provided for each drug:
· General comments on availability, cost, and shelf-life.
· Inclusion in the WHO Model List of Essential Drugs (11th revision, 1999).
· The prices indicated in this report are based on the price data of mid-2000 unless indicated otherwise. The price of drugs (with their range, median, and 25th percentile of the price distribution) was supplied by the manufacturers, with examples of established and publicly available tender prices, where available. The minimum price listed represents the lowest price among products, with no differentiation among original or generic products. In these price comparisons, the 25th percentile is the value point representing the first quartile of quoted prices in ascending order. It is used to give some indication of the dispersion of prices for a given product. The calculation is also used to indicate how many manufacturers can produce the drug below this price.
· The number of manufacturers that gave indicative prices.
· Comparative price lists from the UK and Spain. The UK list price represents the public sector consumer price. This is the price set by the National Health Service (NHS) for reimbursement (British National Formulary 41). It cannot be used for direct comparison and is included for information only. The Spanish list price is ex-works and has been calculated by applying the new margins (as stated in the Royal Decree 5/2000) to the consumer price as published by Consejo General de Colegios Oficiales de Farmacicos in Spain (www.cof.es). In most cases, the indicative prices listed in the report are a fraction of the comparative prices in the Spanish list. It should be noted that Spanish list prices are generally considered the lowest in Europe. The difference in drug costs, associated with treatment of a specific condition, between the Spanish and the 25th percentile price taken from the survey is added for examples for treatment of HIV-related conditions. This illustrates the potential of using the information gathered in this survey.
In addition, the information includes a table summarizing the offers of donation and price reduction of antiretroviral drugs publicly announced by a number of pharmaceutical manufacturers (Annex I). A new section on HIV test kits is included in the report and information on bulk procurement of HIV test kits is included as Annex II. Contact information of manufacturers included in the price survey is attached as Annex III.