XIX International AIDS Conference


WEAE01 The Future of Affordable ART: Trends in Patents and Price
  Oral Abstract Session : Track E
Venue: Session Room 7
Time: 25.07.2012, 11:00 - 12:30
Co-Chairs: Charles B. Holmes, United States
Sharonann Lynch, United States
 
 

11:00
WEAE0101
Webcast
Introduction


C. Holmes, United States

11:05
WEAE0102
Abstract
Powerpoint
Webcast
Compulsory licence and access to medicines: economic savings of efavirenz in Brazil
F. Viegas Neves da Silva, R. Hallal, A. Guimarães
Ministry of Health, Brazil, Department of STD, AIDS and Viral Hepatitis of the Secretariat for Health Surveillance, Brasília, Brazil
F. Viegas Neves da Silva, Brazil

11:18
WEAE0103
Abstract
Powerpoint
Webcast
Understanding voluntary licensing: an analysis of current practices and key provisions in antiretroviral voluntary licenses
C. Park1, S. Moon2, E. Burrone1, P. Boulet3, S. Juneja1, E. 't Hoen1
1Medicines Patent Pool, Geneva, Switzerland, 2Harvard University, Boston, United States, 3Independent Consultant, Geneva, Switzerland
C. Park, Switzerland

11:31
WEAE0104
Abstract
Powerpoint
Webcast
Panorama of the pharmaceutical patenting and sanitary registration of ARVs drugs in Brazil: implications to access and to health industrial complex
P. Villardi
Associação Brasileira Interdisciplinar de AIDS, Rio de Janeiro, Brazil
P. Villardi, Brazil

11:44
WEAE0105
Abstract
Powerpoint
Webcast
Affordability of HIV/AIDS treatment in developing countries: an analysis of ARV drug price determinants
L. Sagaon Teyssier1,2,3, Y. Arrighi1,3,4, B. Dongmo Nguimfack5, J.-P. Moatti1,2,3
1INSERM, U912 (SESSTIM), Marseille, France, 2Aix Marseille Univ, IRD, UMR-S912, Marseille, France, 3ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France, 4GREQAM, Groupement de Recherche en Economie Quantitative d'Aix-Marseille, Marseille, France, 5WHO, World Health Organization, Geneva, Switzerland
J. Moatti, France

11:57
WEAE0106
Abstract
Powerpoint
Webcast
The 'middle-income' curse: should global aid and treatment access decisions be based on national economic criteria?
K. Bhardwaj
Independent Lawyer (HIV, Health and Human Rights), New Delhi, India
K. Bhardwaj, India

12:10
WEAE0107
Webcast
Concluding remarks


S. Lynch, United States

Powerpoints presentations
Compulsory licence and access to medicines: economic savings of efavirenz in Brazil - Francisco Viegas Neves da Silva

Understanding voluntary licensing: an analysis of current practices and key provisions in antiretroviral voluntary licenses - Chan Park

Panorama of the pharmaceutical patenting and sanitary registration of ARVs drugs in Brazil: implications to access and to health industrial complex - Pedro Villardi

Affordability of HIV/AIDS treatment in developing countries: an analysis of ARV drug price determinants - Jean-Paul Moatti

The 'middle-income' curse: should global aid and treatment access decisions be based on national economic criteria? - Kajal Bhardwaj



Rapporteur report

Track E report by . François Dabis


WEAE01 - The future of affordable ART: trends in patents and prices

Session summary

Major changes in global trading rules have occurred in the past decade while countries were struggling with price negotiations on first-line then second-line ARV drugs. This session summarized what happened globally and at country level in this recent period and shed some light on the successes achieved so far as well as the many challenges emerging now.

Viegas et al described the smart use Brazil made of the compulsory license mechanism for efavirenz. A comprehensive legal framework was put in place in 2007 and renewed in 2012. The cost reduction was almost immediate and quite drastic after the adoption of the compulsory license, allowing a rapid and massive increase in the number of patients treated and leading to an estimated 58% in savings. This flexibility in the TRIPS should be used more broadly as it clearly serves to improve access without impairing economics.

Park et al reported the findings of an international survey performed by the Medicines Patent Pool on the use of voluntary licensing, a non-exclusive license granted to generic producers by an originator company. Industry practices varied widely in geographic scope, number of licensees and many terms and conditions although transparency was limited, a problem encountered by Villardi also when critically reviewing the pharmaceutical patenting and sanitary registration of ARV drugs in Brazil. Companies must be encouraged and scrutinized to adopt “maximize access” terms and conditions.

Moatti et al explored the trends in ARV drug prices and their determinants at a global level by analyzing a large international database of donor-funded ARV transactions set under the auspices of UNITAID. Treatment prices seemed to have reached the marginal cost level for first-line drugs but reductions of 50% or more are certainly possible for second- and third-line treatments. Quantities purchased have now become a clear driver of drug costs, like in any mature market, with a positive correlation with GDP per capita. Generic competition has clearly been a driving force for ARV price decreases. Brand firm strategies remain however the major source of higher prices, including when patents expire.

Bhardwaj specific analysis of the situation in middle-income countries was somewhat alarming as universal access is likely to be seriously impaired by such categorization of countries. Indeed, they must now fund themselves their treatment programs and have different negotiation rules imposed by the pharmaceutical industry. Furthermore, the Global Fund has not totally clarified its position on the matter.

Overall, there is a risk to loose the progress made in the past ten years, at least in some countries and certainly for drugs other than those currently used first-line. The goal set of an HIV-free generation and the plea for maximum efficiency appear somewhat contradictory with the global policies on international property supported by some big donor countries as well as their own relative inefficiency in health system organization.

 




   

    The organizers reserve the right to amend the programme.


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