1. Washington D.C., USA, 22-27 July 2012www.aids2012.org An advocacy tool: Untangling the Web of Antiretroviral Price Reductions Arax Bozadjian HIV Focused Pharmacist Access Campaign for Essential Medicines

2. Washington D.C., USA, 22-27 July 2012www.aids2012.org Untangling the Web: 15 th edition History:  Widely varying prices between on patent and off-patent medicines  1998 Thai NGO campaign for generic fluconazole sees price drop 97% in nine months Annual publication since 2000: provides ARV pricing in response to lack of transparent and reliable information  Comprehensive pricing information provided by originator and generic manufacturers of ARVs  Source of price comparison, patent information, access issues Used as advocacy tool; quoted in publications Available online: http://utw.msfaccess.org

3. Washington D.C., USA, 22-27 July 2012www.aids2012.org Purpose and Methodology Purpose: Help purchasers make informed decisions when purchasing ARVs for use in developing countries; used as an advocacy tool How: Details originator and generic company prices of individual ARVs; analyzes price evolution Methodology: –Questionnaire sent to companies (voluntary) –Information requested: ARV prices for developing countries; restrictions that apply to quoted prices –Generic manufacturers with at least one ARV WHO PQ are invited to participate Limitation: –No commitment from manufacturer

4. Washington D.C., USA, 22-27 July 2012www.aids2012.org Practical use of UTW as a Tool Increased Transparency of pricing and access policies UTW provides both price and patent information Market segmentation by innovator companies Advantages of generic competition (first and second line ARVs) Historical data

5. Washington D.C., USA, 22-27 July 2012www.aids2012.org First, Second and Third Line ARV prices at present The price of a third line regimen is 14 x more expensive than the most affordable first line regimen and over 6 x more than the most affordable second line regimen

6. Washington D.C., USA, 22-27 July 2012www.aids2012.org First Line Regimen:TDF/3TC/EFV

7. Washington D.C., USA, 22-27 July 2012www.aids2012.org Second Line Regimen: ATV/r

8. Washington D.C., USA, 22-27 July 2012www.aids2012.org Third Line Regimen: Darunavir

9. Washington D.C., USA, 22-27 July 2012www.aids2012.org Questions and/or comments? Thank You; Arax Bozadjian PharmD Arax.Bozadjian@geneva.msf.org