A Financing AIDS and pricing antiretrovirals (ARV): the Brazilian and Mexican case RAUL MOLINA GONZÁLEZ UNIVERSIDAD AUTONOMA Background: The study focuses on the forms of HIV/AIDS financing and the pricing ARV drugs in the Brazilian and Mexican case. The financing forms are not neutral in relation to an equitable access. The public forms of financing, social security or general taxation, are more equitable than those relying on the household out-of-pocket money. People who live with HIV/AIDS in Brazil have universal access to a comprehensive treatment that includes the ARV drugs, but this it is not the case of Mexico. In Mexico health services are segmented, as well as those for people affected by HIV/AIDS, in the social security system is provided a comprehensive treatment but it is not the case for people without social security regardless of an availability improvement on ARV drugs actually. Methods: The AIDS health accounts are used to study the financing forms. For ARV drug prices the public and private information is used. Results: The main source of financing, in both countries, is public. The Brazilians AIDS mortality rate (AMR) fell down as the AIDS program was implemented and ARV drugs were included on an universal basis. The Mexican AMR is stabilized, nonetheless the AMR is 54% lower for people with social security (Instituto Mexicano del Seguro Social), a widening gap between Mexican society. The ARV drug prices in Mexico are higher than those in Brazil; Lamivudine, Saquinavir and Lopinavir- Ritonavir are highly priced in Mexico relative to Brazilian prices by 2006; As an average the ARV drug cost therapy by patient is 240% higher in Mexico than the Brazilian one by Conclusions: The Mexican health system fails to provide a comprehensive and universal health care to the treatment of HIV/AIDS thus AMR do not fall. The ARV drug therapy cost is a high burden for Mexican society which could put in jeopardy the Mexican AIDS program.

PRICES PER PILL PER YEAR (PPPY) FOR ANTIRETROVIRAL DRUGS IN BRAZIL AND MEXICO: 2006 (US DOLLARS ) MEXICA N CODEDRUGSSTRENGTHSUPPLIER MEXICO PPPY US DOLLAR S BRAZIL PPPY US DOLLAR S % MEXICO PPPY/BRAZ IL PPPY 4273Abacavir (Ziagenavir) TAB 300 mg GLAXO-SKB2,6401, Didanosina (Videx) TAB 100 mg BRISTOL Didanosina Ec (Videx) CAP. 250 mg BRISTOL Didanosina Ec (Videx) CAP. 400 mg. BRISTOL.1, Efavirenz (Stocrin) TAB 600 mg MERCK SHARP & DOHME Indinavir (Crixivan) CAP. 400 mg. MERCK SHARP & DOHME.6691, Lopinavir - Ritonavir (Kaletra) CAP133/33 mg ABBOTT5,2331, Lamivudina (3TC) TAB150 mg GLAXO-SKB.2, , Nelfinavir (Viracep) CAP. 250 mg. ROCHE.4,3651, Ritonavir (Norvir) CAP. 100 mg ABBOTT Saquinavir (Fortovase) CAP. GEL 200 mg, ROCHE.4, , Tenofovir (Viread) CAP. 300 mg STENDHAL1,1161,38780 SOURCE: ESTIMATED FROM GOVERNMENT BIDS: a) BRAZIL´S AIDS TREATMENT PROGRAMME, b) CONASIDA WHO: DEFINED DAYLY DOSE. CURRENT US DOLLARS