1. Differential Pricing UNFPA’s Experience With Contraceptives
Christian Saunders, Chief, Procurement Services

2. Every Minute in the World
380 women become pregnant
190 of these women did not plan or do not wish the pregnancy
Every minute:
380 women become pregnant, and 190 of them did not want the pregnancy at all or did not want it at this time.
A safe and effective modern method of contraception could have prevented these 190 pregnancies.

3. Every Minute in the World
110 women experience a pregnancy-related complication
40 women have an unsafe abortion
1 woman dies from a pregnancy related cause
Every minute:
110 women who are pregnant experience a complication of pregnancy; every minute 40 women undergo an unsafe abortion; and every minute one woman dies from a pregnancy related cause.
Again, contraception could have prevented the recourse to abortion, and the availability of medical assistance including, for example, anti-biotic drugs and drugs for treating raised blood pressure in pregnancy could prevent much maternal mortality and morbidity.

4. Every Minute in the World
650 people are infected with a curable STI
Every minute:
650 people are infected with a curable sexually transmitted disease (syphilis; gonorrhea; chlamidia; or trichomonas). Condom use could have prevented many of these infections, all of which require anti-biotics for their treatment.

5. Every Minute in the World
10 people are infected with HIV
Every minute:
10 people, 9 of them in developing countries, become infected with HIV for which as yet there is no cure. The majority (7 or 8) of these infections are acquired through sexual transmission, and condom use could have prevented them.
RH commodities are thus an essential element of any attempt to address the four main components of reproductive health: FP, maternal mortality and morbidity; RTIs and STDs; and HIV/AIDS.
However, the availability of contraceptives, condoms for STD and HIV prevention, and other essential commodities for maternal health is not in itself sufficient to ensure their use. But their non-availability will certainly ensure their non-use.
In 1994, at the International Conference on Population and Development (ICPD), the goal of universal access to reproductive health care by the year 2015 was established and agreed.

6. ICPD +5
Governments should strive to ensure that by 2015 all primary health-care and family planning facilities are able to provide directly or through referral, the widest achievable range of safe and effective family planning and contraceptive methods; Essential obstetric care; Prevention and management of reproductive tract infections, including sexually transmitted diseases; And barrier methods, such as male and female condoms and microbicides if available, to prevent infection.
Paragraph 53, ICPD +5

7. The United Nations Population Fund (UNFPA)
Advancing universal access to reproductive health
·        Family planning and safe motherhood
·        Preventing sexually transmitted infections, including HIV/AIDS
·        Care for consequences of unsafe abortion
·        Eliminating harmful traditional practices
Advocating informed, responsible and free choices
·        Women’s rights to health, education and freedom from violence
·        Sustainable development
Formulating population strategy & policy
·        Partnerships with governments, NGOs, the private sector and
UN agencies
·        Research on population issues

8. For every $1 million shortfall in contraceptive commodity assistance:
Does Price matter?
For every $1 million shortfall in contraceptive commodity assistance:
Increase in the number of unintended pregnancies: 360,000
Additional induced abortions: 150,000
Additional maternal deaths: 800
Additional infant deaths: 11,000
Additional deaths of children under 5: 14,000

9. Procurement
UNFPA is the largest public sector purchaser of contraceptives. Also supplies commodities for social marketing programmes.
Procurement undertaken by UNFPA is carried out through a fair & transparent process.
UNFPA utilizes competitive bidding and direct negotiation in the case of proprietary products.
Long term pricing agreements have been negotiated with many of the manufacturers.
40% of UNFPA’s Procurement is on behalf of external clients

10. UNFPA vs. MARKET PRICE (US$) UNFPA US MARKET Condom (piece) 0.025 0.50
IUD (Unit)
Injectable (dose)
OCs (cycle)
Spermicides (tablet)
Implants (set)

11. Cost per year of coverage
(US$) UNFPA US MARKET
Condom
IUD
Injectable
OCs
Spermicides
Implants
Surgical (female)
Surgical (male)

12. Possible Factors Affecting Price!
Volume
Procurement Process
Market Share
Image
Philanthropy

13. Procurement Volume

14. Procurement Process Competition Experience Professionalism Quality
Single client
Uncomplicated
Transparent
Long term partnership with strategic suppliers
Standardization
Forecasting allowing for planned production
Flexibility
Guaranteed Payment
Professionalism in Procurement – Negotiation skills
For example.
Keep stocks on our behalf so majority of the time no need for urgent supply – plan production
Leakage – Not often a problem but we treat the issue seriously as we know that our ‘pricing ‘ depends on maintaining our relationship with the supplier and we work with the suppliers and the Government to resolve these issues.
Clear parameters/instructions
Single differential for pricing between developed and developing
Standardized both in terms of the procurement process followed and in terms of the requirements E.G. packaging – so no investment needed. Standardized generic packaging also promotes competition and thus price reductions
No compromise on quality or shelf life
Manufacturer.
Inspected and certified by WHO.
GMP, ISO certified (in last year).
Certified by national authority.
Facility licensed to produce particular product.
General.
Independent sampling by internationally recognized surveillance company (SGS, Inspectorate, Crown Agents).
Quality control in a WHO recognized third country laboratory (with ‘condoms’ 100% batch testing).
Commodity.
Listed in British/American Pharmacopoeia.
Certificate of analyses.
Certificate of conformity.
Authorized for sale in country of origin.
Registered for use in country of final destination.
Meets WHO specifications.
At least 80% shelf life remaining.
Markings, including date of man., Expiry and batch/lot nos.
Instruction inserts in language choice.

15. ORAL CONTRACEPTIVES -‘THE PILL’

16. CONDOMS

17. INJECTABLES

18. IUDs

19. SPERMICIDES

20. Sub dermal Implants

21. Source Of Procurement

22. Differential Pricing PROPRIETORY PRODUCTS
Example
Product ‘X’
(Oral Contraceptive Under Patent)
UNFPA's price US$ 0.364/cycle
US Market price : US$ 34.00/cycle
Different name
Different packaging
Different product that essentially gives same results
Volume of other products contributes
Market share

23. UNFPA - Future Action
“Rapid population growth and high fertility hold back development and help to perpetuate poverty.”
179 countries adopted the ICPD Programme of action in Cairo in Five years later, a review identified key areas for urgent action. .
Contraceptives for couples wishing to space or limit families.
Condoms, voluntary testing and counseling to reduce the spread of HIV/AIDS among young people.
Availability of a wide range of safe and effective family planning methods.
Births assisted by skilled attendants.
    Literacy for women and girls.
     School enrolment, especially for girls.  .

24. The Future E-commerce Competition Group buying Standardization
choice vs. security
With IPPF/ USAID and UNFPA be more than 80% of all donated contraceptives