Ensuring the sustainability of free universal access to treatment for people living with HIV/AIDS in Brazil - financial impacts
R. Burgos Filho, R. Luiz Scapini
Ministry of Health, STD/AIDS Department, Brasilia, Brazil
Issues: Brazil currently provides ARV treatment for 190,000 people living with HIV/AIDS. 72% of spending on ARV involves patented ARV and 28.78% is for third-line ARV provided to 3% of patients. Among the structuring measures adopted to guarantee sustainability, negotiating purchase prices has made it feasible to incorporate third-line drugs without jeopardising the Brazilian policy of sustainability.
Description: the extension of survival time from 58 to 108 months has brought with it a need to incorporate the new ARVs: Enfuvirtide (Fusion®), Darunavir (Prezista®) and Raltegravir (Isentress®). The strategy used in negotiating the price of those drugs since they were first introduced up to the present moment has led to reductions in prices of 23.91% for Enfuvirtide (2005 to 2010), 17.18% for Darunavir (2008 to 2010) and 15.46% for Raltegravir (2009 to 2010) amounting to savings of US$ 20.6 million over the period.
Lessons learned: Negotiating prices and reinforcing national industry for the production of first-line ARV are fundamental measures to ensure the sustainability of the Brazilian policy of free universal access to treatment.
Next steps: Reinforcing and monitoring the use of the National Therapeutic Handbook which indicates sequential therapy and the rational use of medicine to counter the Marketing of the pharmaceutical industry.
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