AEGiS-14IAC: The impact of national production of ARV drugs on the cost of the ARV therapy in Brazil, 1997-2000.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

The impact of national production of ARV drugs on the cost of the ARV therapy in Brazil, 1997-2000.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrE1424)

Szwarcwald CL
Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil

BACKGROUND: Brazil is the unique low-income country to provide universal access to ARV therapy. Highly positive related effects have been evidenced, such as the substantial reduction of AIDS mortality. However, the cost of newly released ARV medicines has challenged the Brazilian Program in maintaining universal access to ARV treatment. Locally production of generics was the main adopted strategy.

METHODOLOGY: A mathematical analysis of the annual total cost of the ARV therapy, in the period 1997-2000, is presented. Firstly, the average cost of individual therapy using two drugs was calculated. Similar calculations were performed for the average cost of individual triple ARV therapy, using either NNRTI or PI medications. The average cost of individual ARV treatment was estimated as a weighted mean of the different therapeutic scheme average costs. The economic impact of the local production of generics was estimated as the reduction in the annual cost of the ARV therapy, provided by the replacement of imported drugs by national products, in the period 1997-2000.

RESULTS: Reductions of 72% in the average individual cost of the two-medicine therapy and of 64% in the triple therapy individual cost were evidenced in the period 1997- 2000. Despite of the increasingly number of patients, the total annual therapy cost decreased 8% from 1999 to 2000, and did not exceed the limit budget of 300 million US dollars. Further, if the average cost per patient/day had remained the same as in 1997, Brazil would had spent 220 million US dollars more in the period 1998-2000.

CONCLUSIONS: As a result of the national production of generics, the cost of ARV treatment has not escalated in recent years, making possible to maintain universal access to ARV therapy. The Brazilian model offers important lessons learned to developing countries, as it shows that universal anti-AIDS therapy is an achievable goal, even in a low-income country context.

Keywords: AEGIS, Costs and Cost Analysis, Antiretroviral Therapy, Highly Active, Federal Government, Acquired Immunodeficiency Syndrome, Developing Countries, Drug Therapy, Combination, Brazil, Health Expenditures, Human, therapy, economics, drug therapy

020707
ThOrE1424