Vasan Ashwin, Hoos David, Mukherjee Joia S, Farmer Paul E, Rosenfield Allan G, Perriëns Joseph H
Department of HIV/AIDS, World Health Organization, Geneva, Switzerland.
Bull World Health Organ. 2006 May;84(5):393-8. doi: 10.2471/blt.05.025684. Epub 2006 May 17.
The Purchase price report released in August 2004 by the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) was the first publication of a significant amount of real transaction purchase data for antiretrovirals (ARVs). We did an observational study of the ARV transaction data in the Purchase price report to examine the procurement behaviour of principal recipients of Global Fund grants in developing countries. We found that, with a few exceptions for specific products (e.g. lamivudine) and regions (e.g. eastern Europe), prices in low-income countries were broadly consistent or lower than the lowest differential prices quoted by the research and development sector of the pharmaceutical industry. In lower middle-income countries, prices were more varied and in several instances (lopinavir/ritonavir, didanosine, and zidovudine/lamivudine) were very high compared with the per capita income of the country. In all low- and lower middle-income countries, ARV prices were still significantly high given limited local purchasing power and economic strength, thus reaffirming the need for donor support to achieve rapid scale-up of antiretroviral therapy. However, the price of ARVs will have to decrease to render scale-up financially sustainable for donors and eventually for governments themselves. An important first step in reducing prices will be to make available in the public domain as much ARV transaction data as possible to provide a factual basis for discussions on pricing. The price of ARVs has considerable implications for the sustainability of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) treatment in the developing world.
全球抗击艾滋病、结核病和疟疾基金（全球基金）于2004年8月发布的采购价格报告是首次公布大量抗逆转录病毒药物（ARV）实际交易采购数据。我们对采购价格报告中的抗逆转录病毒药物交易数据进行了一项观察性研究，以考察发展中国家全球基金赠款主要受援方的采购行为。我们发现，除了特定产品（如拉米夫定）和地区（如东欧）的少数例外情况外，低收入国家的价格大致一致，或低于制药行业研发部门报出的最低差价价格。在中低收入国家，价格差异更大，在某些情况下（洛匹那韦/利托那韦、去羟肌苷和齐多夫定/拉米夫定）与该国人均收入相比非常高。在所有低收入和中低收入国家，鉴于当地购买力和经济实力有限，抗逆转录病毒药物价格仍然显著偏高，从而再次证明需要捐助方支持以实现抗逆转录病毒疗法的快速推广。然而，抗逆转录病毒药物的价格必须降低，以使捐助方乃至最终各国政府在资金上能够实现推广目标。降低价格的重要第一步将是在公共领域提供尽可能多的抗逆转录病毒药物交易数据，为定价讨论提供事实依据。抗逆转录病毒药物的价格对发展中世界人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）治疗的可持续性具有重大影响。
