Transaction Prices for Antiretroviral Medicines and HIV Diagnostics from 2008 to July 2011

Transcription

1 Transaction Prices for Antiretroviral Medicines and HIV Diagnostics from 28 to July 211 WHO AIDS Medicines and Diagnostic Services Global Price Reporting Mechanism

2 WHO Library Cataloguing-in-Publication Data Transaction prices for antiretroviral medicines and HIV diagnostics from 28 to July 211: Global Price Reporting Mechanism, GPRM,. 1.Anti-HIV agents - standards. 2.Anti-HIV agents - economics. 3.Anti-retroviral agents - economics. 4.HIV infections - diagnosis. 5.Drug costs. 6.Drug industry. 7.Data collection. I.World Health Organization. ISBN (NLM classification: QV 268.5) World Health Organization 211 All rights reserved. Publications of the World Health Organization are available on the WHO web site ( or can be purchased from WHO Press, World Health Organization, 2 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: ; fax: ; bookorders@who.int). Requests for permission to reproduce or translate WHO publications whether for sale or for noncommercial distribution should be addressed to WHO Press through the WHO web site ( The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

3 Background and Methods Table of Abbreviations Price trend for Adult ARV Treatment per country income level Table. 1: Median Price (in USD per patient-year) of most frequently used first and second line treatment regimens for adult patients...4 Fig. 1a: Price level and price evolution (compared to 28 prices) of first line treatment regimens in low income, middle income and upper middle income countries for adult patients...5 Fig. 1b: Price level and price evolution (compared to 28 prices) of second-line treatment regimens in low income, middle income and upper middle income countries for adult patients...6 Table 2: The price trend for the most commonly used second-line for pediatric patients (5 kg)...7 Fig. 2a: Price level and price evolution (compared to 28 prices) of first-line treatment regimens in low income, middle income and upper middle income countries for pediatric patients (5 kg)...8 Fig. 2b: Price level and price evolution (compared to 28 prices) of second-line treatment regimens in low income, middle income and upper middle income countries for pediatric patients (5 kg)...9 Table 3: The price trend for the most commonly used second-line for pediatric patients (1 kg)...1 Fig. 3a: Price level and price evolution (compared to 28 prices) of first-line treatment regimens in low income, middle income and uppper middle income countries for pediatric patients (1 kg)...11 Fig. 3b: Price level and price evolution (compared to 28 prices) of second-line treatment regimens in low income, middle income and upper middle income countries for pediatric patients (1 kg) Discussion Annex Table 1: Median transaction price of first-line ARV medicines for adult treatment per patient per year (US$/ppy) at a WHO recommended defined daily dose (DDD)...14 Table 2: Median transaction price of second-line ARV medicines (US$/ppy) for adult treatment at a WHO recommended adult DDD Table 3: Median transaction price of ARV medicines (US$/ppy) for paediatric treatment (infant weighing 5 kg) at a WHO recommended paediatric DDD.. 2 Table 4: Median transaction price of ARV medicines (US$/ppy) for paediatric treatment (infant weighing 1 kg) at a WHO recommended paediatric DDD. 23 References

4 Background and Methods The Global Price Reporting Mechanism (GPRM) contains information on transaction prices and quantities of antiretrovirals (ARVs), tuberculosis drugs, malaria drugs and HIV, TB and Malaria diagnostics purchased by HIV/AIDS, TB and Malaria programmes in low-income countries*, lower middle-income countries and upper middle-income countries. The country classification is done using the World Bank Atlas calculation and classification method 1, 2. The GPRM complements reports of price quotes from pharmaceutical companies 3,4,5 as well as smaller sets of transaction prices published by other sources 6. The data set in the GPRM for year 28, 29 and 21, GPRM currently includes at least 8% of all public procurement of ARVs. This report features transaction data of ARVs in 28, 29, 21 and in the two first quarters of 211. The transaction data in the GPRM are provided by the following organizations: the Clinton Foundation; HIV/AIDS Initiative; the Global Fund to Fight AIDS, Tuberculosis, and Malaria; the International Dispensary Association; USAID/ deliver (former John Snow Inc./deliver); Management Sciences for Health; Missionpharma; PEPFAR; Supply Chain Management System; UNITAID; the United Nations Children s Fund; and the World Health Organization s Contracting and Procurement Service. All transaction data used in this analysis have been compiled and stored in the searchable database developed and maintained by the Secretariat of the AIDS Medicines & Diagnostics Services (AMDS) in the WHO HIV/AIDS Department. This report is limited to transactions of thirty-five (35) formulations used for adult and thirty one (31) formulations used in pediatric HIV ARV treatment 7,8,9 recommended or prequalified by WHO for first and/or second-line regimens 1,11, 9 In the data tables, regimens are ranked according to their uptake according the 211 WHO survey on the country use of ARVs 12. Tables in annexes provide information on medians for all formulations and drugs matching the criteria of at least five transactions. The data used for 28, 29 and 21 is based on the full year, while the 211 data is only based on data reported for the period going from January to the end of July 211, received up to 2 September 211. The transaction prices are presented as the median price for each formulation (represents the price separating the 5% transactions with higher prices from the 5% with lower prices) and inter-quartile range between the 25 th and 75 th percentiles also called the midspread, a measure of statistical dispersion being equal to the difference between the third and first quartiles). We * countries with a gross national income (GNI) per capita of US$ 995 or less countries with a GNI per capita between US$ 996 and US$ 3,945 countries with a GNI per capita between US$ 3,946 and US$ 12,195 For single dose formulation, we divided the number of patients that could be treated per year using the total number of tablets or capsules from that formulation by three, and by two for the fixed dose combination made of two drugs and by 1 for the fixed dose made of three drugs. From the sum of the number of patient, we derived the percentage from the estimated number of patients reported on treatment those years 1

5 opted for this presentation in view of the asymmetrically distributed nature of the data. For the interpretation and use of the data in this report, it is important to note that: 1. All prices are shown in US Dollars (US$) per patient per year of a defined daily dose of each medicine for adults or children. 2. The statistics are not presented for formulations with less than five worldwide transaction lines in a given calendar year. 3. The prices in this report are international transaction prices, and not the prices paid by end-users at country level. End-user prices are often higher than international transaction prices due to tariffs, taxes, transportation costs, and mark-ups, or lower when end-user prices are subsidized (this is often the case for antiretroviral drugs). More information on the structure of enduser prices can be found on the Health Action International website at Taxes, tariffs, and cost or condition of transport, insurance, etc. categorized as International Commercial Terms (INCOTERMS) were not consistently reported and therefore are not considered, but whenever possible EXW, FCA, or FOB prices were included in the database in preference of prices including taxes, tariffs, transport and/or insurance. 5. All transactions listed in the GPRM with a price of US$, or appearing as duplications, can be either ARV donations or erroneous information. Such transactions were removed from the analysis. 6. Median prices published in this report for a specific year may be different from the ones published in previous reports for the same year, as of more data continued to be added (e.g. PEPFAR procurement data for the year before received in April of the New Year). 7. The median price for specific regimens recommended by the new WHO guidelines and highlighted in this analysis is the sum of median of specific formulations that make up the regimen or the median price of its fixed dose combination This summary report is intended to provide the pricing data of key ARVs to governments, non-governmental organizations, donors, international organizations, academia, and individuals or institutions directly involved or interested in the procurement of ARVs in resource-poor settings. Comments and suggestions would be greatly appreciated. Please send comments to Mr Boniface Dongmo Nguimfack at dongmonguimfackb@who.int. ** Previous investigations by the U.S. Government Accounting Office and Management Sciences for Health suggested that any variation in INCOTERMS constituted a 3% -15% increases over the factory or ex works (EXW) price 12. 2

6 Table of Abbreviations International Non-proprietary Name (INN) abacavir atazanavir darunavir didanosine efavirenz emtricitabine etravirine fosamprenavir indinavir lamivudine lopinavir nelfinavir nevirapine raltegravir ritonavir saquinavir stavudine tenofovir zidovudine Abbreviation ABC ATV DRV ddi EFV FTC ETV FPV IDV 3TC LPV NFV NVP RAL RTV SQV d4t TDF ZDV 3

7 1. Price trend for Adult ARV Treatment per country income level Table. 1: Median Price (in USD per patient-year) of most frequently used first and second line treatment regimens for adult patients First Line Regimens Low Income Countries Low Middle Income Countries Upper Middle Income Countries [3TC+NVP+d4T] [15+2+3]mg TC+NVP+ZDV [15+2+3]mg EFV+[3TC+ZDV] 6mg+[15+3]mg EFV+FTC+TDF [6mg+2+3]mg [FTC+TDF]+NVP [2+3]mg+2mg [3TC+TDF]+NVP [3+3]mg+2mg [3TC+ TDF]+EFV [3+3]+6mg Second Line Regimens ZDV+ ddi+[lpv/r] 3mg+4mg+[2+5]mg ABC+ddI+LPV/r] 3mg+4mg+[2+5]mg [FTC+TDF]+[LPV/r] [2+3] mg+[2+5]mg [3TC+ZDV]+[LPV/r] [15+3] mg+[2+5]mg [3TC+TDF]+[LPV/r] [3+3] mg+[2+5]mg [3TC+ZDV]+[LPV/r]+TDF [15+3] mg+[2+5]mg+3mg [FTC+TDF]+[LPV/r]+ZDV [2+3] mg+[2+5]mg+3mg

8 Fig. 1a: Price level and price evolution (compared to 28 prices) of first line treatment regimens in low income, middle income and upper middle income countries for adult patients LIC LMIC [3TC+NVP+d4T] [15+2+3]mg 3TC+NVP+ZDV [15+2+3]mg EFV+[3TC+ZDV] 6mg+[15+3]mg EFV+FTC+TDF [6mg+2+3]mg [FTC+TDF]+NVP [2+3]mg+2mg [3TC+TDF]+NVP [3+3]mg+2mg [3TC+ TDF]+EFV [3+3]+6mg [3TC+NVP+d4T] [15+2+3]mg 3TC+NVP+ZDV [15+2+3]mg EFV+[3TC+ZDV] 6mg+[15+3]mg EFV+FTC+TDF [6mg+2+3]mg [FTC+TDF]+NVP [2+3]mg+2mg [3TC+TDF]+NVP [3+3]mg+2mg [3TC+ TDF]+EFV [3+3]+6mg UMIC Percent change INN LIC LMIC UMIC [3TC+NVP+d4T] [15+2+3]mg -29% -34% -4% 3TC+NVP+ZDV [15+2+3]mg -15% -21% -18% EFV+[3TC+ZDV] 6mg+[15+3]mg -41% -47% -63% EFV+FTC+TDF [6mg+2+3]mg -6% -77% -64% [FTC+ TDF]+NVP [2+3]mg+2mg -57% -61% -65% [3TC+ TDF]+NVP [3+3]mg+2mg -39% -51% -63% [3TC+ TDF]+EFV [3+3]+6mg -53% -6% -68% [3TC+NVP+d4T] [15+2+3]mg 3TC+NVP+ZDV [15+2+3]mg EFV+[3TC+ZDV] 6mg+[15+3]mg EFV+FTC+TDF [6mg+2+3]mg [FTC+ TDF]+NVP [2+3]mg+2mg [3TC+ TDF]+NVP [3+3]mg+2mg [3TC+ TDF]+EFV [3+3]+6mg 5

9 Fig. 1b: Price level and price evolution (compared to 28 prices) of second-line treatment regimens in low income, middle income and upper middle income countries for adult patients LIC LMIC ZDV+ ddi+[lpv/r] 3mg+4mg+[2+5]mg ABC+ddI+LPV/r] 3mg +4mg+[2+5]mg [FTC+TDF]+[LPV/r] [2 +3]mg+[2+5]mg [3TC+ZDV]+[LPV/r] [15 +3]mg+[2+5]mg [3TC+TDF]+[LPV/r] [3 +3]mg+[2+5]mg [3TC+ZDV]+[LPV/r] +TDF [15+3]mg +[2+5]mg+3mg [FTC+TDF]+[LPV/r] +ZDV [2+3]mg +[2+5]mg+3mg ZDV+ ddi+[lpv/r] 3mg +4mg+[2+5]mg ABC+ddI+LPV/r] 3mg +4mg+[2+5]mg [FTC+TDF]+[LPV/r] [2 +3]mg+[2+5]mg [3TC+ZDV]+[LPV/r] [15 +3]mg+[2+5]mg [3TC+TDF]+[LPV/r] [3 +3]mg+[2+5]mg [3TC+ZDV]+ [LPV/r]+TDF [15+3]mg +[2+5]mg+3mg [FTC+TDF]+ [LPV/r]+ZDV [2+3]mg +[2+5]mg+3mg ZDV+ ddi+[lpv/r] 3mg +4mg+[2+5]mg ABC+ddI+LPV/r] 3mg +4mg+[2+5]mg [FTC+TDF]+[LPV/r] [2 +3]mg+[2+5]mg UMIC [3TC+ZDV]+[LPV/r] [15 +3]mg+[2+5]mg [3TC+TDF]+[LPV/r] [3 +3]mg+[2+5]mg [3TC+ZDV]+[LPV/r] +TDF [15+3]mg +[2+5]mg+3mg [FTC+TDF]+[LPV/r] +ZDV [2+3]mg +[2+5]mg+3mg Percent change INN LIC LMIC UMIC ZDV+ ddi+[lpv/r] 3mg+4mg+[2+5]mg -17% -7% -86% ABC+ddI+LPV/r] 3mg+4mg+[2+5]mg -26% -69% -85% [FTC+TDF]+[LPV/r] [2+3]mg+[2+5]mg -35% -58% -87% [3TC+ZDV]+[LPV/r] [15+3]mg+[2+5]mg -17% -51% -88% [3TC+TDF]+[LPV/r] [3+3]mg+[2+5]mg -24% -52% -88% [3TC+ZDV]+[LPV/r]+TDF [15+3]mg+[2+5] mg+3mg -3% -53% -87% [FTC+TDF]+[LPV/r]+ZDV [2+3]mg+[2+5] mg+3mg -32% -55% -86% 6

10 Table 2: The price trend for the most commonly used second-line for pediatric patients (5 kg). First Line Regimens Low Income Countries Low Middle Income Countries Upper Middle Income Countries [3TC+NVP+d4T] [15+2+3]mg TC+NVP+ZDV [15+2+3]mg EFV+[3TC+ZDV] 6mg+[15+3]mg EFV+FTC+TDF [6mg+2+3]mg [FTC+TDF]+NVP [2+3]mg+2mg [3TC+TDF]+NVP [3+3]mg+2mg [3TC+ TDF]+EFV [3+3]+6mg Second Line Regimens ZDV+ ddi+[lpv/r] 3mg+4mg+[2+5]mg ABC+ddI+LPV/r] 3mg+4mg+[2+5]mg [FTC+TDF]+[LPV/r] [2+3] mg+[2+5]mg [3TC+ZDV]+[LPV/r] [15+3] mg+[2+5]mg [3TC+TDF]+[LPV/r] [3+3] mg+[2+5]mg [3TC+ZDV]+[LPV/r]+TDF [15+3] mg+[2+5]mg+3mg [FTC+TDF]+[LPV/r]+ZDV [2+3] mg+[2+5]mg+3mg

11 Fig. 2a: Price level and price evolution (compared to 28 prices) of first-line treatment regimens in low income, middle income and upper middle income countries for pediatric patients (5 kg). 2 LIC LMIC [3TC+NVP+d4T] [3+5+6]mg [3TC+NVP+ZDV] [3+5+6 mg] ABC+3TC+NVP mg/ml EFV+3TC+d4T 5mg +1 mg/ml+1 mg/ml EFV+3TC+ZDV 5mg+1+1 mg/ml [3TC+NVP+d4T] [3+5+6]mg [3TC+NVP+ZDV] [3+5+6 mg]* ABC+3TC+NVP mg/ml EFV+3TC+d4T 5mg +1 mg/ml+1 mg/ml EFV+3TC+ZDV 5mg+1+1 mg/ml UMIC Percent change INN LIC LMIC UMIC [3TC+NVP+d4T] [3+5+6]mg -6% -42% -96% [3TC+NVP+ZDV] [3+5+6 mg]* -2% -74% -71% ABC+3TC+NVP mg/ml -21% -43% -56% EFV+3TC+d4T 5mg+1 mg/ml+1 mg/ml 4% -4% -86% EFV+3TC+ZDV 5mg+1+1 mg/ml % -27% -5% * we made a sum of single doses for 28 [3TC+NVP+d4T] [3+5+6]mg* [3TC+NVP+ZDV] [3+5+6 mg]* ABC+3TC+NVP mg/ml EFV+3TC+d4T 5mg+ 1 mg/ml+1 mg/ml EFV+3TC+ZDV 5mg+1+1 mg/ml * used of 3TC+NVP+d4T mg/ml and 3TC+NVP+ZDV mg/ml instead of a FDC of [3TC+NVP+d4T] [3+5+6]mg [3TC+NVP+ZDV] [3+5+6]mg in 28 8

12 Fig. 2b: Price level and price evolution (compared to 28 prices) of second-line treatment regimens in low income, middle income and upper middle income countries for pediatric patients (5 kg) LIC LMIC [3TC+ZDV]+ [LPV+RTV] [3+6] mg+[8+2mg/ml] ABC+3TC+ [LPV+RTV] 2+1 mg/ml +[8+2mg/ml] [3TC+d4T]+ [ LPV+RTV] [3+6] mg+[8+2mg/ml] [3TC+ZDV]+ [LPV+RTV] [3+6] mg+[8+2mg/ml] ABC+3TC+[LPV+RTV] 2+1 mg/ml +[8+2mg/ml] [3TC+d4T]+[ LPV+RTV] [3+6]mg +[8+2mg/ml] UMIC Percent change INN LIC LMIC UMIC [3TC+ZDV]+[LPV+RTV] [3+6] mg+[8+2mg/ml] -1% -46% -16% ABC+3TC+[LPV+RTV] 2+1 mg/ml+[8+2mg/ml] -22% -36% -32% [3TC+d4T]+[ LPV+RTV] [3+6]mg+[8+2mg/ml] -15% -33% -74% [3TC+ZDV]+[LPV +RTV] [3+6] mg +[8+2mg/ml] ABC+3TC+[LPV +RTV] 2+1 mg/ml +[8+2mg/ml] [3TC+d4T]+[ LPV +RTV] [3+6]mg +[8+2mg/ml] 9

13 Table 3: The price trend for the most commonly used second-line for pediatric patients (1 kg). GPRM - Global Price Reporting Mechanism First Line Regimens Low Income Countries Low Middle Income Countries Upper Middle Income Countries [3TC+NVP+d4T] [6+1+12]mg [3TC+NVP+ZDV] [3+5+6]mg ABC+3TC+NVP mg/ml EFV+[3TC+d4T] 5mg +[6 m+12]mg EFV+[3TC+ZDV] 5 mg+[3+6]mg Second Line Regimens [3TC+ZDV]+[LPV+RTV] [3+6] mg+[1+25]mg ABC+3TC+[LPV+RTV] 2+1 mg/ml+[1+25]mg [3TC+d4T]+[ LPV+RTV] [6+12]mg+[1+25]mg

14 Fig. 3a: Price level and price evolution (compared to 28 prices) of first-line treatment regimens in low income, middle income and uppper middle income countries for pediatric patients (1 kg) LIC LMIC [3TC+NVP+d4T] [6+1+12]mg [3TC+NVP+ZDV] [3+5+6]mg ABC+3TC+NVP mg/ml EFV+[3TC+d4T] 5mg +[6 m+12]mg EFV+[3TC+ZDV] 5 mg+[3+6]mg [3TC+NVP+d4T] [6+1+12]mg [3TC+NVP+ZDV] [3+5+6]mg ABC+3TC+NVP mg/ml EFV+[3TC+d4T] 5mg +[6 m+12]mg EFV+[3TC+ZDV] 5 mg+[3+6]mg UMIC Percent change INN LIC LMIC UMIC [3TC+NVP+d4T] [6+1+12]mg -22% -1% -3% [3TC+NVP+ZDV] [3+5+6]mg -5% -2% -2% ABC+3TC+NVP mg/ml 29% -38% -43% EFV+[3TC+d4T] 5mg +[6 m+12]mg -18% -27% -8% EFV+[3TC+ZDV] 5 mg+[3+6]mg -21% -21% -6% [3TC+NVP+d4T] [6+1+12]mg [3TC+NVP+ZDV] [3+5+6]mg ABC+3TC+NVP mg/ml EFV+[3TC+d4T] 5mg +[6 m+12]mg EFV+[3TC+ZDV] 5 mg+[3+6]mg 11

15 Fig. 3b: Price level and price evolution (compared to 28 prices) of second-line treatment regimens in low income, middle income and upper middle income countries for pediatric patients (1 kg) LIC LMIC [3TC+ZDV]+[LPV+ RTV] [3+6] mg +[1+25]mg ABC+3TC+[LPV+ RTV] 2+1 mg/ml +[1+25]mg [3TC+d4T]+ [ LPV+RTV] [6+ 12]mg+[1+25]mg [3TC+ZDV]+[LPV+ RTV] [3+6] mg +[1+25]mg ABC+3TC+[LPV+ RTV] 2+1 mg/ml +[1+25]mg [3TC+d4T]+[ LPV+ RTV] [6+12]mg+ [1+25]mg UMIC Percent change INN LIC LMIC UMIC [3TC+ZDV]+[LPV+RTV] [3+6] mg+[1+25]mg -31% 165% -6% ABC+3TC+[LPV+RTV] 2+1 mg/ml+[1+25]mg -13% 76% -33% [3TC+d4T]+[ LPV+RTV] [6+12]mg+[1+25]mg -3% % -6% [3TC+ZDV]+[LPV+ RTV] [3+6] mg +[1+25]mg ABC+3TC+[LPV+ RTV] 2+1 mg/ml +[1+25]mg [3TC+d4T]+[ LPV+ RTV] [6+12]mg+ [1+25]mg 12

16 Discussion The median price of medicines for adults and children for major first- and second-line regimens continued to decrease in LIC, LMIC and UMIC between 28 and the first half of 211. The price of main regimens in LIC for adults declined by 15 % for 3TC+NVP+ZDV [15+2+3] mg to 6% for EFV+FTC+TDF [6mg+2+3] mg between 28 and July 211, while the price decrease for second-line regimens was 17%for ZDV+ ddi+[lpv/r] 3mg+4mg+[2+5]mg and 35% for [FTC+TDF]+[LPV/r] [2+3]mg+[2+5]mg. The price of first and second line treatment are today the lowest ever observed in LIC, LMIC, UMIC in all groups. This price decline is likely not due to the change in the pricing policy of pharmaceutical companies as most have not changed their pricing policy since 28. However voluntary licensing, and the creation of the patent pool might have played a role. In addition, it remains difficult to quantify exactly how these mechanisms have impacted the market and the price of medicines. A likely explanation is the entry of more suppliers, as the WHO Prequalification Programme and the USFDA Antiretrovirals Approved and Tentatively Approved in Association with the President s Emergency Plan Expedited Review Process have increased the availability of lowerpriced, high-quality generic ARVs. In the pediatric world, the median price of major first-line regimens between 28 and followed the same downward trend as observed in first line regimens for adults. For example, the median price of the most commonly prescribed regimen for pediatric use, 3TC+NVP+d4T, dropped by 6% in LIC, 42% in LMIC and 96% in UMIC. The price decline for paediatric patients can partly be explained by the introduction of suitable fixed dose formulations, the introduction of generic EFV 5 mg formulation, their prequalification and stringent regulatory approval, and the decision of LIC, LMIC and UMIC to procure them. Last, prices in LMIC and UMIC might have been reported as decreased since 29 because of the inclusion in the statistics since 29 of countries which migrated from lower income categories to higher income categories, but which retained their prior ARV prices. 13

17 Annex GPRM - Global Price Reporting Mechanism Table 1: Median transaction price of first-line ARV medicines for adult treatment per patient per year (US$/ppy) at a WHO recommended defined daily dose (DDD) 1a) Low-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or capsules) d4t 3 mg 2 19 (19 29) 19 (18 19) 17 (17 23) 19 (18 21) 3TC 15 mg 2 37 (35 48) 31 (3 35) 29 (29 31) 29 (29 37) 3TC 3 mg 2 59 (59 59) NVP 2 mg 2 41 (4 48) 39 (36 42) 32 (32 34) 32 (31 35) 3TC+d4T 15+3mg 2 53 (49 61) 44 (44 47) 39 (39 44) 37 (37 37) 3TC+NVP+d4T mg 2 88 (83 93) 81 (75 87) 66 (58 73) 62 (59 68) ZDV 3 mg 2 14 (99 114) 92 (89 99) 88 (82 97) 93 (86 99) 3TC+ZDV 15+3 mg ( ) 17 (16 19) 13 (1 17) 11 (1 15) 3TC+NVP+ZDV mg ( ) 139 ( ) 136 ( ) 131 ( ) EFV 2 mg ( ) 186 ( ) 161 ( ) 15 (14 156) EFV 6 mg ( ) 83 (7 19) 55 (52 62) 52 (52 55) TDF 3 mg (151 27) 151 ( ) 86 (85 95) 8 (77 84) TDF+FTC 3+2 mg (28 319) 319 (28 319) 141 ( ) 125 ( ) TDF+3TC 3+3 mg ( ) 14 ( ) 114 ( ) 99 (78 16) TDF+FTC+EFV mg ( ) 25 ( ) 242 ( ) 242 ( ) TDF+3TC+EFV mg (24 213) 193 (172 24) ZDV+3TC+ABC mg ( ) 554 ( ) 365 ( ) - 14

18 1b) Lower middle-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or capsules) d4t 3 mg 2 26 (23 3) 19 (19 34) 19 (18 19) 18 (18 19) 3TC 15 mg 2 4 (37 45) 35 (34 38) 3 (29 32) 29 (29 31) 3TC 3 mg ( ) NVP 2 mg 2 48 (43 51) 43 (41 46) 34 (32 35) 32 (28 35) 3TC+d4T 15+3mg 2 6 (48 6) 33 (33 34) 4 (39 43) 39 (38 43) 3TC+NVP+d4T mg 2 1 (91 114) 76 (61 83) 69 (62 73) 66 (58 66) ZDV 3 mg (19 118) 14 (1 14) 89 (88 94) 89 (88 97) 3TC+ZDV 15+3 mg ( ) 113 (112 12) 16 (13 112) 11 (11 15) 3TC+NVP+ZDV mg (152 29) 139 ( ) 137 (136 14) 134 ( ) EFV 2 mg 3 23 ( ) 319 ( ) 123 ( ) 12 ( ) EFV 6 mg ( ) 95 (9 114) 6 (55 74) 53 (52 69) TDF 3 mg 1 27 ( ) 154 (15 272) 91 (85 1) 82 (8 9) TDF+FTC 3+2 mg ( ) 143 ( ) 146 (143 27) 133 (13 162) TDF+3TC 3+3 mg ( ) (84 16) TDF+FTC+EFV mg ( ) 667 ( ) 242 ( ) 242 ( ) TDF+3TC+EFV mg (22 28) ZDV+3TC+ABC mg ( ) 481 ( ) 15

19 1c) Upper middle-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or capsules) d4t 3 mg 2 33 (3 34) 73 (36 193) 28 (24 82) - 3TC 15 mg 2 48 (45 383) 73 (73 33) 33 (29 42) 3 (29 3) 3TC 3 mg ( ) NVP 2 mg 2 69 (48 247) 25 (24 354) 36 (32 15) 34 (32 34) 3TC+d4T 15+3mg 2 53 (53 53) 47 (47 51) 39 (38 4) 36 (36 36) 3TC+NVP+d4T mg 2 11 (96 166) 88 (86 91) 66 (65 69) 66 (66 66) ZDV 3 mg (11 128) 184 (11 473) 91 (89 121) 89 (89 9) 3TC+ZDV 15+3 mg ( ) 225 ( ) 128 (14 128) 1 (1 12) 3TC+NVP+ZDV mg ( ) 16 ( ) 136 ( ) 131 ( ) EFV 2 mg ( ) 377 (198 65) 191 (171 59) 114 (1 15) EFV 6 mg ( ) 2 (11 237) 69 (55 153) 55 (53 56) TDF 3 mg ( ) 254 ( ) 95 (85 29) 79 (79 83) TDF+FTC 3+2 mg (465 48) 385 ( ) 146 ( ) 157 ( ) TDF+3TC 3+3 mg (13 152) 76 (76 76) TDF+FTC+EFV mg ( ) 242 ( ) TDF+3TC+EFV mg ZDV+3TC+ABC mg ( ) 365 ( ) 16

20 Table 2: Median transaction price of second-line ARV medicines (US$/ppy) for adult treatment at a WHO recommended adult DDD 2a) Low-income countries including all SSA countries (except South Africa) Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or capsules) ABC 3 mg (28 358) 28 ( ) 25 (192 29) 181 (177 27) ABC+3TC 6+3 mg 1-28 (28 28) 274 ( ) 274 ( ) ATV 15mg* ( ) 317 ( ) 317 ( ) 268 ( ) ATV 2mg* ( ) 515 ( ) - - DRV 3 mg* ( ) 195 ( ) 1132 ( ) ddi 1 mg (187 31) 188 ( ) 188 (18 188) - ddi 2 mg (218 35) 21 ( ) 162 ( ) 268 ( ) ddi 25 mg ( ) 184 ( ) 165 ( ) 181 ( ) ddi 4 mg ( ) 261 (158 27) 243 ( ) 244 (17 267) ETV 1 mg ( ) 145 ( ) FPV 7 mg* IDV 2 mg* (73 73) IDV 4 mg* 4 46 (35 445) 46 ( ) 478 (49 486) 46 (46 467) LPV+RTV 2+5 mg 4 5 (5 574) 51 (51 575) 44 ( ) 41 ( ) NFV 25 mg ( ) 2118 ( ) 173 ( ) - RAL 4 mg ( ) 2227 ( ) RTV 1 mg** 2 84 (83 114) 83 (83 13) 84 (84 12) 84 (84 121) SQV 2 mg* (135 3) 1234 ( ) - 14 (14 14) * Protease inhibitor to be used boosted with ritonavir ** The dose of ritonavir is given for its use as a booster of other protease inhibitors only

21 2b) Lower middle-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or capsules) ABC 3 mg 2 35 ( ) 271 ( ) 27 (21 232) 197 ( ) ABC+3TC 6+3 mg (274 28) 28 ( ) ATV 15mg* ( ) 4497 ( ) 83 ( ) - ATV 2mg* ( ) ( ) - DRV 3 mg* ( ) 5391 ( ) 3939 ( ) 3128 ( ) ddi 1 mg ( ) 217 ( ) 188 ( ) 345 ( ) ddi 2 mg ( ) 266 ( ) 189 ( ) 189 ( ) ddi 25 mg ( ) 19 ( ) 167 ( ) 176 ( ) ddi 4 mg (57 132) 274 ( ) 244 ( ) 244 ( ) ETV 1 mg ( ) 4117 ( ) FPV 7 mg* (143 5) 1448 ( ) - - IDV 2 mg* ( ) (73 73) IDV 4 mg* ( ) 363 ( ) 46 (46 42) 435 (46 47) LPV+RTV 2+5 mg 4 1 ( ) 1 ( ) 463 (44 621) 447 (41 495) NFV 25 mg ( ) 274 ( ) 2793 ( ) - RAL 4 mg ( ) RTV 1 mg** (99 811) 762 ( ) 199 (84 671) 133 (84 392) SQV 2 mg* ( ) 2651 ( ) 1892 ( ) 286 ( ) * Protease inhibitor to be used boosted with ritonavir ** The dose of ritonavir is given for its use as a booster of other protease inhibitors only 18

22 2c) Upper middle-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or capsules) ABC 3 mg ( ) 365 (285 45) 222 (2 232) 177 ( ) ABC+3TC 6+3 mg ( ) ATV 15mg* ( ) 3614 ( ) 535 ( ) ATV 2mg* DRV 3 mg* ( ) 657 ( ) ddi 1 mg ( ) 396 ( ) 194 ( ) - ddi 2 mg 2 22 ( ) 28 (28 28) 268 (216 37) 268 ( ) ddi 25 mg (2 997) 192 (171 29) 264 ( ) 168 ( ) ddi 4 mg ( ) 286 ( ) 34 ( ) - ETV 1 mg ( ) FPV 7 mg* ( ) 129 ( ) 1648 ( ) 1589 ( ) IDV 2 mg* IDV 4 mg* ( ) LPV+RTV 2+5 mg ( ) 3168 ( ) 448 (431 55) 437 ( ) NFV 25 mg ( ) 486 (4 4823) 235 ( ) - RAL 4 mg ( ) RTV 1 mg** ( ) 699 (163 71) 226 (72 626) 183 ( ) SQV 2 mg* ( ) * Protease inhibitor to be used boosted with ritonavir ** The dose of ritonavir is given for its use as a booster of other protease inhibitors only 19

23 Table 3: Median transaction price of ARV medicines (US$/ppy) for paediatric treatment (infant weighing 5 kg) at a WHO recommended paediatric DDD 3a) Low-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or ml) ABC 2 mg/ml 4 91 (91 1) 91 (89 19) 83 (46 83) 83 (76 83) ddi 1 mg/ml ( ) 275 (249 39) 184 ( ) 312 ( ) ddi 25 mg 4 17 (17 17) 17 ( ) 17 (17 186) 134 ( ) ddi 5 mg ( ) 116 (1 116) 116 ( ) 116 ( ) EFV 3 mg/ml (88 116) 112 ( ) 112 ( ) 112 ( ) EFV) 5 mg 2 18 (16 37) 59 (55 7) 54 (54 57) 54 (54 57) 3TC 1 mg/ml 6 59 (59 71) 17 (16 32) 17 (17 22) 29 (17 4) LPV+RTV 8+2 mg/ml 2 1 (1 153) 1 (1 124) 88 (88 88) 85 (8 88) NFV 5 mg/g ( ) 1343 ( ) 1318 ( ) 1318 ( ) NFV 25 mg (526 1) 847 ( ) 621 ( ) 621 ( ) NVP 1 mg/ml (35 4) 35 (35 65) 36 (35 39) 36 (36 11) d4t 1 mg/ml (29 53) 3 (29 37) 32 (29 4) 29 (28 31) ZDV 1 mg/ml (39 91) 64 (39 98) 38 (37 49) 38 (38 119) 3TC+d4T 3+6 mg 2 26 (22 26) 23 (23 25) 23 (23 23) 21 (2 22) 3TC+d4T 6+12 mg 1 25 (22 26) 2 (2 22) 2 (2 2) 2 (19 2) 3TC+NVP+d4T mg 2 3 (26 3) 29 (26 29) 28 (28 28) 28 (28 33) 3TC+NVP+d4T mg 1 27 (24 28) 26 (23 26) 26 (26 26) 29 (26 33) 3TC+ZDV 3+6 mg 2 41 (41 41) 41 (41 43) 36 (36 4) 43 (41 43) 3TC+NVP+ZDV mg 2 53 (53 53) 53 (53 53) 52 (52 52) 52 (51 54) 2

24 3b) Lower middle-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or ml) ABC 2 mg/ml (1 142) 17 (12 121) 83 (82 83) 83 (75 91) ddi 1 mg/ml (692 98) 934 ( ) 156 ( ) - ddi 25 mg (97 39) 352 ( ) 17 (17 17) 744 ( ) ddi 5 mg 2 ( ) 88 (88 19) 116 ( ) 92 (554 92) EFV 3 mg/ml ( ) 112 ( ) 112 ( ) EFV) 5 mg 2 77 (73 9) 66 (63 67) 54 (54 62) 66 (63 72) 3TC 1 mg/ml 6 38 (21 54) 24 (16 36) 17 (15 18) 17 (17 17) LPV+RTV 8+2 mg/ml (217 5) 2 ( ) 11 (88 24) 145 (85 25) NFV 5 mg/g ( ) 2139 ( ) 5237 ( ) - NFV 25 mg 4 93 ( ) 181 ( ) 1117 ( ) 1117 ( ) NVP 1 mg/ml (58 122) 78 (62 85) 36 (33 36) 36 (36 83) d4t 1 mg/ml (51 117) 57 (3 57) 28 (27 3) 41 (34 47) ZDV 1 mg/ml (49 91) 92 (59 18) 38 (36 38) 57 (38 77) 3TC+d4T 3+6 mg 2 24 (23 25) 46 (46 46) 23 (23 23) 23 (23 23) 3TC+d4T 6+12 mg 1 25 (24 26) 23 (21 26) 2 (2 2) 2 (17 23) 3TC+NVP+d4T mg 2 53 (53 53) 29 (29 29) 28 (28 28) 3 (28 3) 3TC+NVP+d4T mg 1 27 (27 28) 28 (27 28) 26 (26 26) 27 (26 29) 3TC+ZDV 3+6 mg 2 ( ) 44 (44 44) 4 (36 4) 4 (36 4) 3TC+NVP+ZDV mg 2 ( ) 53 (53 53) 52 (52 52) 52 (52 52) 21

25 3c) Upper middle-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or ml) ABC 2 mg/ml 4 18 (92 144) 96 (96 96) 93 (83 96) 56 (56 56) ddi 1 mg/ml 8 94 ( ) ( ) - ddi 25 mg (222 25) 368 ( ) 158 ( ) 417 ( ) ddi 5 mg ( ) 118 ( ) 83 (83 83) 116 ( ) EFV 3 mg/ml ( ) EFV) 5 mg (85 139) 12 (86 663) 71 (57 77) 59 (55 59) 3TC 1 mg/ml 6 55 (55 72) 56 (47 56) 2 (17 27) 19 (18 19) LPV+RTV 8+2 mg/ml 2 25 ( ) 121 (88 168) 22 (88 37) 27 (27 27) NFV 5 mg/g NFV 25 mg ( ) 1924 ( ) 814 ( ) - NVP 1 mg/ml (62 98) 198 (171 26) 57 (39 284) 36 (34 36) d4t 1 mg/ml (31 823) 44 (41 58) 366 (31 734) 3 (29 31) ZDV 1 mg/ml (36 94) 93 (72 124) 43 (37 57) 38 (38 48) 3TC+d4T 3+6 mg 2 ( ) 23 (23 34) 23 (23 23) 23 (23 23) 3TC+d4T 6+12 mg 1 ( ) 2 (2 2) 2 (2 2) 2 (2 2) 3TC+NVP+d4T mg 2 ( ) 29 (29 29) 28 (28 28) 28 (28 28) 3TC+NVP+d4T mg 1 ( ) 26 (26 26) 26 (26 27) 26 (26 26) 3TC+ZDV 3+6 mg 2 41 (41 41) 44 (44 44) 4 (4 4) 36 (36 38) 3TC+NVP+ZDV mg 2 ( ) 53 (53 53) 52 (52 52) 52 (52 52) 22

26 Table 4: Median transaction price of ARV medicines (US$/ppy) for paediatric treatment (infant weighing 1 kg) at a WHO recommended paediatric DDD 4a) Low-income countries 23 Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or ml) ABC 2 mg/ml ( ) 228 ( ) 28 (114 28) 27 (19 28) ddi 25 mg ( ) 213 (28 213) 372 ( ) 482 ( ) ddi 5 mg ( ) 173 (15 173) 213 ( ) 19 ( ) ddi 1 mg (94 155) 94 (94 118) 173 ( ) 173 ( ) ddi 125 mg 1 94 (93 95) 13 (13 13) 94 (9 94) 212 ( ) EFV 5 mg ( ) 118 (19 14) 52 (52 52) 13 (9 193) EFV 2 mg 1 65 (59 74) 62 (52 11) 19 (19 12) 119 ( ) 3TC 1 mg/ml 1 3 (27 53) 29 (27 53) 54 (39 55) 5 (35 52) LPV+RTV 8+2 mg/ml 3 15 (15 16) 15 (15 152) 85 (85 85) 48 (29 55) LPV+RTV 1+25 mg ( ) 188 ( ) 132 ( ) 132 ( ) LPV+RTV 2+5 mg ( ) 188 ( ) 165 ( ) 154 ( ) NFV 25 mg (78 147) 1271 ( ) 164 (155 17) 164 (155 17) NVP 1 mg/ml 2 59 (59 67) 58 (58 19) 165 ( ) 154 ( ) NVP 2 mg 1 21 (2 24) 19 (18 21) 122 ( ) 122 ( ) d4t 15 mg 2 18 (18 23) 18 (18 18) 59 (58 73) 61 (59 182) d4t 2 mg 2 21 (21 27) 2 (18 21) 16 (15 17) 15 (15 17) ZDV 1 mg/ml 2 67 (65 115) 17 (64 164) 16 (16 18) 16 (16 17) ZDV 1 mg 2 37 (35 44) 37 (35 38) 16 (16 17) 16 (16 17) 3TC+d4T 15+3 mg 1 26 (24 3) 22 (22 24) 64 (61 82) 72 (63 177) 3TC+NVP+d4T mg 1 44 (42 46) 41 (37 43) 35 (33 35) 42 (35 5) 3TC+d4T 3+6 mg 4 51 (45 53) 46 (46 51) 19 (19 22) 19 (19 2) 3TC+d4T 6+12 mg 2 5 (44 51) 4 (4 44) 35 (34 38) 35 (34 38) 3TC+NVP+d4T mg 4 59 (52 61) 58 (52 59) 46 (46 46) 46 (43 46) 3TC+NVP+d4T mg 2 54 (47 55) 52 (47 52) 4 (4 4) 4 (4 4) 3TC+ZDV 3+6 mg 4 83 (83 83) 83 (83 88) 56 (56 56) 56 (56 63) 3TC+NVP+ZDV mg 4 15 (15 15) 15 (15 15) 52 (52 52) 52 (52 64) ABC 6mg 4 ( ) ( ) 73 (73 79) 85 (8 91) ABC/3TC 6/3mg 4 ( ) 177 ( ) 13 (13 13) 13 (1 13)

27 4B) Lower middle-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or ml) ABC 2 mg/ml ( ) 268 (255 34) 27 (25 28) 28 ( ) ddi 25 mg ( ) 151 ( ) 213 ( ) 472 ( ) ddi 5 mg (132 73) 129 ( ) 173 ( ) 283 ( ) ddi 1 mg 2 16 (94 118) 19 (95 136) 94 (93 113) 155 ( ) ddi 125 mg 1 86 (74 99) - 52 (52 52) 52 (52 52) EFV 5 mg ( ) 132 ( ) 19 (19 125) 19 (19 127) EFV 2 mg 1 68 (64 131) 16 (56 114) 41 (38 55) 4 (38 53) 3TC 1 mg/ml 1 63 (36 9) 44 (27 64) 28 (26 29) 28 (26 28) LPV+RTV 8+2 mg/ml (326 75) 3 ( ) 141 (132 36) 175 (13 299) LPV+RTV 1+25 mg 3 25 ( ) 213 ( ) 193 (165 24) 84 (213 84) LPV+RTV 2+5 mg ( ) 375 ( ) 173 ( ) 167 ( ) NFV 25 mg ( ) 1622 ( ) 1676 ( ) 1676 ( ) NVP 1 mg/ml (77 145) 121 (11 141) 58 (55 59) 58 (55 59) NVP 2 mg 1 24 (21 25) 21 (21 23) 16 (15 17) 16 (15 17) d4t 15 mg 2 18 (18 21) 18 (18 18) 16 (16 17) 16 (16 18) d4t 2 mg 2 18 (18 21) 26 (35 339) 16 (17 17) 16 (17 17) ZDV 1 mg/ml (73 146) 153 (98 18) 64 (58 64) 64 (63 125) ZDV 1 mg 2 43 (37 48) 42 (37 43) 35 (35 35) 35 (35 38) 3TC+d4T 15+3 mg 1 3 (28 38) 22 (2 24) 2 (19 22) 19 (19 22) 3TC+NVP+d4T mg 1 5 (46 57) 41 (33 42) 41 (41 42) 41 (41 42) 3TC+d4T 3+6 mg 4 49 (47 51) 92 (92 92) 46 (46 46) 46 (46 46) 3TC+d4T 6+12 mg 2 51 (49 51) 51 (41 51) 4 (4 4) 4 (4 4) 3TC+NVP+d4T mg 4 52 (52 52) 58 (58 58) 56 (56 56) 61 (56 61) 3TC+NVP+d4T mg 2 54 (54 55) 55 (55 55) 52 (52 52) 53 (52 59) 3TC+ZDV 3+6 mg 4 83 (83 83) 88 (88 88) 79 (73 79) 79 (73 79) 3TC+NVP+ZDV mg 4 15 (15 15) 15 (15 15) 13 (13 13) 13 (13 14) ABC 6mg 4 ( ) ( ) ( ) ( ) ABC/3TC 6/3mg 4 ( ) ( ) 158 ( ) 158 ( ) 24

28 4C) Upper middle-income countries Median transaction price (25th -75th Quartile range) (US$/ppy) DDD (tablets or ml) ABC 2 mg/ml ( ) 241 ( ) 233 (233 24) 141 ( ) ddi 25 mg ( ) 462 ( ) 197 ( ) 522 ( ) ddi 5 mg 3 97 (8 115) ( ) 173 ( ) ddi 1 mg ( ) 157 ( ) 97 (97 97) 94 (93 156) ddi 125 mg (78 13) 78 (65 9) EFV 5 mg ( ) 24 ( ) 142 ( ) 119 ( ) EFV 2 mg 1 62 (61 7) 126 (66 217) 64 (56 196) 47 (33 56) 3TC 1 mg/ml 1 92 (76 16) 86 (66 98) 32 (28 62) 31 (3 31) LPV+RTV 8+2 mg/ml 3 35 ( ) 179 ( ) 33 ( ) 36 (151 36) LPV+RTV 1+25 mg ( ) 197 (192 23) 176 ( ) 182 ( ) LPV+RTV 2+5 mg ( ) 24 ( ) 168 ( ) 162 ( ) NFV 25 mg ( ) 2887 ( ) 964 ( ) 964 ( ) NVP 1 mg/ml 2 67 (67 16) 317 (27 42) 96 (64 473) 59 (58 62) NVP 2 mg 1 24 (24 32) 122 (45 125) 18 (16 5) 17 (16 17) d4t 15 mg 2-78 (69 82) 24 (18 24) 82 (18 82) d4t 2 mg 2 2 (2 2) 185 (73 193) 24 (17 24) 8 (74 82) ZDV 1 mg/ml 2 61 (61 152) 188 ( ) 72 (62 95) 64 (64 8) ZDV 1 mg (83 253) 99 (99 99) 3TC+d4T 15+3 mg 1 26 (26 26) 35 (35 35) 19 (19 19) 19 (19 19) 3TC+NVP+d4T mg 1 42 (42 52) 46 (46 46) 33 (33 35) 33 (33 35) 3TC+d4T 3+6 mg 4 52 (47 53) 46 (46 69) 46 (46 46) 46 (46 46) 3TC+d4T 6+12 mg 2 5 (44 51) 4 (4 4) 4 (4 4) 4 (4 4) 3TC+NVP+d4T mg 4 58 (58 58) 58 (58 58) 56 (56 56) 56 (56 56) 3TC+NVP+d4T mg 2 54 (47 55) 52 (52 52) 52 (52 52) 52 (52 52) 3TC+ZDV 3+6 mg 4 83 (83 83) 88 (88 88) 79 (79 79) 73 (73 76) 3TC+NVP+ZDV mg 4 15 (15 15) 15 (15 15) 13 (56 13) 13 (13 13) ABC 6mg 4 ( ) ( ) ( ) ( ) ABC/3TC 6/3mg 4 ( ) ( ) ( ) ( ) 25

29 References 1. World Bank Group -Data and statistics: Country Classification; Income group. Washington 2. World Bank Group -Data and statistics: World Bank Atlas Method Washington June 29 PK:239419,.html 3. Sources and Prices of selected medicines for children including therapeutic food, dietary vitamin and mineral supplementation. UNICEF in collaboration with WHO, April Untangling the Web of Antiretroviral Price Reduction, web based database Médecins Sans Frontieres. Geneva, Switzerland. November The Global Fund Secretariat The Price & Quality Reporting (PQR) system : portal/pqr%2public&page=regional%2price%2reference 6. International Drug Price Indicator Guide, 21 edition. Guide produced in collaboration with the World Health Organization and supported by the Strategies for Enhancing Access to Medicines (SEAM) Program, which is funded by the Bill & Melinda Gates Foundation. Cambridge, MA Antiretroviral therapy for HIV infection in adults and adolescents: Recommendations for a public health approach: 21 revision World Health Organization. Geneva, Switzerland Antiretroviral therapy for HIV infection in adults and adolescents: towards universal access: Recommendations for a public health approach, 26 revision. World Health Organization. Geneva, Switzerland

30 9. Antiretroviral therapy of HIV infection in infants and children: towards universal access: Recommendations for a public health approach, 21 revision. World Health Organization. Geneva, Switzerland Antiretroviral therapy of HIV infection in infants and children: towards universal access: Recommendations for a public health approach, 26 revision. World Health Organization. Geneva, Switzerland Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: Recommendations for a public health approach, 21 revision. World Health Organization. Geneva, Switzerland Joint WHO & UNAIDS Annual Consultation with Pharmaceutical Companies, Global forecasts of Antiretroviral Demand , Geneva, 9&1 December 21: Medicine Prices. Health Action International (HAI) and the World Health Organization Department of Essential Drugs and Medicines Policy published a working draft of a manual to collect and analyse the prices people pay for a selection of important medicines, as well as identifying price components (taxes, mark-ups etc.) and the affordability and availability of key medicines. 21,

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32 WHO AIDS Medicines and Diagnostic Services Global Price Reporting Mechanism Transaction Prices for Antiretroviral Medicines and HIV Diagnostics from 28 to July 211 ISBN