Untangling the Web of Antiretroviral Price Reductions

Médecins Sans Frontières has released the 18th edition of its HIV drug pricing report, Untangling the Web of Antiretroviral Price Reductions, at the International AIDS Conference in Durban, South Africa today. The report finds that prices of older HIV drugs continue to decline, while newer drugs remain largely priced out of reach. This is in large part because pharmaceutical corporations maintain monopolies that block price-lowering generic competition.

Today, the lowest available price for a quality-assured, World Health Organization-recommended first-line one-pill-a-day combination is US$100 per person per year (tenofovir/emtricitabine/efavirenz). This is a decrease of 26 per cent since MSF last recorded the lowest price for first-line treatment at US$136 in 2014. For a WHO-recommended second-line regimen, the lowest available price is now US$286 per person per year (zidovudine/lamivudine + atazanavir/ritonavir) – an 11 per cent decrease from US$322 two years ago.

These prices continue to fall as a result of robust competition among generics manufacturers in key producing countries, primarily India. But the price of newer drugs – needed for people who have run out of other HIV treatment options – remain high, largely because of patent monopolies held by drug corporations. The lowest price for salvage treatment today is US$1,859 per person per year (raltegravir + darunavir/ritonavir + etravirine). This is more than 18 times the price of first-line therapy, and more than six times the price of today’s most affordable second-line combination. The price for this combination has come down only by seven per cent, from US$2,006 per year in 2014. These are the lowest global prices, but many countries, especially ‘middle-income’ countries, pay much higher prices for these medicines because pharmaceutical patents block them from using generics.