(2012; 120 pages)
Highlights from UNTANGLING THE WEB, 15th Edition:
The price of tenofovir-based regimens is now nearly the same (when combined with nevirapine), or lower (when combined with efavirenz), than AZT-based regimens, for countries that can access generic versions because patents do not form a barrier, or where voluntary licences allow access to generic versions.
The fixed-dose combination of TDF/FTC/EFV (produced by Merck/BMS/Gilead) which is an adherence-friendly once-a-day pill has remained priced at $613 and $1033 per patient per year (ppy) for lower-income and lower-middle-income countries, respectively, for the last five years. For middle-income countries, prices can be even higher, as most companies have eliminated their standardised discount programmes for these countries, in favour of case-by-case price negotiations.
The price of the TDF/3TC/EFV co-pack of two pills to be taken once a day has come down by 20% since last year, to $113 ppy, making it the most affordable option of the WHO recommended first-line regimens, with the added benefit of once-daily dosing.
Today s most affordable second-line regimen (AZT/3TC + ATV/r) is priced at $399 ppy, down from $442 for last year s most affordable combination. This however is still three times more than the most affordable first-line regimen. For countries where generic versions cannot be used because of patent barriers or because they are excluded from the geographical scope of the voluntary licences, the price can be many times higher.