Title: Multicountry collaboration: The Andean negotiations November 2002 June 2003
1Multi-country collaborationThe Andean
negotiations November 2002 June 2003
- Inter-country Meeting on Antiretroviral Drugs
Pricing, Procurement and Supply Management - Cairo, Egypt, 5-7 April 2005
Peter Graaff WHO Aids Medicines and Diagnostic
Service Geneva
2 3Andean (Lima) Negotiations begin November 2002
- November 2002 Joint meeting of Ministers of
Health from Andean Countries and Ministers from
Southern Cone - Resolution to execute regional negotiations with
manufacturers of ARV, brand and generics, as well
as laboratory diagnostics adopted jointly by - Bolivia, Chile, Colombia, Ecuador, Peru,
Venezuela - Argentina, Mexico, Paraguay, Uruguay
- Coordinated by regional institutions for economic
integration (CAN / ORAS) and supported by PAHO
and UNAIDS
4Open Competition Negotiation Model
- Rejection of the principles of the Accelerated
Access Initiative - Prices to be negotiated on price and volume, and
not based on any other condition - Countries would pre-qualify companies to ensure
that the manufacturer and product conform with
quality criteria - Quality criteria based on WHO standards (GMP
certification and bioequivalence)
5Development of the Negotiation Model
- Nomination by the Minister of Health of a
Technical Commission, with members from each
country (10) - Development of a status report on HIV/AIDS in the
Andean region, focusing on treatment access and
pricing - Regional meetings (3) of the Technical Commission
to - Review the Status Report
- Define prequalification criteria (coherent with
WHO criteria) - Identify manufacturers meeting criteria
- Define the Basis for the negotiation (one
regional price, no external conditions) - Briefing of the negotiators (Ministers of Health)
- Organize the negotiation
6ARV Manufacturers Prequalified for Negotiation
- 1. ABBOTT LABORATORIES 9.KAMPEL MARTIAN S.A.
- 2. BOEHRINGER INGELHEIM 10.LAZAR
- 3. BRISTOL MYERS SQUIBB 11.MERCK SHARP DOHME
- 4. CIPLA LTD 12.RANBAXY
- 5. COMBINO PHARM S.L. 13.REFASA S.A.C.
- 6. ELEA S.C.I.F.Y.A. 14.RICHMOND
- 7. FILAXIS S.A. 15.PRODUCTOS ROCHE S.A.
- 8. GLAXO SMITH KLINE 16. RONTAG S.A
7HIV Diagnostic Manufacturers Prequalified for
Negotiation
1. ABBOTT LABORATORIES 2. BAYER 3. BECKMAN 4. BECT
ON DICKINSON 5. BIOMERIEUX 6. BIORAD 7. CROMOION
PROMED 8. INNOGENETICS, N.V. 9. ROCHE
DIAGNOSTIC
8Outcomes of the Andean NegotiationLima, Peru,
June 2003
- Signing of Statement of Intent between 8 ARV
manufacturers, and 5 HIV diagnostics
manufacturers, and the countries - Of the ARV Manufacturers 7 Generic Companies and
1 Originator - Of 37 items negotiated, price reductions were
obtained for 15 items, compared to the lowest
reference price in any of the countries prior to
the negotiation
9Results
New
No
102. Outcomes of the Lima Negotiation Peru, June
2003
112. Outcomes of the Lima Negotiation, Peru, June
2003
Latin Americans lead price-cut drive AIDS
DRUGS Countries in Latin America have been
taking an increasingly aggressive stance towards
the pharmaceuticals industry over patented Aids
treatments, which could set a pattern for other
developing nations. "The prices they have
achieved are in some cases lower than in
sub-Saharan Africa," says James Fitzgerald, a
drug procurement specialist at the Pan American
Health Organization in Washington.
12Take home messages
- Development of a regional negotiation process
requires significant political commitment and
technical input from countries (and partners) - Joint action by the EMR countries in addressing
the determinants of access to ARVs can result in
important direct benefits (price reductions) and
indirect benefits (sharing of information, policy
development, advocacy, coordination of efforts,
intercountry cooperation) - Negotiations have to be followed by procurement
- Impact should be monitored
- AND
- Working together works (to deal with technical
and political issues) - ??? GCC model
- ??? Council of Arab Ministers of Health
13An example of countries working togetherPrices
paid for ARVs as reported to the GFATM
14For further information
- James Fitzgerald of PAHO not only assisted the
Andean countries with their negotiation process,
but also me with the preparation of this
presentation. - Contact details
- graaffp_at_who.int
- amds_at_who.int
- http//www.who.int/3by5/amds/en/