Sources and prices of selected drugs and diagnostics for people living with HIV/AIDS

Sources and pricesof selected medicines and

diagnostics forpeople living with

HIV/AIDS

A JOINT UNICEF – UNAIDS – WHO – MSF PROJECT

JUNE 2004

WHO/EDM/PAR/2004.4

WHO

Inside cover

Sources and pricesof selected medicines and

diagnostics forpeople living with

HIV/AIDS

JUNE 2004

A joint UNICEF – UNAIDS Secretariat – WHO – MSF Project

WHO/EDM/PAR/2004.4

WHO

This report is also available

On the following web pages:

UNICEF: www.unicef.org/supply

UNAIDS: www.unaids.org

WHO/ Department of Essential Drugsand Medicines Policy: www.who.int/medicines

WHO/ Department of HIV/AIDS:www.who.int/HIV_AIDS

Médecins Sans Frontières (MSF):www.accessmed-msf.org

© World Health Organization, United Nations Children’s Fund, Joint United Nations Programme on HIV/AIDS (UNAIDS),Médecins Sans Frontières, 2004. All rights reserved.

Published by WHO, also on behalf of UNICEF, the UNAIDS Secretariat, and Médecins Sans Frontières.

WHO, UNICEF, the UNAIDS Secretariat, and Médecins Sans Frontières have made every effort to ensure the accuracy of price, supplier,and other information presented in this report. Reader’s attention is drawn to the introduction, which describes the specific sourcesand limitations of information provided in this report.

Reader’s attention is also drawn to the importance of quality assurance for pharmaceutical products. Licensing authorities in therespective countries of manufacture are expected to be responsible for the review and approval of the detailed composition andformulation when authorizing a pharmaceutical product to be marketed, including the specifications of its ingredients, as submitted bythe manufacturer of the dosage form, and to oversee compliance with Good Manufacturing Practice requirements as recommended byWHO.

The data and information contained herein are being provided as is and WHO, UNICEF, the UNAIDS Secretariat, and Médecins SansFrontières make no representations or warranties, either expressed or implied, as to their accuracy, completeness or fitness for aparticular purpose. Neither WHO, UNICEF, the UNAIDS Secretariat, nor Médecins Sans Frontières accepts any responsibility or liabilitywith regard to the reliance on, or use of, such data and information.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended byWHO, UNICEF, the UNAIDS Secretariat or Médecins Sans Frontières in preference to others of a similar nature that are not mentioned.Errors or omissions excepted, the names of proprietary products are distinguished by initial capital letters.

The designations employed and the presentation of the material in this report, including tables and maps, do not imply the expressionof any opinion whatsoever on the part of WHO, UNICEF, the UNAIDS Secretariat and Médecins Sans Frontières concerning the legalstatus of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dottedlines on maps represent approximate border lines for which there may not yet be full agreement.

Design and layout by minimum graphicslayout/production Janet PetitpierrePrinted in France

Or by contacting:

Pharmaceuticals and Micronutrients Team,UNICEF Supply DivisionFax: +45 35 269421

Department of Social Mobilization and Information,UNAIDSFax: +41 22 7914741

Essential Drugs and Medicines Policy (EDM),World Health OrganizationFax: +41 22 7914167

Campaign for Access to Essential Medicines,Médecins Sans FrontièresFax: +41 22 8498404

Information on HIV/AIDS diagnostic support, HIV test kit evaluations and bulk procurement are available on the WHO/Department of Essential Health and Technologies website: www.who.int/eht

Information on HIV/AIDS and substance abuse dependence is available from www.who.int/substance_abuse

WHO Library Cataloguing-in-Publication Data

Sources and prices of selected medicines and diagnostics for people living withHIV/AIDS / a joint UNICEF, UNAIDS Secretariat, WHO, MSF project.1. Pharmaceutical preparations - supply and distribution2. Reagent kits, Diagnostic - supply and distribution3. HIV infections - diagnosis4. HIV infections - drug therapy5. Price lists6. Catalogs, Drug I.UNICEF

ISBN 92 4 159179 X (LC/NLM classification: QV 772)

Contents

ANNEX 4.FURTHER READING, REFERENCES, AND CONTACTS

iii

Glossary v

1. Introduction 1

2. Diagnostics 9

3. Access to quality HIV/AIDS medicines 10

4. Prices of medicines and diagnostics 11

5. List of manufacturers - medicines and diagnostics 26

Annex 1 A. CD4+ T- cell enumeration technologies 37

B. Summary of main characteristics of Viral Load Technologies 39

Annex 2 A. Registration status of products included in the sources and prices survey 41

B. Sources of medicines 106

Annex 3 Further reading, references and contacts 117

Annex 4 Untangling the web of price reductions: a pricing guide for the purchase of ARVsfor developing countries 121

Feedback and enquiry form

Tables

Table 1. Anti-infective medicines 11

Anthelminthics 11

Antibacterials, beta lactam medicines 11

Other antibacterials 12

Antifilarials 14

Antifungal medicines 15

Aniprotozoal medicines 15

Antiviral medicines 15

Antiviral medicines - Antiretrovirals 16

Table 2. Antineoplastic medicines 18

Cytotoxic medicines 18

iv

Table 3. Medicines used for the treatment of mental and substance use disorders 19

Medicines used in depressive disorders 19

Medicines used in generalized anxiety and sleep disorders 19

Medicines used in the treatment of opioid dependence 19

Table 4. Analgesics 20

Opioid analgesics 20

Table 5. Gastrointestinal medicines 20

Antacids and other antiulcer medicines 20

Antiemetic medicines 21

Laxatives 21

SOURCES AND PRICES OF SELECTED DRUGS AND DIAGNOSTICS FOR PEOPLE LIVING WITH HIV/AIDS

GlossaryAIDS1 Acquired Immune Deficiency Syndrome – the late

stage of HIV disease. AIDS involves the loss of functionof the immune system as CD4 cells are infected anddestroyed, al lowing the body to succumb toopportunistic infections (e.g., Pneumocystis cariniipneumonia, toxoplasmosis) that are generally notpathogenic in people with intact immune systems.

CIF2 Cost Insurance and Freight – (…named port ofdestination) the seller delivers when the goods passthe ship’s rail in the port of shipment. The seller mustpay the cost of freight if necessary to bring the goodsto the named port of destination but the risk of loss ordamage to the goods, as well as any additional costsdue to events occurring after the time of delivery, aretransferred from the seller to the buyer. This term canbe used only for sea or inland waterway transport.

COF Consejo General de Colegios Oficiales deFarmacéuticos (General Spanish Council of Pharma-cists and Pharmaceutical Associations) – Spanish or-ganization of Pharmaceutical Colleges, whichrepresents all colleges in the national and internationalforum, develops norms, rules, and professional policy,and acts as the interlocutor with Spanish Ministries.

Diagnostics Laboratory tests used in the diagnosis ofinfection.

ELISA Enzyme-linked immunosorbent assay – first HIVantibody test which requires a machine to measurecolor change in test wells.

Endemic1 The continuous presence of a disease in ageographic location, community or population.

Epidemic1 An outbreak of a disease within a population.See also pandemic.

EXW2 Ex-works – (... named place) the seller’s onlyresponsibility is to make the goods available at theseller’s premises, i.e., the works or factory. The selleris not responsible for loading the goods on the vehicleprovided by the buyer unless otherwise agreed. Thebuyer bears the full costs and risk involved in bringingthe goods from there to the desired destination. Exworks represents the minimum obligation of the seller.

FCA (nearest port)2 Free Carrier – (... named place) Thisterm has been designed to meet the requirements ofmultimodal transport, such as container or roll-on, roll-off traffic by trailers and ferries. It is based on thesame name principle as F.O.B. (free on board), exceptthe seller fulfils its obligations when the goods aredelivered to the custody of the carrier at the namedplace. If no precise place can be named at the time ofthe contract of sale, the parties should refer to theplace where the carrier should take the goods into itscharge. The risk of loss or damage to the goods istransferred from seller.

FOB2 Free-on-board – (... named port of shipment) Under“F.O.B” the goods are placed on board the ship by theseller at a port of shipment named in the salesagreement. The risk of loss of or damage to the goodsis transferred to the buyer when the goods pass theship’s rail (i.e., off the dock and placed on the ship).The seller pays the cost of loading the goods.

Generic medicine3 The term “generic product” hassomewhat different meaning in different jurisdictions.In many technical documents, use of this term isavoided, and the term ‘multisource pharmaceuticalproduct’ is used instead. In this document, where theterm generic medicine is used, it means apharmaceutical product usually intended to beinterchangeable with the innovator product, which isusually manufactured without a license from theinnovator company and marketed after expiry of patentor other exclusivity rights where these have previouslyexisted. Generic products may be marketed eitherunder the non-proprietary approved name or under anew brand (proprietary) name. They may sometimesbe marketed in dosage forms and/or strengths differentfrom those of the innovator products.

GMP Good Manufacturing Practice

HAART Highly Active Antiretroviral Therapy

HDI Human Development Index

HIV Human Immunodeficiency Virus – a slow-actingretrovirus of the lentivirus family, believed to be thesole or primary cause of AIDS. HIV is transmittedsexually, through blood or vertically (from mother tochild). There are 2 known types: HIV-1 and HIV-2.

HIV Test kit There are 3 main types of test for detectingthe presence of HIV antibodies: simple/rapid tests,ELISA tests, and confirmatory tests.

International Drug Price Indicator Guide 2003 A jointpublication by the World Health Organization and Man-agement Sciences for Health (MSH). Provides a spec-trum of prices from non-profit drug suppliers,procurement agencies, and ministries of health, basedon their current catalogs or price lists.

ITC International Trade Centre – technical cooperationagency of the United Nations Conference on Trade andDevelopment (UNCTAD) and the World Trade Organiza-tion (WTO) for operational, enterprise-oriented aspectsof trade development.

GLOSSARY

v

1 AIDS Education Global Information System

2 International Chamber of Commerce

3 World Health Organization. Quality Assurance of Pharmaceu-ticals. A compendium of guidelines and related materials. Vol1, 1997

vi

Manufacturing license Granted by national licensingauthorities and gives authorization to manufacture aspecific product in a specified manufacturing plant.

MSF Médecins Sans Frontières is an international humani-tarian aid organization that provides emergency medi-cal assistance to populations in danger in more than80 countries, since 1971.

MSH Management Sciences for Health is a private, non-profit educational and scientific organization. Since1971, MSH has worked with its worldwide partners toimprove the management of, and access to, publichealth services.

MTCT Mother-to-child transmission (of HIV)

Opportunistic infection1 (OI) An illness caused by amicro-organism that usually does not cause disease inpersons with healthy immune systems, but which maycause serious illness when the immune system issuppressed. Common OIs in HIV positive people includePneumocystis carinii pneumonia (PCP), Mycobacteriumavium complex (MAC) and cytomegalovirus (CMV)infection.

Originator [pharmaceutical manufacturers]Manufacturers that produce mainly innovativemedicines

Palliative care4 Pain and symptom management, andpsycho-social support for persons living with a terminalillness, as well as for their families and caregivers.

Pandemic1 A widespread disease outbreak affecting thepopulation of an extensive area of the world. See alsoepidemic.

Patents5 A title granted by the public authoritiesconferring a temporary monopoly for the exploitationof an invention upon the person who reveals it, furnishesa sufficiently clear and full description of it, and claimsthis monopoly.

PLWA People Living With HIV/AIDS

Protease inhibitor (PI) Type of antiretroviral medicine

Proprietary medicines Medicines that are under patentrestrictions belonging to a company, institution, or gov-ernment.

Reverse transcriptase inhibitor Type of ARV medicine.Can be divided into two classes: Nucleoside ReverseTranscriptase Inhibitor (NRTI) and Non NucleosideReverse Transcriptase Inhibitor (NNRTI)

Simple/rapid test Can generally be carried out in 15minutes and results are read with the naked eye. Theyare easy to use and require limited training and little orno equipment, making them particularly suitable foruse in Voluntary Counselling and Testing (VCT) centres.

The World Bank Group Established in 1944 it is one ofthe world’s largest sources of development assistance.

In Fiscal Year 2003, the institution provided more thanUS$18.5 billion in loans to its client countries.

TRIPS6 Agreement on Trade Related Aspects of Intellec-tual Property Rights

UNAIDS The Joint United Nations Programme on HIV/AIDS (UNAIDS) – by the mid-1990s, it became clearthat the epidemic’s devastating impact on all aspectsof human development, were creating an emergencythat would require a greatly expanded United Nationseffort. UNAIDS created in 1995 was tasked tocoordinate this effort.

UNCTAD United Nations Conference on Trade andDevelopment, established in 1964, aims at thedevelopment-friendly integration of developingcountries into the world economy. It is the focal pointwithin the United Nations for the integrated treatmentof trade and development and the interrelated issuesin the areas of finance, technology, investment andsustainable development.

UNFPA United Nations Population Fund – began opera-tions in 1969. It is the largest international source ofpopulation assistance. About a quarter of all populationassistance from donor nations to developing countriesis channelled through UNFPA.

UNICEF United Nations Children’s Fund – Created bythe United Nations General Assembly in 1946 to helpchildren after World War II in Europe. Headquartered inNew York, UNICEF carries out its work through eightregional offices and 126 country offices covering morethan 160 countries, territories and areas.

WHO World Health Organization – Founded in 1948, theWorld Health Organization leads the world alliance forHealth for All. WHO promotes technical cooperationfor health among nations, carries out programmes tocontrol and eradicate disease and strives to improvethe quality of human life.

WIPO World Intellectual Property Organization – Foundedin 1970, WIPO administers 23 international treatiesdealing with different aspects of intellectual propertyprotection.

WTO World Trade Organization – succeeded the GeneralAgreement on Tariffs and Trade (GATT), first signed in1947 by 23 countries and aimed at protecting andregulating international trade. WTO now has 147members, three quarters of which are developing orleast developed countries.

4 Council on palliative care, Canada

5 Globalization and access to drugs—perspectives on the WTOTRIPS Agreement. Health Economics and Drugs EDM Series7. WHO, Geneva, 1999

6 http:// www.wto.org


1

1. Introduction

framework. WHO’s 3 by 5 team assembled and refinedthe framework in intensive consultation with partners. Thisconsultation will continue, and the framework itself willcontinue to evolve.

WHO’s strategic framework for emergency scaling up ofantiretroviral therapy contains 14 key strategic elements.These elements fall into five categories – the pillars ofthe 3 by 5 campaign:

1. Global leadership, strong partnership and advocacy

2. Urgent, sustained country support

3. Simplified, standardized tools for deliveringantiretroviral therapy

4. Effective, reliable supply of medicines and diag-nostics

5. Rapidly identifying and reapplying new knowledgeand successes

The full text of the WHO strategic framework can be foundat : http://webitpreview.who.int/entity/3by5/publications/documents/en/3by5StrategyMakingItHappen.pdf

In addition, drug users, PLWA and their advocates fromaround the world have urged WHO to ensure the inclusionof injecting drug users in the scale-up of ARV therapy inits 3 by 5 initiative (Media Alert dated 19 February 2004).

The new simplified ARV therapy guidelines mentioned inthe 3rd pillar also allow for cost savings and real scaling-up activities through the potential use of cheaper fixed-dose combinations (FDCs), where countries are favorableto import generics or where local production facilitiesexist8 .

1.1 Background

Antiretroviral therapy, prevention and treatment of oppor-tunistic infections and cancers, as well as palliative careare important elements of HIV/AIDS care and support.HIV/AIDS care hence requires a wide range of essentialmedicines. If available, these effective and often relativelyinexpensive medicines can prevent, treat, or help manageHIV/AIDS and most of the common HIV-related diseases.

Less than 8% of people who require antiretroviral (ARV)treatment can access these medicines in developingcountries (see Figure 1).

The high price of many of the HIV-related medicines anddiagnostics offered by common suppliers – especiallyantiretroviral and anti-cancer medicines – is one of themain barriers to their availability in developing countries.

There are several other important barriers, including alack of the basic components required for care, treatment,and support of people living with HIV/AIDS (PLWA) suchas: trained staff in health facilities, constant availability oflaboratory equipment and supplies, sufficient funding,efficient pharmaceutical services, strong political will andgovernment commitment. Wider availability of informationon prices and reliable sources of medicines can help thoseresponsible for procurement make better decisions.

Since 2000, prices of important first-line ARVs have fallenconsiderably. This trend is attributable to a cumulation offactors including advocacy, corporate responsiveness,competition from generic manufacturers, sustained pub-lic pressure, and the growing political attention paid tothe AIDS epidemic. In addition, originator companies be-gan announcing discount offers for the benefit of the poor-est countries or those where HIV/AIDS prevalence ishighest7 .

Furthermore, the announcement of WHO’s “3 by 5” initia-tive of providing ARV treatment to 3 million PLWA in devel-oping countries by the end of 2005 has lead to anticipationthat increased volumes of medicine will be purchased.This may further reduce the prices of certain medicines.

Treating 3 million people by the end of 2005 will requireconcerted, sustained action by many partners. To chartthe direction and to show what WHO itself will be doing toaccelerate action, WHO has developed an initial strategic


7 HIV prevalence status of countries see www.who.int/emc-hiv/fact_sheets/All_countries.html

8 More information on fixed dose combinations can be obtainedfrom the MSF briefing note: Two pills a day saving lives: Fixed-dose combinations (FDCs) of antiretroviral drugs, MSF, Feb2004 (see http://www.accessmed-msf.org/documents/factsheetfdc.pdf)


2

1.2 Aim

This report sets out to provide market information thatcan be used to help procurement agencies make informeddecisions on the sources of medicines and diagnostics,and serve as the basis for negotiating affordable prices.The aim is to help increase access to treatment for PLWAin developing countries.

The data provided by the manufacturers serve to drawattention to the multiplicity of suppliers and the variationin price of some essential HIV/AIDS-related medicines onthe international market. Without this information, thereis a risk that low-income countries may be paying morethan needed to obtain HIV/AIDS-related medicines. Pricevariations are highlighted through the tables and graphsincluded.

However, provision of price information addresses onlyone barrier to access to medicines in countries with lim-ited resources. It should be noted that many other fac-tors will affect the availability of medicines. Some of theother issues that must be considered are health infrastruc-ture, human resources, funding and supply and distribu-tion systems9 .

1.3 Target audience

This report is intended for use primarily by national pro-curement agencies in resource-limited countries that lackeasily accessible information on reliable sources andprices of medicines and diagnostics.

It may also be useful to others involved in the procure-ment of medicines and diagnostics, such as not-for-profitorganizations, distributors, importers and wholesalers orpublic health professionals interested in current price lev-els of medicines and diagnostics for PLWA.

Those who will become involved in planning and imple-menting HIV/AIDS care and treatment interventions willfind important regulatory information in this document.

Source: WHO/UNAIDS. Treating 3 million by 2005 – Making it happen. Geneva, WHO, 2003.

Figure 1. Estimated percentage of people covered among those in need of antiretroviral treatment,situation as of November 2003

9 Management Sciences for Health and the World HealthOrganization second edition of Managing Drug Supply providesa complete overview as well as step-by-step approaches onhow to manage pharmaceutical systems effectively.

3

1.4 Generating the report

This is the fifth in a series of annual reports commencedin 1999, investigating sources and prices of medicinesand diagnostics commonly required by PLWA, but diffi-cult to obtain locally due to a small number of producers,the lack of distribution channels, or high prices. Thesesurveys will be continued and the report will be regularlyupdated and made available when appropriate.

A survey was carried out from December 2003 throughto January 2004. The responses of 84 manufacturers in29 different countries as well as those participating in theWHO bulk procurement scheme (see Chapter 2) formedthe basis of this report. The number of manufacturersreached has greatly increased since the first survey in1999 as more resources are made available via industrywebsites and cooperation with other international organi-zations. Manufacturers that participated in previous sur-veys, those held in various databases, and those belongingto National Pharmaceutical Associations were contactedfor voluntary participation and for completion of a ques-tionnaire.

The UNAIDS Secretariat, UNICEF, MSF, and WHO haveworked jointly to conduct a price survey and put togetherthe results into a comprehensive publication, whilst re-specting the manufacturers’ requests for confidentialitywith respect to their individual pricing information.

It must be pointed out that the companies included in thisreport have been screened only through the complete-ness of the requested documents they have provided,such as the questionnaire, a National GMP certificate, andassociated documents relating to the company and theirproducts. Inclusion in this report does not necessarily con-stitute prequalification or approval of any sort by UNICEF,WHO, UNAIDS or MSF. Only those products identified inAnnex 2B in bold and with an asterisk (*) have (at the timeof publication of this document) been approved throughthe ongoing Pre-qualification Project (see Chapter 3).

Additional companies are sought for future updates ofthis publication.

1.5 Theme of the report: Diagnostics

Increased access to ARV medicines has also highlightedthe need for appropriate and cost-effective HIV/AIDSdiagnostic support. Diagnostic technologies are impor-tant to monitor the progression of the safety and efficacyof treatment, and the development of resistance.

The existing systems for assessment and procurementof HIV test kits is being expanded to include technologiesused to monitor ARV therapy (CD4+ counts and viral load)and drug resistance. An overview of types of CD4+ T-cell

enumeration technologies available are given in Annex 1Awhilst information on HIV viral load technologies is givenin Annex 1B.

1.6 How to use this report:

1.6.1 Information on prices

Detailed price information is provided in Chapter 4 and inthe MSF document included in Annex 5.

Chapter 4 provides prices of medicines and diagnostictests based on data obtained from the survey. Official UNexchange rates for the month of February 2004 were usedto convert local currencies into US dollars. The pricesyou will find listed in section 4.1 are provided as statisti-cal ranges explained below.

Price ranges and how these prices are distributed indi-cate what a purchaser should expect to pay when plan-ning procurement. Section 4.2 provides negotiated pricesof essential HIV test kits of the UN bulk procurementscheme 2004.

Annex 5 is a contribution from MSF and is the latest ver-sion of their bi-annual publication Untangling the Web ofPrice Reductions: a pricing guide for the purchase of ARVsfor developing countries.

Most of the prices in this report are ex-works (EXW) orFree Carrier (FCA). They do not include added costs suchas freight, insurance, import duties or taxes. For this rea-son the prices in this report cannot be compared withconsumer prices. Many countries continue to imposeconsiderable import duties, tariffs and taxes on the priceof essential medicines10 . In addition, wholesale and retailmark-ups vary from one country to another. As a result,the EXW price is often less than half end-price to the con-sumer.

10 See Policy and programming options for reducing the pro-curement costs of essential medicines in developing coun-tries, Levinson, L, Boston University School of Public Health,2003

INTRODUCTION


4

(a) Therapeutic category (according to the WHO ModelList of Essential Medicines)

(b) The number of manufacturers that provided an in-dicative price and the number of countries they rep-resent

(c) The indicative price

unitThe price quoted relates to the unit described. For exam-ple, if the unit is “tablet” the price quoted is for one singletablet.

maxThe maximum price listed represents the highest priceamong products in this category, with no differentiationbetween originator or generic products.

minThe minimum price listed represents the lowest priceamong products in this category, with no differentiationbetween originator or generic products.

medianThe median price is the middle price, or where there is aneven number of prices listed, it is the mean of the twomiddle numbers. This means that half the prices quotedare above this median price, and the other half arebelow it.

25th percThe 25th percentile is the value point representing the firstquartile of quoted prices in ascending order. It is used togive some indication of the dispersion of prices for a givenproduct.

For example, if 4 suppliers were identified as manufactur-ing cefixime paediatric oral suspension, 100 mg/5 ml,and the 25th percentile is US$ 0.023 per ml of suspen-sion: 1 out of the 4 (a quarter) manufacturers surveyedoffer a price equal to or less than US$ 0.023.

(d) The List prices are used to indicate the differencein price, if any, between a developing and a devel-oped country. Brazilian prices are selected as Bra-zil is a developing country with considerablemanufacturing capacity; and Spanish prices becausethese are generally considered the lowest in Europe.

Brazilian list priceThe Brazilian list price included in this report representsthe minimum price payable by Brazilian health institutions,between 01/01/2003 and 01/01/2004, for the productand is taken from the Brazilian databank of healthpurchases (refer to http://bpreco.saude.gov.br/pls/BPREFD/consulta.inicio). Where the entry reads “none”,this indicates no purchase has been made for that prod-uct, therefore no minimum price payable is available.

Spanish list priceThis EXW price has been calculated by applying the newmargins (as stated in the Royal Decree 286/2001) to theconsumer price as published by The General SpanishCouncil of Pharmacists and Pharmaceutical Associations.(www.portalfarma.com). It should be noted that Spanishlist prices are generally considered the lowest in Europe.In most cases, the indicative prices listed in the reportare a fraction of the comparative prices in the Spanishlist.

1.6.2 Information on sources

Complete lists of manufacturers, their contact informa-tion, and the HIV/AIDS-related medicines and diagnosticsthey manufacture are given in Chapter 5. Annexes 2Aand 2B provide a country by country list of the registra-tion status and sources for each of these medicines.

The following structure is used for reporting the price information:

(a) (b) (c) (d)

Therapeutic category Manufacturer Indicative prices, US$ List prices, US$

No No

of ofmanuf countries unit max min median 25th perc Brazil Spain

5

1.6.3 Selection of medicines and diagnostics

This report includes antiretroviral medicines, medicinesused to treat a range of opportunistic infections, medi-cines for use in palliative care, medicines for the treat-ment of HIV/AIDS-related cancers and medicines for themanagement of opioid dependence. It also provides in-formation on a range of test kits available for diagnosisof HIV/AIDS.

The medicines included in the report were selected basedon recommendations from available WHO treatment guide-lines. The list is not intended to be exhaustive but tobroadly cover the most commonly used medicines ormedicine categories, in order to ensure that combinedwith their own resources, purchasing agencies can haveat their disposal all medicines and diagnostics requiredfor the comprehensive treatment of HIV/AIDS.

Additional medicines are often provided as they may behelpful due to:

— Greater cost offset by greater safety, e.g.fluconazole instead of ketoconazole;

— Fewer unwanted adverse effects, e.g. alternativesto amitriptyline.

Paediatric formulations have been included whereverpossible.

Antiretroviral therapySince October 2000, this report has included informationon the availability and price range of antiretroviralmedicines for use in Highly Active Antiretroviral Therapy.In resource - poor settings, it is critical that these medi-cines are used in conjunction with WHO treatment guide-lines which are intended to support and facilitate the propermanagement and scale-up of ART in the years to come,by proposing a public health approach to achieve thesegoals.

The topics addressed in the treatment guidelines includewhen to start ART, which antiretroviral regimens to start,reasons for changing ART, and what regimens to continueif treatment needs to be changed. They also address howtreatment should be monitored, with specific referenceto the side effects of ART, and make specif icrecommendations for certain patient subgroups.

The newly recommended first - line ARV regimens in adultsand adolescents consist of a thymidine analog nucleosidereverse transcriptase inhibitor (NRTI) [stavudine (d4T) orzidovudine (ZDV)], a thiacytidine NRTI [lamivudine (3TC)]and a non-nucleoside reverse transcriptase inhibitor(NNRTI) [nevirapine (NVP) or efavirenz (EFV)].

The full text of the treatment guidelines can be found at:http://www.who.int/3by5/publications/documents/arv_guidelines/en/

Antituberculosis medicinesThis report does not include data on sources and pricesof medicines for first line treatment of tuberculosis (TB)as this information is available on the website of the Inter-national Price Indicator Guide 200311 or of the GlobalDrug Facility at http://www.stoptb.org/GDF/drugsupply/drugs.available.html.

Further resources for information on TB can be found inAnnex 3, including links to the DOTS-plus for multidrugresistant TB website and the prequalification of TBmedicines.

1.7 Offers of medicine donationsand price reductions

Public pressure, advocacy, competition from genericmanufacturers and initiatives from pharmaceuticalcompanies have led to reduced prices of some medicinesfor developing countries. There is no systematic approachto this equitable pricing. Each company determines itsown eligibility criteria for countries, sectors and institu-tions that may benefit from its reduced price. Some com-panies offer donations of medicines for specific indicationssuch as to prevent mother-to-child transmission of HIV, orto treat certain opportunistic infections affecting PLWAs.

The prices that are quoted in Chapter 4 of this report donot necessarily reflect all agreements that may have beennegotiated with individual countries. Information on priceoffers for ARVs publicly announced by pharmaceuticalmanufacturers, including information on countries eligi-ble for the offers and other conditions, can be found inthe MSF report Untangling the web of price reductions: apricing guide for the purchase of ARVs for developingcountries (see Annex 4). Apart from providing prices ofARVs as offered by originator companies and selectedgeneric companies, it highlights the lack of standardiza-tion among different companies on eligibility and termsand conditions of price offers. For example, some com-panies use UNCTAD classification (Least Developed Coun-tries), or the World Bank classification (Low Income/ MiddleIncome Countries) or a combination of UNDP classifica-tion (Human Development Index) and UNAIDS prevalencedata.

11 The International Price Indicator Guide 2003 is a jointpublication of MSH and WHO. For more information refer toAnnex 4, Websites: Drug Prices.

INTRODUCTION


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1.8 Additional Methods of Costreduction

In addition to generic competition and advocacy for thereduced pricing in line with the purchasing power of coun-tries, important parallel avenues to be pursued by gov-ernments include the active use of compulsory licensing,government use of patents, and parallel importation12.

As agreed by the Member States of the WTO in 2001,Least developed countries (LDCs) are not obliged toenforce pharmaceutical patents until at least 201613. LDCsshould make use or avail themselves of this provision topurchase lowest cost medicines on the world market. Forvaluable and concise information on this subject, pleasesee the MSF report Drug patents under the spotlight: Shar-ing practical knowledge about pharmaceutical patents andHIV/AIDS medicines and related supplies: Contemporarycontext and procurement.12 Alternatively, to obtain fur-ther guidance from the appropriate organisation, pleasefill in the feedback form in Annex 5.

The Global Fund to Fight AIDS, Malaria and Tuberculosis“encourages recipients to comply with national laws andapplicable international obligations in the field of intellec-tual property including the flexibilities provided in the TRIPS

agreement and referred to in the Doha Declaration in amanner that achieves the lowest possible price for prod-ucts of assured quality.”14

Other measures may include reducing or eliminating im-port duties and taxes. As data clearly demonstrate, thesefactors can severely distort the prices patients will payfor medicines compared with the price at which they weresold (see Figure 2). Increasing demand through pooledprocurement may also be an option for purchasers to ex-plore.

Figure 2. Some examples of taxes and mark-ups as a percentage of the import price.

12 For further details, refer to the practical guide “HIV/AIDS Medi-cines and related supplies: Contemporary context andprocurement” Chapter 2: Intellectual Property Rights: a Con-cise Guide. The World Bank, Washington, February 2004.

13 Doha Declaration on the TRIPS agreement and Public Health,paragraphs 6 & 7

14 The Global Fund to Fight AIDS, Tuberculosis and Malaria, Reportof the Third Board Meeting, GF/B4/2, page 25, para 10 (a).

Source: http://www.haiweb.org/medicineprices

7

1.9 Other price information projects

1.9.1 Medicine Prices: a newapproach to measurement

Initiated at the WHO–NGO Round Table in 2000, this projecthas developed technical guidance for a standard approachto the measurement of the prices people pay for key medi-cines. Availability and retail prices are recorded for a corelist of 30 widely used medicines in their originator brand,most-sold and lowest-priced generic versions. Supplemen-tary lists with different medicines can be tailored to meetlocal needs using the same method.

Price information is collected at a sample set of pharma-cies in public, private and one other sector which can bedefined to fit local conditions (eg. NGO agencies, religiousmissions or other charity services, or other types of not-for profit service providers). The method uses median pricesprovided by Management Sciences for Health (MSH) forthe core medicines as a benchmark and the spreadsheet(CD-ROM included) calculates price ratios for each medi-cine to the MSH “reference” price.

The principal add-ons or “price components” between themanufacturer sales price and retail price are estimated forselected medicines, and treatment affordability is calcu-lated for ten common conditions, relative to the daily wageof the lowest paid government worker. The concept ofaffordability is especially important, because it allows toevaluate “access” by referring to the actual income of theindividual, according to a patient-focused approach.

A manual and accompanying spreadsheet on CD-ROM arefreely available in English, French and Spanish on the websites of both WHO: http://www.who.int/medicines/library/prices.shtml and Health Action International: http://www.haiweb.org/medicineprices/

Arabic and Russian versions will be produced in the courseof 2004.

The HAI website also contains an open-access repositoryof data from studies undertaken so far, and a synthesis ofresults from the nine pilot studies.

1.9.2 Price monitoring of pharma-ceutical starting materials

With today’s immense flow of information, finding the rightsource for unbiased, accurate and timely marketintelligence can be difficult, costly and time-consuming.Identifying the right source of information is the first steptoward maximizing international business opportunities.The Market News Service (MNS) of the UNCTAD/Interna-tional Trade Centre (ITC) strives to fill this need by provid-ing detailed price and market information on selectedprimary and semi-processed products of particular inter-est to developing countries and economies in transition,including a monthly report on Pharmaceutical StartingMaterials of Essential Drugs.

The Market News Service (MNS) for Pharmaceutical Start-ing Materials was established in 1992 in collaborationwith the Essential Drugs and Medicine Policy (EDM) of theWorld Health Organization (WHO) to issue a monthly re-port providing up-to-date prices and supporting commer-cial data on pharmaceutical starting materials used in theproduction of essential medicines. The report of Decem-ber 2003 listed 303 active pharmaceutical ingredients.The report is an information source with the sole aim ofimproving market transparency and encouraging price andquality competition for the benefit of all market players. Itcovers the main trading centres in Europe and Asia anddraws information from a network of price informationproviders.

INTRODUCTION


8

Figure 3. Price trends of various active pharmaceutical ingredients used in manufacturingantiretroviral medicines.

The prices of active pharmaceutical ingredients used in manufacturing antiretrovirals have been significantly reducedduring the last two years as shown in the graph below.

As part of its effort to provide information to improvemarket transparency, MNS reports are now directly avail-able on-line through ITC’s latest market analysis tool, Prod-uct Map, www.p-maps.org, a subscription based service.Subscribers from least developed countries and WHORegional Offices receive printed copies free-of-charge. The

Product Map on Pharmaceuticals combines quantitativemarket information in relation to international trade sta-tistics and macroeconomic indicators, qualitative marketintelligence - such as market briefs and published marketstudies - and networking links to key market players in thepharmaceuticals industry.

9


2. Diagnostics

ARVs have to be used with appropriate and cost-effectivediagnostics. Diagnostic technologies are important tomonitor the progression of the disease, the safety andefficacy of the treatment and the development ofresistance.

Since 1988, WHO has provided objective assessmentsof commercially available HIV test kits. This ongoing evalu-ation programme is coordinated by the WHO Departmentof Essential Health Technologies in collaboration with theUNAIDS Secretariat.

In 1989, WHO established a HIV test kit bulk-procurementscheme, which is now operated in collaboration with otherUN agencies. The aim is to provide national AIDS pro-grammes, blood transfusion services, large hospitals, non-governmental organizations, reference laboratories, UNagencies, donor-supported AIDS projects, and regulatoryauthorities in developing countries with high quality testsat reasonable cost. All HIV tests available through thescheme have been successfully evaluated by the WHOevaluation programme and meet specific, rigorous crite-ria. Manufacturers of test kits that have met the criteriaare invited to make their quotations in a selective tenderprocess. In addition to the assay performance other as-pects such as production capacity, distribution and serv-ice networks, patent issues, shelf life and storageconditions, are considered. This process has enabled theUN agencies to offer high quality tests at reduced prices,resulting in considerable annual savings to countries.

The test kits listed in chapter 4 are reviewed annually andcover the three broad categories, including simple/rapidtests, ELISA tests and supplemental tests.

The demand for simple/rapid HIV tests has increased anda wide range of high quality simple/rapid tests are avail-able. These are easy-to-use tests that require little or noequipment and limited training to perform and can provideaccurate same-day results. This makes them particularlysuitable for use in voluntary counselling and testing (VCT)centres and in antenatal clinics for prevention of motherto child transmission of HIV. When initial tests are reac-tive for HIV, confirmation of the test results is needed torule out any false positive results.

The existing systems for assessment and procurementof HIV test kits are being expanded to include technolo-gies used to monitor ARV therapy (CD4+ counts and viralload) and drug resistance.

An overview of types of CD4+ T-cell enumeration tech-nologies available are given in Annex 1A, whilst informa-tion on HIV viral load technologies is given in Annex 1B.Please note that this information is regularly updated anda v a i l a b l e a t : h t t p : / / w w w . w h o . i n t / e h t / M a i n_areas_of_work/BTS/HIV_Diagnostics/HIV_Test_Kit_Evaluation.htm#Reports

Additional documents with relevant information related todiagnostics are listed in Annex 3.


10

3. Access to quality HIV/AIDSmedicines

3.1 Prequalification project

The Procurement, Quality and Sourcing Project was initi-ated by WHO in collaboration with other United NationsOrganizations (UNAIDS Secretariat, UNICEF, and UNFPA,supported by the World Bank) in March 2001, as part of aUN-wide strategy to improve access to HIV-related treat-ment.

This project evaluates pharmaceutical products accord-ing to WHO recommended standards of safety, efficacyand quality and compliance with good manufacturing prac-tices (GMP). The prequalification process follows a stand-ard procedure developed through WHO’s ExpertCommittee on Specifications for Pharmaceutical Prepa-rations. Assessment of product dossiers submitted bycompanies and GMP inspections are followed promptlyby feedback to the companies concerned. A medicine isadded to the list of prequalified products only when theproducts and manufacturing sites meet the required stand-ards. A list of HIV-related products/manufacturers thathave been found acceptable, in principle, for procurementby UN agencies is available on the web sites of collabo-rating UN agencies.

As of January 2004, 265 product dossiers for variousproducts and dosage forms from over 40 manufacturerswere received: 95 of these products, from 26 manufac-turing sites have been fully reviewed and listed asprequalified products. The remaining products are cur-rently under review. The products evaluated are ARVs (in-cluding fixed dose combinations), and medicines for thetreatment of opportunistic infections and cancers. A listof products evaluated under this project is regularly up-dated through the websites of collaborating UN agencies.Interested readers are advised to consult these sites forthe latest versions, or to access the list via the WHOwebsite: http://mednet3.who.int/prequal/.

This report is a pricing service, not a prequalification serv-ice. Every effort has been made to ensure the accuracyof the price information presented here and screening ofthe products included in this survey has been carried outas indicated on page 3. However, this screening in noway constitutes an in depth review of product quality. Prod-ucts that have been prequalified are marked in Annex 2B

of this report in bold and with an asterisk (*). Other prod-ucts listed in this document should, in relation to purchase,be subject to prequalification review as indicated in theWHO General Procedure for Prequalification of Suppliersof Pharmaceutical Products. Manufacturers are encour-aged to apply for WHO prequalification for their HIV-re-lated products.

In scaling up access to ARVs, it is not only the quantity ofmedicines that is important, but also their quality. ThePrequalification Project will guide potential buyers or pro-curement agencies by providing them with a current, reli-able and standardised inventory to select from whenpurchasing these life-saving medicines.

3.2 Product registration

In order to guide procurement, governments must ensurethey have strong national drug regulatory authorities(DRAs) with a clear mandate and legal authority,appropriate organizational structure, adequate number ofqualified staff, sufficient resources and a sustainablefinancing mechanism.

The primary objective of DRAs is to safeguard public healthby ensuring that all medicines circulating in the marketsmeet appropriate standards of safety, quality and efficacy.Safety aspects cover potential or actual harmful effects;quality relates to development and manufacture; andefficacy is a measure of the beneficial effect of themedicine on patients.

To assist procurement agencies with regulatory aspectsof medicine importation and procurement, Annex 2A pro-vides information on countries in which the majority ofproducts listed in this report are currently registered. Thisinformation is provided by manufacturing companies andis subject to change.

To improve the accuracy of this publication, DRAs arestrongly encouraged to submit any known changes orcorrections to the data provided, either by email [email protected]; or by fax to UNICEF Supply Division inCopenhagen, Denmark +45 35269421.


11

Table 1. Anti-infective medicines

Manufacturer Indicative prices, US$ List prices, US$

No No

of of

Anthelminthics manuf countries unit max min median 25th perc Brazil Spain

albendazole

chewable tablet, 400 mg 10 5 tab 0.180 0.015 0.036 0.022 0.048 1.317

Antibacterials,beta lactam medicines

benzathine benzylpenicillin

powder for injection, 1 1 vial 0.257 0.257 0.257 0.257 none n/a1.44 g (=2.4 million IU) in 24-ml vial

powder for injection, 3 3 vial 1.660 0.150 0.170 0.160 none 2.8711.44 g (=2.4 million IU) in 5-ml vial

benzylpenicillin

powder for injection, 3 g (=5 million IU) 3 3 vial 0.346 0.150 0.180 0.165 0.619 1.211(as sodium or potassium salt) in vial

powder for injection, 600 mg 1 1 vial 0.268 0.268 0.268 0.268 none n/a(=1 million IU) (as potasium salt) in vial

cefixime

paediatric oral suspension, 3 3 ml 0.201 0.025 0.034 0.030 none 1.856100 mg/5 ml

paediatric oral suspension, 1 1 ml 0.108 0.108 0.108 0.108 none n/a40 mg/5 ml

powder for injection, – – vial – – – – none n/a250 mg (as sodium salt)*

tablet, 200 mg 3 2 tab 1.213 0.315 0.375 0.345 none 0.935


ceftriaxone

powder for injection, 18 12 1g vial 12.680 0.600 1.086 0.852 0.687 8.2471 g (as sodium salt) in vial

powder for injection, 13 8 vial 2.809 0.230 0.775 0.650 none 2.684250 mg (as sodium salt) in vial

powder for injection, 11 8 vial 8.140 0.320 0.825 0.756 none 4.322500 mg (as sodium salt) in vial

procaine benzylpenicillin

powder for injection, 3 3 vial 0.237 0.144 0.170 0.157 none n/a3 g (=3 million IU) in vial


* No price informationnone - no purchase has been made for this product, therefore no minimum price payable is availablen/a - not available

4. Prices of medicinesand diagnostics

4.1 Medicines


12


No No

of ofOther antibacterials manuf countries unit max min median 25th perc Brazil Spain

azithromycin

oral suspension, 2 2 ml 0.200 0.040 0.120 0.080 0.078 0.310200 mg/5 ml (dihydrate)

capsule/tablet, 250 mg (dihydrate) 8 4 caps/tab 0.532 0.117 0.198 0.147 none 1.685

capsule/tablet, 500 mg (dihydrate) 8 5 caps/tab 1.500 0.250 0.470 0.308 0.447 4.120

capreomycin

powder for injection, 1 g in vial 2 2 1g vial 5.000 5.000 5.000 5.000 none 2.730

chloramphenicol

oily suspension for injection, 1 1 amp 0.620 0.620 0.620 0.620 none n/a0.5 g/ml (as sodium succinate)in 2-ml ampoule

oral suspension, 1 1 ml 0.006 0.006 0.006 0.006 none n/a150 mg/5 ml (as palmitate)

powder for injection, 5 4 1g vial 0.680 0.175 0.231 0.200 0.371 1.0551 g (sodium succinate) in vial

ciprofloxacin

tablet, 250 mg (as hydrochloride) 29 16 tab 0.605 0.011 0.041 0.018 0.048 0.227


clarithromycin

oral suspension, 125 mg/5 ml* – – ml – – – – none n/a

powder for injection, 500 mg 1 1 vial 0.700 0.700 0.700 0.700 none 23.346

tablet, 250 mg 15 10 tab 0.434 0.105 0.170 0.151 0.296 0.600

clindamycin

capsule, 150 mg 2 2 caps 0.113 0.036 0.075 0.055 0.660 0.164

injection, 150 mg/ml 1 1 amp 1.848 1.848 1.848 1.848 0.464 1.506(as phosphate) in 2-ml ampoule

cycloserine

capsule, 250 mg 2 2 caps 0.600 0.466 0.533 0.500 none n/a

doxycycline

capsule/tablet, 100 mg (hydrochloride) 15 10 caps/tab 0.114 0.007 0.015 0.011 0.052 0.112

erythromycin

powder for injection, – – vial – – – – none n/a500 mg (as lactobionate) in vial*

powder for oral suspension, 10 9 ml 0.899 0.005 0.011 0.008 0.010 n/a125 mg (as stearate or ethylsuccinate)

capsule/tablet, 250 mg 19 10 caps/tab 0.068 0.020 0.031 0.026 none 0.099(as stearate or ethylsuccinate)

capsule/tablet, 500 mg 12 7 caps/tab 0.126 0.040 0.051 0.046 0.099 0.202(as stearate or ethylsuccinate)


13


No No

of ofOther antibacterials manuf countries unit max min median 25th perc Brazil Spain

gentamicin

injection, 10 mg (as sulfate) in 2-ml vial 4 4 vial 0.295 0.045 0.073 0.045 0.072 n/a

injection, 40 mg (as sulfate) in 2-ml vial 7 4 vial 0.319 0.047 0.058 0.056 0.065 0.615

metronidazole

injection, 500 mg in 100-ml vial 6 6 vial 2.880 0.300 1.268 0.827 0.189 3.039

Suppository, 1 g 1 1 sup 0.450 0.450 0.450 0.450 none n/a

Suppository, 500 mg* – – sup – – – – none n/a

ofloxacin

IV infusion, 2 mg/ml (hydrochloride) 1 1 ml 0.032 0.032 0.032 0.032 none 17.828


tablet, 400 mg 5 4 tab 0.661 0.062 0.100 0.082 1.014 n/a

rifabutin

capsule, 150 mg 1 1 caps 0.753 0.753 0.753 0.753 none 2.813

silver nitrate

solution (eye drops), 1% 1 1 ml 0.070 0.070 0.070 0.070 none n/a

spectinomycin

powder for injection, 2 g 3 3 vial 4.000 2.747 3.750 3.249 none n/a(as hydrochloride) in vial

sulfadiazine

injection, 250 mg – – amp – – – – none n/a(sodium salt) in 4-ml ampoule*

tablet, 500 mg 4 4 tab 0.298 0.037 0.060 0.037 0.018 0.075

sulfamethoxazole+trimethoprim

injection, 80+16 mg/ml – – amp – – – – none 0.789in 5-ml ampoule*

oral suspension, 200+40 mg/5 ml 15 9 ml 0.137 0.003 0.006 0.005 0.002 0.022

tablet, 100+20 mg 9 7 tab 0.187 0.004 0.006 0.005 none 0.026

tablet, 400+80 mg 23 13 tab 0.187 0.005 0.010 0.008 0.016 0.049

tablet, 800+160 mg 11 9 tab 0.100 0.009 0.019 0.015 0.069 0.129

tetracycline

tablet, 500 mg 3 3 tab 0.021 0.014 0.014 0.014 0.031 n/a

4. PRICES OF MEDICINES AND DIAGNOSTICS



14


No No

of ofAntifilarials manuf countries unit max min median 25th perc Brazil Spain

crotamiton

cream/lotion 10% 1 1 ml 0.010 0.010 0.010 0.010 none 0.665

ivermectin

scored tablet, 3 mg* – – tab – – – – none n/a

scored tablet, 6 mg* – – tab – – – – none n/a

lindane

cream, lotion or powder 0.3%* – – tube – – – – none n/a

permethrin

cream, 5%* – – tube – – – – none 9.201

lotion, 1% – – tube – – – – none n/a

Antifungal medicines

amphotericin B

liposomal IV infusion, 5 mg/ml* – – vial – – – – none 172.950

liposomal IV infusion, – – vial – – – – none 76.089powder for reconstitution 50 mg*

powder for injection, 50 mg in vial 2 2 vial 9.000 5.181 7.091 6.136 2.426 2.567

clotrimazole

cream, 1% 11 10 gram 0.240 0.007 0.027 0.018 0.653 1.622

pessary, 500 mg 2 2 pess 0.600 0.026 0.313 0.170 none 2.196

fluconazole


capsule, 150 mg 9 4 caps 1.840 0.034 0.500 0.280 0.151 4.303


oral suspension, 50 mg/5 ml* – – ml – – – – none n/a

solution for injection, 5 2 ml 0.042 0.029 0.033 0.029 0.014 n/a2 mg/ml in ampoule

itraconazole

capsule, 100 mg 3 3 caps 0.640 0.128 0.500 0.314 0.292 1.539

oral solution, 10 mg/ml* – – ml – – – – none 2.126

ketoconazole

cream, 2% 7 5 gram 0.227 0.014 0.044 0.022 none 3.831

oral suspension, 100 mg/5 ml* – – ml – – – – none 0.087



15


No No

of ofAntifungal medicines manuf countries unit max min median 25th perc Brazil Spain

miconazole

cream/ointment 2% 5 5 tube 1.176 0.350 0.418 0.400 none n/a(as nitrate) 15 g tube

cream/ointment 2% 8 5 tube 0.980 0.130 0.435 0.394 0.618 2.395(as nitrate) 30 g tube

nystatin

lozenge, 100,000 IU* – – loz – – – –- none n/a

pessary, 100,000 IU 5 4 pess 0.030 0.017 0.024 0.021 none 0.071

tablet, 100,000 IU 2 2 tab 0.025 0.022 0.024 0.023 none 0.000

tablet, 500,000 IU 7 4 tab 0.069 0.022 0.036 0.030 none 0.081

Antiprotozoal medicines

pentamidine

powder for injection, 1 1 vial 9.000 9.000 9.000 9.000 none n/a200 mg (isetionate) in vial

tablet, 200 mg* – – tab – – – – none n/a

tablet, 300 mg* – – tab – – – – none n/a

powder for injection, 4 4 vial 48.400 9.980 18.350 11.495 36.948 10.739300 mg (isetionate) in vial

pyrimethamine

tablet, 25 mg 2 2 tab 0.050 0.045 0.048 0.046 0.017 0.079

tinidazole

tablet, 2 g* – – tab – – – – none n/a


Antiviral medicines

aciclovir

cream, 5% 4 3 gram 0.986 0.037 0.450 0.039 0.409 1.424

powder for injection, 3 3 vial 14.286 2.000 3.451 2.726 1.457 4.923250 mg (as sodium salt) in 10-ml vial

tablet, 200 mg 14 10 tab 0.540 0.030 0.054 0.039 0.086 0.699

tablet, 400 mg 12 8 tab 0.565 0.048 0.084 0.062 none n/a


cidofovir

IV infusion, 75 mg/ml in vial* – – vial – – – – none n/a

famciclovir

tablet, 125 mg* – – tab – – – – none 3.095





16


No No

of of

Antiviral medicines manuf countries unit max min median 25th perc Brazil Spain

foscarnet sodium

IV infusion, 24 mg/ml – – vial – – – – none 40.326

ganciclovir

capsule, 250 mg* – – caps – – – – none 4.027

capsule, 500 mg* – – caps – – – – none n/a

powder for IV infusion, 500 mg in vial 1 1 vial 42.520 42.520 42.520 42.520 17.337 24.874

imiquimod

cream, 5%* – – tube – – – – none n/a

podofilox

cream, 0.15%* – – tube – – – – none 17.182

solution or gel, 0.5%* – – tube – – – – none 11.040

podophyllum resin

solution, 10-25%* – – ml – – – – none n/a

valacyclovir


valganciclovir


Antiviral medicines – Antiretrovirals

abacavir (ABC)

syrup, 20 mg/ml 1 1 ml 0.131 0.131 0.131 0.131 none 0.333


didanosine (ddI)

buffered chewable tablet, 100 mg 8 6 tab 0.376 0.179 0.298 0.241 0.317 1.370

buffered chewable tablet, 25 mg 5 5 tab 0.286 0.083 0.108 0.083 none 0.342

syrup, 2 g 2 2 ml 0.171 0.125 0.148 0.137 none 27.402

unbuffered enteric coated capsule, – – caps – – – – none 2.139125 mg*

unbuffered enteric coated capsule, 2 1 caps 0.666 0.648 0.657 0.653 none 3.923250 mg

unbuffered enteric coated capsule, 2 1 caps 1.008 0.928 0.968 0.948 none 5.596400 mg

efavirenz (EFZ)

capsule, 50 mg* – – caps – – – – none n/a

capsule, 200 mg 4 2 caps 2.001 0.490 0.540 0.518 none n/a

tablet, 600 mg 3 1 tab 1.582 1.300 1.467 1.384 2.182 n/a


17


No No

of of

Antiviral medicines-Antiretrovirals manuf countries unit max min median 25th perc Brazil Spain

indinavir (IDV)


capsule, 400 mg 6 3 caps 1.058 0.301 0.341 0.308 0.404 1.934

lamivudine (3TC)

syrup, 50 mg/5 ml 3 3 ml 0.028 0.025 0.025 0.025 0.035 0.208

tablet, 150 mg 13 8 tab 1.531 0.086 0.150 0.124 0.237 3.129


nelfinavir (NFV)

capsule, 250 mg 6 4 caps 1.340 0.269 0.520 0.311 0.611 1.453

powder for suspension, 50 mg/g* – – g – – – – none 0.466

nevirapine (NVP)

syrup, 50 mg/5 ml 3 2 ml 0.100 0.015 0.031 0.023 0.143 0.225


saquinavir (SQV)


stavudine (d4T)



capsule, 30 mg 11 7 caps 0.140 0.047 0.068 0.065 0.093 2.830

capsule, 40 mg 15 10 caps 2.101 0.058 0.101 0.079 0.182 2.925

syrup, 1 mg/ml 3 3 ml 0.050 0.011 0.048 0.049 none 0.596

tenofovir (TDF)


zalcitabine (ddC)

tablet, 0.375 mg 1 1 tab 0.402 0.402 0.402 0.402 none n/a

tablet, 0.75 mg 2 2 tab 0.865 0.761 0.813 0.787 none 1.757

zidovudine (AZT or ZDV)

capsule, 100 mg 14 10 caps 0.617 0.084 0.142 0.113 0.114 1.097



injection, 10 mg/ml in 20-ml vial 1 1 vial 5.000 5.000 5.000 5.000 1.443 8.532

oral solution, 50 mg/5 ml 3 3 ml 0.036 0.019 0.026 0.023 0.015 0.085




18


No No

Antiviral medicines - Antiretrovirals of of(combinations) manuf countries unit max min median 25th perc Brazil Spain

3TC/AZT

tablet, 300/150 mg 11 7 tab 2.951 0.278 0.384 0.328 0.471 8.036

3TC/D4T/NVP

tablet, 150/30/200 mg 1 1 tab 0.431 0.431 0.431 0.431 none n/a


ABC/3TC/ZDV

tablet, 300/150/300 mg 2 2 tab 2.294 1.700 1.997 1.849 none 13.566

AZT/3TC/NVP


lopinavir/ritonavir (LPV/r)

oral solution, 20+80 mg/ml* – – ml – – – – none 8.060

capsule, 133.3+33.3 mg* – – caps – – – – none 2.687

Table 2. Antineoplastic medicines


No No

of ofCytotoxic medicines manuf countries unit max min median 25th perc Brazil Spain

bleomycin

powder for injection, 15 mg 2 2 vial 21.000 18.000 19.500 18.750 22.515 13.930(as sulfate) in vial

calcium folinate (leucovorin)


doxorubicine HCl

powder for injection, 10 mg in 5-ml vial 4 4 vial 23.720 3.000 7.660 5.063 3.196 7.286

powder for injection, 50 mg in 25-ml vial 4 4 vial 111.111 14.000 29.525 17.675 14.739 31.858

etoposide

capsule, 100 mg* – – caps – – – – none 11.566

injection, 20 mg/ml in 5-ml ampoule 5 3 amp 31.211 1.723 9.850 5.000 2.921 2.492

methotrexate

injection, 25 mg/ml 2 2 vial 18.100 1.400 9.750 5.575 2.062 3.603(as sodium salt) in 2-ml vial

powder for injection, 3 3 vial 4.310 2.000 3.360 2.680 none 3.77250 mg (as sodium salt) in 2-ml vial

tablet, 2.5 mg 4 3 tab 0.188 0.031 0.068 0.057 none 0.056

vinblastine

powder for injection, 3 2 vial 14.260 1.400 2.347 1.874 11.684 6.81510 mg (sulfate) in 10-ml vial

19


No No

of of

Cytotoxic medicines manuf countries unit max min median 25th perc Brazil Spain

vincristine

injection, 1 mg/ml (sulfate) in vial 3 3 vial 4.500 0.674 3.080 1.877 2.405 n/a

powder for injection, 1 1 vial 2.000 2.000 2.000 2.000 2.405 5.4681 mg (sulfate) in 1-ml vial

vinorelbine

injection concentrate 10 mg/ml in vial 1 1 ml 16.480 16.480 16.480 16.480 143.086 21.352

Table 3. Medicines used for the treatmentof mental and substance use disorders


No No

Medicines used of ofin depressive disorders manuf countries unit max min median 25th perc Brazil Spain

amitriptyline


fluoxetine

tablet, 20 mg 10 7 tab 0.491 0.015 0.078 0.040 0.034 0.221

Medicines used in generalizedanxiety and sleep disorders

lorazepam

injection, 4 mg/ml in ampoule* – – amp – – – – none n/a


methotrimepazine /methotrimepazine/levomepromazine

injection, 25 mg/ml in ampoule – – amp – – – – none 0.181

tablet, 25 mg 2 2 tab 0.108 0.033 0.071 0.052 0.038 0.059

Medicines used in the treatmentof opioid dependence

buprenorphine

sublingual tablet, – – tab – – – – none 0.370200 mcg (hydrochloride)*

sublingual tablet, – – tab – – – – none n/a400 mcg (hydrochloride)*

naltrexone HCl





20

Table 4. Analgesics


No No

of ofOpioid analgesics manuf countries unit max min median 25th perc Brazil Spain

codeine

tablet, 30 mg (phosphate) 5 5 tab 0.066 0.020 0.034 0.030 0.232 0.100

methadone


morphine

injection, 10 mg/ml 6 4 amp 1.998 0.271 0.470 0.311 0.495 0.231(sulfate or HCl), in 1-ml ampoule

oral solution, 4 2 ml 1.000 0.055 0.058 0.056 none n/a10 mg/5 ml (sulfate or HCl)

tablet, modified release, 10 mg (sulfate) – – tab – – – – none 0.137

pethidine

injection, 50 mg/ml 4 3 amp 0.450 0.284 0.370 0.334 0.344 n/a(hydrochloride) in 1-ml ampoule

injection, 50 mg/ml 7 6 amp 1.773 0.258 0.505 0.392 none 0.598(hydrochloride) in 2-ml ampoule



Table 5. Gastrointestinal medicines


No No

Antacids and other of of

antiulcer medicines manuf countries unit max min median 25th perc Brazil Spain

omeprazole

capsule, 10 mg 8 6 caps 0.312 0.014 0.070 0.050 0.028 n/a

capsule, 20 mg 19 9 caps 1.046 0.011 0.093 0.030 0.034 0.210


powder for injection, 1 1 vial 3.000 3.000 3.000 3.000 1.371 9.58440 mg (as sodium salt) in vial

powder for IV infusion, 2 2 vial 3.000 1.950 2.475 2.213 none n/a40 mg (as sodium salt) in vial


2121


No No

of ofAntiemetic medicines manuf countries unit max min median 25th perc Brazil Spain

dimenhydrinate


metoclopramide

injection 5 mg/ml in 2-ml ampoule 5 5 amp 0.219 0.055 0.112 0.108 0.062 0.177


prochlorperazine

injection, 12.5 mg/ml 2 2 ml 0.359 0.130 0.245 0.187 none n/a


Laxatives

docusate sodium

capsule, 100 mg* – – tab – – – – none n/a




22

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24

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onor

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ired

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ase

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, E15

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ower

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peci

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men

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onor

test

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ired

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3 Ple

ase

not e

t hat

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ot in

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es



26

5. L

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d d

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man

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ark,

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com

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lfam

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prim

, zid

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ine

(AZT

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27

Man

ufac

ture

rAd

dres

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leph

one

Fax

E-m

ail/

Web

site

Prod

ucts

Aven

tis L

td.

6/2/

A, S

egun

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icha

,+

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rique

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ipro

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ery

thro

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in, m

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00, D

haka

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ntis

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cod

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ate,

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Pte

Ltd.

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apor

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cons

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ycin

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ocon

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Jun

g-G

uw

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cy c

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lam

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pine

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), st

avud

ine

(d4T

), zi

dovu

dine

(AZT

or

ZDV)

Repu

blic

of K

orea

5. LIST OF MANUFACTURERS - MEDICINES AND DIAGNOSTICS


28

Man

ufac

ture

rAd

dres

sTe

leph

one

Fax

E-m

ail/

Web

site

Prod

ucts

Cipl

a Lt

d.28

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ella

sis

Road

+91

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3 02

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aexp

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3TC/

AZT,

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, aba

cavi

r (A

BC),

acic

lovi

r,M

umba

i Cen

tral

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649,

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w.c

ipla

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albe

ndaz

ole,

azi

thro

myc

in, A

ZT/3

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efix

ime,

Indi

ace

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xone

, cip

roflo

xaci

n, c

lotr

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ole,

did

anos

ine

(ddI

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xycy

clin

e, e

favi

renz

(EFZ

), er

ythr

omyc

in, e

topo

side

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cona

zole

, ind

inav

ir (ID

V), l

amiv

udin

e (3

TC),

met

hotr

exat

e,ne

lfina

vir

(NFV

), ne

vira

pine

(NVP

), ny

stat

in, o

floxa

cin,

omep

razo

le, s

tavu

dine

(d4T

), vi

nbla

stin

e, v

incr

istin

e,zi

dovu

dine

(AZT

or

ZDV)

.

CLAR

IS L

ifesc

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tdCo

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com

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bino

Pha

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Carr

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Gel

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t,+

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com

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sac

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amph

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B, c

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ne, c

linda

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in,

6–8

Edifi

cio

Cona

ta 2

,w

ww

.com

bino

-pha

rm.e

sflu

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pen

tam

idin

e, z

idov

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e (A

ZT o

r ZD

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t Joa

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mac

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2818

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3312

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nelfi

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4T),

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r ZD

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Ecob

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com

nelfi

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FV),

saqu

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QV)

CH-4

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w.ro

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Base

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land

Far

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Size

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100

Man

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w.fa

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cruz

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sul

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Gen

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m. M

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neph

arm

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cefix

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cip

roflo

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n, c

larit

hrom

ycin

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Pal

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Gre

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ww

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fluox

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e, m

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amid

e, o

floxa

cin,

om

epra

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29

Man

ufac

ture

rAd

dres

sTe

leph

one

Fax

E-m

ail/

Web

site

Prod

ucts

Gla

xo S

mith

Klin

eG

SK H

ouse

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ABC

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baca

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reat

Wes

t Roa

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.gsk

.com

lam

ivud

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or

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TW8

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Gle

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arm

aceu

tical

sL-

82 &

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Kara

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ompl

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racu

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clo

trim

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CH-

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888

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com

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lovi

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Ashr

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rror

, low

bio

-haz

ard

risk,

Qui

ck r

esul

ts,

Abso

lute

CD

4 an

d CD

8 co

unts

Abso

lute

CD

4 an

d CD

8 co

unts

,EQ

A av

aila

ble

Qui

ck re

sults

, EQ

A av

aila

ble

Dis

adva

ntag

esEx

pens

ive

reag

ents

,CD

4% a

mon

g ly

mph

ocy t

es10

sam

ples

pro

cess

ed a

t a ti

me,

6 sa

mpl

es p

roce

ssed

at a

tim

e,12

sam

ples

pro

cess

ed a

t a ti

me,

not

repo

rted

,Su

bjec

tivity

in v

isua

l cou

ntin

g,Su

bjec

tivity

in v

isua

l cou

ntin

g,CD

4% a

mon

g ly

mph

ocy t

esIn

stru

men

t not

pro

ven

inCD

4% a

mon

g ly

mph

ocy t

es o

r CD

8 co

unts

CD4%

am

ong

lym

phoc

y tes

not

rep

orte

d a

n in

depe

nden

t mul

ti-ce

ntre

stu

dy n

ot re

port

ed.

No

EQA

avai

labl

e n

ot re

port

ed.

No

EQA

avai

lab

MAb

– m

onoc

lona

l ant

ibod

y; E

QA

– ex

t ern

al q

ualit

y as

sess

men

ta T

he a

naly

sis

of c

orre

lat io

n us

ing

linea

r re

gres

sion

is n

ot a

ppro

pria

t e t o

st u

dy m

etho

d co

mpa

rison

. Ins

t ead

, the

ana

lysi

s of

agr

eem

ent s

houl

d be

per

form

ed. U

nfor

t una

t ely

, non

e of

t he

publ

ishe

d st

udie

s ha

sus

ed t

his

anal

ysis

t o c

ompa

re t h

ese

met

hods

wit h

flow

cyt

omet

ry. T

here

fore

, her

e t h

e r

valu

es a

re s

t ill r

epor

t ed.

b D

epen

ding

on

if a

light

or

fluor

esce

nce

mic

rosc

ope

is u

sed.

c Rea

gent

cos

t may

dec

reas

e su

bst a

ntia

lly in

t he

near

fut u

re.



38

B an

d N

K ce

lls –

sub

sets

of l

ymph

ocy t

es; Q

C –

qual

ity c

ontr

ol; E

QA

– ex

tern

al q

ualit

y as

sess

men

ta A

ny fl

ow c

y tom

eter

from

any

of t

he th

ree

man

ufac

ture

rs c

an o

pera

te w

ith th

is m

etho

d to

pro

vide

abs

olut

e co

unts

. The

resu

lts o

f flo

w c

y tom

etry

are

com

bine

d w

ith th

ose

from

hae

mat

olog

y to

cal

cula

te a

bsol

ute

coun

ts.

b Vol

umet

ric in

stru

men

ts h

ave

the

inhe

rent

har

dwar

e pr

oper

ty o

f mea

surin

g th

e vo

lum

e of

the

sam

ple,

pro

vidi

ng d

irect

abs

olut

e co

unts

with

out t

he u

se o

f hae

mat

olog

y an

aly s

ers

or b

eads

.c A

ny fl

ow c

y tom

eter

from

any

of t

he th

ree

man

ufac

ture

rs c

an o

pera

te w

ith th

is m

etho

d to

pro

vide

abs

olut

e co

unts

.d I

nstr

umen

ts fr

om th

is m

anuf

actu

rer,

incl

udin

g th

e Cy

Flow

, rem

ain

to b

e va

lidat

ed a

s vo

lum

etric

abs

olut

e CD

4 T

cell

coun

ters

by

inde

pend

ent i

nves

tigat

ors

in m

ultic

entr

ic s

tudi

es.

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w c

yto

met

ry

Para

met

erD

oubl

e-pl

atfo

rma

Sing

le-p

latf

orm

Volu

met

ricb

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d-ba

sedc

Inst

rum

ents

, Man

ufac

ture

rsFl

ow c

ytom

eter

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cyt

omet

erFl

ow c

ytom

eter

Part

ec G

mbH

(M

unst

er, G

erm

any)

dPa

rtec

Gm

bH (

Mun

ster

, Ger

man

y)d

Bect

on D

icki

nson

(CA,

USA

)Be

cton

Dic

kins

on (

CA,U

SA)

Gua

va T

echn

olog

ies

(CA,

USA)

Coul

ter

Corp

orat

ion

(FL,

USA

)Co

ulte

r Co

rpor

atio

n (F

L, U

SA)

Cos

t of

inst

rum

ent

(US$

)20

000

– 9

5 00

020

000

– 7

0 00

020

000

– 9

5 00

0

Cos

t of

rea

gent

s/te

st (

US$

)3

– 11

2 –

108

– 25

Spec

imen

Who

le b

lood

Who

le b

lood

Who

le b

lood

Res

ults

Abso

lute

CD

4 co

unt

Abso

lute

CD

4 co

unt

Abso

lute

CD

4 co

unt

Abso

lute

CD

8 co

unt

Abso

lute

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8 co

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lute

CD

8 co

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and

CD

8% a

mon

g ly

mph

ocy t

esCD

4% a

nd C

D8%

am

ong

lym

phoc

y tes

CD4%

and

CD

8% a

mon

g ly

mph

ocy t

esCD

4/CD

8 ra

tioCD

4/CD

8 ra

tioCD

4/CD

8 ra

tioB

and

NK

cells

are

pos

sibl

eB

and

NK

cells

are

pos

sibl

eB

and

NK

cells

are

pos

sibl

e

Thro

ughp

ut (

sam

ples

/day

)Up

to 2

00Up

to 5

0Up

to 2

00

Adva

ntag

esAc

cura

te p

ipet

ting

less

cru

cial

No

need

for

extr

a be

ads

or h

aem

atol

ogy

anal

y ser

No

need

for

haem

atol

ogy

anal

y ser

One

tube

ass

ay p

ossi

ble

with

out Q

C pr

oble

ms

or

haem

atol

ogy

anal

y ser

Prot

ocol

s fo

r ag

ed s

ampl

es a

vaila

ble

EQA

avai

labl

eEQ

A av

aila

ble

EQA

avai

labl

e

Dis

adva

ntag

esRe

quire

s th

e us

e of

a h

aem

atol

ogy

anal

y ser

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ires

accu

rate

pip

ettin

g te

chni

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ires

accu

rate

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ettin

g te

chni

que

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e pr

one

to c

leric

al e

rror

sIn

tern

al Q

C fo

r pi

petti

ng re

quire

s tw

o tu

bes

assa

yIn

tern

al Q

C fo

r pi

petti

ng re

quire

s tw

o tu

bes

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h sa

mpl

es n

eede

d in

ord

er to

Inst

rum

ents

not

yet

pro

ven

in a

n in

depe

nden

t a

ssay

obt

ain

abso

lute

cou

nts

mul

ti ce

ntre

stu

dyBe

ads

are

expe

nsiv

e an

d re

quire

car

eful

han

dlin

g

3939

ANN

EX 1

B

Su

mm

ary

of

mai

n c

har

acte

rist

ics

of

Vir

al L

oad

Tec

hn

olo

gies

(nuc

leic

aci

d ba

sed)

Com

pany

Abbo

ttR

oche

Bay

erbi

oMér

ieux

bioM

érie

uxPr

imag

en

Assa

y N

ame

LcX

® H

IV R

NA

Ampl

icor

HIV

-1Ve

rsan

t® H

IV-1

Nuc

liSen

s®N

ucliS

ens

Easy

Q®

Ret

inaTM

Qua

ntita

tive

Mon

itor®

Tes

tR

NA

3.0

Assa

yH

IV-1

-QT

HIV

-1R

ainb

ow

Type

of

assa

yRT

-PCR

RT-P

CRbD

NA

NAS

BAN

ASBA

NAS

BA

Dyn

amic

Ran

ge50

– 1

000

000

50 –

750

000

75 –

500

000

50 –

1 0

00 0

0050

– 3

000

000

500

– 50

000

000

(cop

ies/

ml)

Spec

imen

Typ

ePl

asm

aPl

asm

a, d

ried

bloo

dPl

asm

aPl

asm

a, s

erum

, drie

dPl

asm

a, s

erum

, drie

dPl

asm

a, s

erum

, who

le b

lood

,sp

ots

bloo

d sp

ots

bloo

d sp

ots

drie

d bl

ood

spot

s

Spec

imen

vol

ume

200

– 1

000

µl10

0 –

500

µl1

000

– 2

000

µl10

– 2

000

µl

10 –

2 0

00 µ

l20

0 µl

Area

of

HIV

Pol

Gag

Pol

Gag

Gag

LTR

geno

me

ampl

ified

HIV

-1 s

ubty

pes

Gro

up M

(sub

type

s A-

G)

All,

plus

som

e HI

V-2

Gro

up M

(sub

type

s A-

G)

All

All

All

ampl

ified

and

Gro

up O

Tim

e fo

r re

sult

5 ho

urs

6 –

7 ho

urs

22 h

ours

2 ho

urs

2 ho

urs

1.5

hour

s

Cos

t/te

st (

US$

)120

– 70

28 –

90

125

40 –

96

(US$

) 40

– 60

(US$

) 17

– 23

Num

ber

of s

ampl

es/r

un21

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)9

– 48

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t re

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pCO

BAS

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ipre

pBa

yer

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em 3

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ract

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y ser

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rifug

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ead-

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,Fu

me

hood

Easy

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naly

ser

Heat

bloc

kHe

at b

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Com

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ata

Man

agem

ent

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ter

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y ser

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rifug

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com

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rifug

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ater

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cons

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qua

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peci

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says

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t ex

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r al

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)



40

Com

pany

Abbo

ttR

oche

Bay

erbi

oMér

ieux

bioM

érie

uxPr

imag

en

Equi

pmen

t C

ost

($U

S)8

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+ L

Cx A

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ser

10 0

00 +

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BAS

10 0

00 +

Bay

er14

0 00

013

0 00

023

000

25 0

00Am

plip

rep

Syst

em A

naly

zer

30 0

00

(non

-nuc

leic

aci

d ba

sed)

Com

pany

Cav

idi

Perk

in E

lmer

Inno

gene

tics

ExaV

irTM

Load

Qua

ntita

tive

HIV

-1 p

24 U

ltra

ELIS

AAs

say

Nam

eH

IV-R

T Lo

ad K

itEL

AST

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A am

plifi

catio

n sy

stem

Inno

test

TM

Type

of

Assa

yEn

zym

e im

mun

oass

ay fo

r qu

antit

atio

n of

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me

imm

unoa

ssay

for

quan

titat

ion

ofEn

zym

e im

mun

oass

ay fo

r qu

antit

atio

n of

RT a

ctiv

ityp2

4 an

tigen

p24

antig

en

Dyn

amic

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ge75

0–

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000

copi

es/m

l40

0 co

pies

/ml

7 pg

/ml –

250

(50

– 20

0 00

0 co

pies

/ml)

Spec

imen

Typ

ePl

asm

aPl

asm

a, s

erum

or

cell

cultu

re s

uper

nata

ntPl

asm

a, s

erum

or

cell

cultu

re s

uper

nata

nt

Spec

imen

Vol

ume

1000

µl10

0 µl

100

µl

Area

of

HIV

Gen

ome

Sele

cted

RT a

ctiv

ityp2

4 an

tigen

p24

antig

enfo

r Am

plifi

catio

n

HIV

-1 S

ubty

pes

Ampl

ified

All,

plus

HIV

-2HI

V-1

All,

plus

HIV

-2

Tim

e fo

r R

esul

t24

hou

rs2.

30 h

ours

2 ho

urs

Cos

t/Te

st (

US$

)13

– 15

1010

Num

ber

of S

ampl

es/R

un30

9696

Equi

pmen

t R

equi

red2

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bato

r (3

3deg

), Fr

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ader

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bato

r (3

7deg

), EL

ISA

read

er, r

efrig

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or

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A re

ader

, com

pute

rRe

frig

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or

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pmen

t C

ost

($U

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000

– 10

000

(sta

rt u

p pa

ck in

clud

es7

000

– 9

000

7 00

0 –

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othe

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pmen

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its)

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l tes

ts re

quire

pip

ette

s, v

orte

x m

ixer

s

41

ANNEX 2A

Registration status ofproducts included in thesources and prices surveyIf the products you require are not listed as registered in your country, this does not mean they cannot be purchased.Please contact the manufacturer to find out if they are able to supply to your country, and contact your Drug RegulatoryAuthority for quality assurance and importation issues. It is also advisable to check if products of interest have beenauthorised for marketing in countries that have a strong regulatory system such as the United Kingdom or South Africa.

Country/ RegistrationMedicine Name (INN) Dosage form & strength Manufacturer status

Afghanistan

benzylpenicillin powder for injection, Alembic Ltd. Completed3 g (=5 million IU) (as sodium orpotassium salt) in vial

cefixime paediatric oral suspension, 100 mg/5 ml Bilim Pharmaceutical Ind. Completed

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Bilim Pharmaceutical Ind. Completed

clarithromycin tablet, 250 mg Bilim Pharmaceutical Ind. Completed

gentamicin injection, 40 mg (as sulfate) in 2-ml vial Neon Laboratories Ltd. Completed

nelfinavir (NFV) capsule, 250 mg F. Hoffmann-La Roche Ltd. Completed

procaine benzylpenicillin powder for injection, 3 g (=3 million IU) in vial Alembic Ltd. Completed

saquinavir (SQV) capsule, 200 mg F. Hoffmann-La Roche Ltd. Completed

sulfamethoxazole+trimethoprim tablet, 400+80 mg IPCA Laboratories Ltd. Completed

Albania

aciclovir cream, 5% Ecobi Farmaceutici S.a.s Completed

amitriptyline tablet, 25 mg (as hydrochloride) Remedica Ltd. Completed

benzathine benzylpenicillin powder for injection, Alembic Ltd. Completed1.44 g (=2.4 million IU) in 5-ml vial

calcium folinate (leucovorin) tablet, 15 mg Ecobi Farmaceutici S.a.s. Completed

chloramphenicol powder for injection, 1 g (sodium succinate) Sanavita Aktiengesellschaft & Co. Completedin vial

ciprofloxacin tablet, 250 mg (as hydrochloride) Alembic Ltd. Completed

clotrimazole cream, 1% Purna Pharmaceuticals NV Completed

ketoconazole tablet, 200 mg Remedica Ltd. Completed

methotrexate tablet, 2.5 mg Remedica Ltd. Completed

miconazole cream/ointment 2% (as nitrate) 30 g tube Ecobi Farmaceutici S.a.s. Completed

sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Ecobi Farmaceutici S.a.s. Completed

zidovudine (AZT or ZDV) capsule, 250 mg Glaxo SmithKline Completed

Algeria

aciclovir cream, 5% Ecobi Farmaceutici S.a.s. Completed

azithromycin tablet/capsule, 250 mg (dihydrate) Aleppo Pharmaceutical Industries (Alpha) Completed

bleomycin powder for injection, 15 mg (as sulfate) in vial Aventis Intercontinental Completed

cefixime paediatric oral suspension, 40 mg/5 ml Aventis Intercontinental Completed

ceftriaxone powder for injection, 250 mg (as sodium salt) Aleppo Pharmaceutical Industries (Alpha) Completedin vial



42

Algeria

ciprofloxacin tablet, 500 mg (as hydrochloride) Aleppo Pharmaceutical CompletedIndustries (Alpha)

indinavir (IDV) capsule, 400 mg Cipla Ltd. Completed

ketoconazole tablet, 200 mg Intas Pharmaceuticals Ltd Completed

lamivudine (3TC) syrup, 50 mg/5 ml Cipla Ltd. Completed

methotrexate powder for injection, Aventis Intercontinental Completed50 mg (as sodium salt) in 2-ml vial

methotrimepazine/ tablet, 25 mg Aventis Intercontinental Completedlevomepromazine

metronidazole injection, 500 mg in 100-ml vial Aventis Intercontinental Completed


ofloxacin tablet, 200 mg Aventis Intercontinental Completed

omeprazole capsule, 20 mg Mepha Ltd Completed

sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Aspen Pharmacare Completed

zidovudine (AZT or ZDV) injection, 10 mg/ml in 20-ml vial Glaxo SmithKline Completed

Angola



Argentina

3TC/AZT tablet, 300/150 mg Donato y Zurlo S.A. Completed

abacavir (ABC) syrup, 20 mg/ml Glaxo SmithKline Completed

ABC/3TC/ZDV tablet, 300/150/300 mg Glaxo SmithKline Completed

aciclovir powder for injection, Lab. Filaxis International S.A. Completed250 mg (as sodium salt) in 10-ml vial

calcium folinate (leucovorin) tablet, 15 mg Lab. Filaxis International S.A. Completed

ciprofloxacin tablet, 250 mg (as hydrochloride) Bayer Healthcare AG Completed

didanosine (ddI) buffered chewable tablet, 100 mg Donato y Zurlo S.A. Completed

doxorubicine HCl powder for injection, 10 mg in 5-ml vial Lab. Filaxis International S.A. Completed

efavirenz (EFZ) capsule, 200 mg Lab. Filaxis International S.A. Completed

etoposide injection, 20 mg/ml in 5-ml ampoule Lab. Filaxis International S.A. Completed

ganciclovir powder for IV infusion, 500 mg in vial Lab. Filaxis International S.A. Completed

indinavir (IDV) capsule, 200 mg Donato y Zurlo S.A. Completed

lamivudine (3TC) syrup, 50 mg/5 ml Donato y Zurlo S.A. Completed

methotrexate powder for injection, Aventis Intercontinental Completed50 mg (as sodium salt) in 2-ml vial



nelfinavir (NFV) capsule, 250 mg Donato y Zurlo S.A. Completed

nevirapine (NVP) syrup, 50 mg/5 ml Boehringer Ingelheim Gmbh Completed

nevirapine (NVP) tablet, 200 mg Boehringer Ingelheim Gmbh Completed

nevirapine (NVP) tablet, 200 mg Lab. Filaxis International S.A. Completed

pentamidine powder for injection, 300 mg (isetionate) in vial Lab. Filaxis International S.A. Completed

stavudine (d4T) capsule, 30 mg Donato y Zurlo S.A. Completed

vinblastine powder for injection, 10 mg (sulfate) in 10-ml vial Lab. Filaxis International S.A. Completed


43


Argentina

vincristine injection, 1 mg/ml (sulfate) in vial Lab. Filaxis International S.A. Completed

vinorelbine injection concentrate 10 mg/ml in vial Lab. Filaxis International S.A. Completed

zalcitabine (ddC) tablet, 0.75 mg Lab. Filaxis International S.A. Completed

zidovudine (AZT or ZDV) capsule, 100 mg Donato y Zurlo S.A. Completed

Armenia

aciclovir cream, 5% Cipla Ltd. Completed

azithromycin tablet/capsule, 250 mg (dihydrate) Cipla Ltd. Completed


gentamicin injection, 40 mg (as sulfate) in 2-ml vial Sanavita Aktiengesellschaft & Co. Completed

metronidazole injection, 500 mg in 100-ml vial Demo S.A., Pharmaceutical Industry Completed

ofloxacin tablet, 200 mg Intas Pharmaceuticals Ltd Completed

omeprazole capsule, 20 mg Cipla Ltd. Completed

Aruba

3TC/AZT tablet, 300/150 mg Glaxo SmithKline Completed



lamivudine (3TC) syrup, 50 mg/5 ml Glaxo SmithKline Completed



Australia

aciclovir tablet, 400 mg Ranbaxy Laboratories Ltd Completed


clotrimazole cream, 1% Cipla Ltd. Completed



Austria

ciprofloxacin tablet, 250 mg (as hydrochloride) Alpharma Completed

clarithromycin tablet, 250 mg Alpharma Completed



Azerbaijan



fluconazole capsule, 150 mg Bilim Pharmaceutical Ind. Completed




Bahrain



ANNEX 2A. REGISTRATION STATUS OF PRODUCTS INCLUDED IN THE SOURCES AND PRICES SURVEY


44


Bahrain

ceftriaxone powder for injection, Ranbaxy Laboratories Ltd Completed250 mg (as sodium salt) in vial







zidovudine (AZT or ZDV) oral solution, 50 mg/5 ml Glaxo SmithKline Completed

Bangladesh

azithromycin tablet/capsule, 250 mg (dihydrate) The Acme Laboratories Ltd. Completed

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Aventis Ltd. Completed

ciprofloxacin tablet, 250 mg (as hydrochloride) Aventis Ltd. Completed

clarithromycin tablet, 250 mg The Acme Laboratories Ltd. Completed

clotrimazole cream, 1% The Acme Laboratories Ltd. Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) The Acme Laboratories Ltd. Completed

erythromycin powder for oral suspension, Aventis Ltd. Completed125 mg (as stearate or ethylsuccinate)

lamivudine (3TC) tablet, 150 mg Glaxo SmithKline Completed

metoclopramide injection 5 mg/ml in 2-ml ampoule Aventis Ltd. Completed


nystatin pessary, 100,000 IU The Acme Laboratories Ltd. Completed

omeprazole capsule, 10 mg Aventis Ltd. Completed

prochlorperazine injection, 12.5 mg/ml Aventis Ltd. Completed


sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Aventis Ltd. Completed

vinblastine powder for injection, 10 mg (sulfate) in 10-ml vial Cipla Ltd. Completed

vincristine injection, 1 mg/ml (sulfate) in vial Cipla Ltd. Completed


Belarus


ceftriaxone powder for injection, 1 g (as sodium salt) in vial Ranbaxy Laboratories Ltd Completed


fluconazole capsule, 50 mg Cipla Ltd. Completed





omeprazole capsule, 20 mg Intas Pharmaceuticals Ltd Completed

Belgium


ciprofloxacin tablet, 250 mg (as hydrochloride) Ranbaxy Laboratories Ltd Completed

etoposide injection, 20 mg/ml in 5-ml ampoule Neon Antibiotics PVT. Ltd. In Process

45


Belgium

ketoconazole cream, 2% Gracure Pharmaceuticals Ltd. Completed






Benin




ceftriaxone powder for injection, 1 g (as sodium salt) in vial Mepha Ltd Completed

ciprofloxacin tablet, 250 mg (as hydrochloride) Cipla Ltd. Completed

erythromycin tablet/capsule, Phyto-Riker Pharmaceuticals Ltd. Completed250 mg (as stearate or ethylsuccinate)


lamivudine (3TC) tablet, 150 mg Ranbaxy Laboratories Ltd Completed





nevirapine (NVP) tablet, 200 mg Ranbaxy Laboratories Ltd Completed

ofloxacin IV infusion, 5 mg/ml (hydrochloride) Aventis Intercontinental Completed



zidovudine (AZT or ZDV) tablet, 300 mg Ranbaxy Laboratories Ltd Completed

Bhutan



Bolivia




dimenhydrinate tablet, 50 mg Laboratorios Cinfa S.A. Completed

gentamicin injection, 40 mg (as sulfate) in 2-ml vial Intas Pharmaceuticals Ltd Completed

omeprazole capsule, 20 mg Alembic Ltd. Completed


Bosnia and Herzegovina





46


Botswana



erythromycin tablet/capsule, Hovid SDN. BHN. Completed250 mg (as stearate or ethylsuccinate)

fluconazole capsule, 200 mg Remedica Ltd. Completed







Brazil

3TC/AZT tablet, 300/150 mg Far Manguinhos Completed

3TC/AZT tablet, 300/150 mg Strides Arcolab Ltd. Completed



aciclovir powder for injection, Lab. Filaxis International S.A. Completed250 mg (as sodium salt) in 10-ml vial


ceftriaxone powder for injection, 1 g (as sodium salt) in vial Cheil Jedang Corp. Completed

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Strides Arcolab Ltd. Completed

chloramphenicol powder for injection, 1 g (sodium succinate) in vial Strides Arcolab Ltd. Completed


ciprofloxacin tablet, 250 mg (as hydrochloride) Strides Arcolab Ltd. Completed

ciprofloxacin tablet, 500 mg (as hydrochloride) Strides Arcolab Ltd. Completed

clarithromycin powder for injection, 500 mg Strides Arcolab Ltd. Completed

clarithromycin tablet, 250 mg Strides Arcolab Ltd. Completed

clarithromycin tablet, 250 mg Ranbaxy Laboratories Ltd Completed

clindamycin injection, 150 mg/ml (as phosphate) Strides Arcolab Ltd. Completedin 4-ml ampoule

didanosine (ddI) buffered chewable tablet, 100 mg Far Manguinhos Completed



fluconazole capsule, 50 mg CLARIS Lifesciences Ltd. Completed

fluoxetine capsule, 20 mg Ranbaxy Laboratories Ltd Completed

indinavir (IDV) capsule, 400 mg Far Manguinhos Completed

ketoconazole tablet, 200 mg Far Manguinhos Completed

ketoconazole tablet, 200 mg Strides Arcolab Ltd. Completed

lamivudine (3TC) syrup, 50 mg/5 ml Far Manguinhos Completed

lamivudine (3TC) tablet, 150 mg Strides Arcolab Ltd. Completed

methotrexate powder for injection, Lab. Filaxis International S.A. Completed50 mg (as sodium salt) in 2-ml vial

metoclopramide injection 5 mg/ml in 2-ml ampoule CLARIS Lifesciences Ltd. Completed



47


Brazil

nevirapine (NVP) tablet, 200 mg Far Manguinhos Completed

nevirapine (NVP) tablet, 200 mg Strides Arcolab Ltd. Completed

ofloxacin tablet, 200 mg Ranbaxy Laboratories Ltd Completed


omeprazole capsule, 20 mg Strides Arcolab Ltd. Completed

pentamidine powder for injection, 300 mg (isetionate) in vial Aventis Intercontinental Completed

stavudine (d4T) capsule, 30 mg Far Manguinhos Completed

stavudine (d4T) capsule, 30 mg Strides Arcolab Ltd. Completed


sulfadiazine tablet, 500 mg Far Manguinhos Completed

sulfamethoxazole+trimethoprim tablet, 400+80 mg Far Manguinhos Completed

sulfamethoxazole+trimethoprim tablet, 400+80 mg Strides Arcolab Ltd. Completed





zidovudine (AZT or ZDV) capsule, 100 mg Far Manguinhos Completed

Bulgaria

ceftriaxone powder for injection, Lupin Ltd. Completed250 mg (as sodium salt) in vial




fluconazole capsule, 150 mg Ranbaxy Laboratories Ltd Completed

Burkina Faso





ciprofloxacin tablet, 250 mg (as hydrochloride) Mepha Ltd Completed

ketoconazole tablet, 200 mg Bilim Pharmaceutical Ind. Completed










Burundi

3TC/AZT tablet, 300/150 mg Cipla Ltd. Completed

3TC/d4T/NVP tablet, 150/30/200 mg Ranbaxy Laboratories Ltd Completed



48


Burundi

efavirenz (EFZ) tablet, 600 mg Ranbaxy Laboratories Ltd Completed




nevirapine (NVP) tablet, 200 mg Cipla Ltd. Completed


stavudine (d4T) capsule, 30 mg Cipla Ltd. Completed

zidovudine (AZT or ZDV) oral solution, 50 mg/5 ml Cipla Ltd. Completed

Cambodia

3TC/AZT tablet, 300/150 mg Aurobindo Pharma Ltd. In Process

3TC/d4T/NVP tablet, 150/40/200 mg The Government Pharmaceutical CompletedOrganization


albendazole chewable tablet, 400 mg IPCA Laboratories Ltd. Completed

azithromycin tablet/capsule, 250 mg (dihydrate) Alembic Ltd. Completed

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Cheil Jedang Corp. In Process

chloramphenicol powder for injection, 1 g (sodium succinate) in vial Neon Laboratories Ltd. In Process

ciprofloxacin tablet, 250 mg (as hydrochloride) Lyka Labs Ltd. Completed


clotrimazole cream, 1% SM Pharmaceuticals Sdn Bhd Completed

didanosine (ddI) buffered chewable tablet, 100 mg Aurobindo Pharma Ltd. Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Remedica Ltd. Completed

erythromycin tablet/capsule, Lyka Labs Ltd. Completed250 mg (as stearate or ethylsuccinate)



indinavir (IDV) capsule, 400 mg Ranbaxy Laboratories Ltd Completed

ketoconazole tablet, 200 mg Hovid SDN. BHN. In Process

lamivudine (3TC) syrup, 50 mg/5 ml Aurobindo Pharma Ltd. Completed





nystatin pessary, 100,000 IU SM Pharmaceuticals Sdn Bhd Completed


omeprazole capsule, 20 mg Hovid SDN. BHN. Completed


stavudine (d4T) capsule, 30 mg Aurobindo Pharma Ltd. Completed

sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Aurobindo Pharma Ltd. Completed

zidovudine (AZT or ZDV) capsule, 100 mg Aurobindo Pharma Ltd. Completed

Cameroon

3TC/AZT tablet, 300/150 mg Ranbaxy Laboratories Ltd Completed



49


Cameroon

albendazole chewable tablet, 400 mg Cipla Ltd. Completed

benzathine benzylpenicillin powder for injection, Aventis Intercontinental Completed1.44 g (=2.4 million IU) in 5-ml vial





erythromycin powder for oral suspension, Beltapharm SpA Completed125 mg (as stearate or ethylsuccinate)


ketoconazole tablet, 200 mg Beltapharm SpA Completed

lamivudine (3TC) tablet, 150 mg Cipla Ltd. Completed

methotrexate injection, 25 mg/ml (as sodium salt) in 2-ml vial Aventis Intercontinental Completed

miconazole cream/ointment 2% (as nitrate) 15 g tube Beltapharm SpA Completed

naltrexone HCl tablet, 50 mg Lachifarma, SRL Completed








sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Lachifarma, SRL Completed

tetracycline tablet, 250 mg Phyto-Riker Pharmaceuticals Ltd. Completed

zidovudine (AZT or ZDV) tablet, 300 mg Cipla Ltd. Completed

Canada




Cape Verde



Central African Republic (the)


3TC/d4T/NVP tablet, 150/40/200 mg Cipla Ltd. Completed











50


Central African Republic (the)




Chad


3TC/d4T/NVP tablet, 150/40/200 mg Strides Arcolab Ltd. Completed









stavudine (d4T) capsule, 30 mg Ranbaxy Laboratories Ltd Completed


Chile




aciclovir cream, 5% IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.

benzylpenicillin powder for injection, Alembic Ltd. Completed3 g (=5 million IU)(as sodium or potassium salt) in vial

ceftriaxone powder for injection, 1 g (as sodium salt) in vial IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.


clarithromycin tablet, 250 mg IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.


fluconazole solution for injection, 2 mg/ml in ampoule CLARIS Lifesciences Ltd. Completed

fluoxetine tablet, 20 mg IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.

itraconazole capsule, 100 mg IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.

ketoconazole cream, 2% IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.




miconazole cream/ointment 2% (as nitrate) 40 g tube IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.



51


Chile

omeprazole capsule, 10 mg IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.


sulfamethoxazole+trimethoprim tablet, 100+20 mg IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.



China





calcium folinate (leucovorin) tablet, 15 mg Medac GmbH, International Operations Completed

ceftriaxone powder for injection, Lupin Ltd.. Completed250 mg (as sodium salt) in vial







Hong Kong




aciclovir tablet, 200 mg Hovid SDN. BHN. Completed

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Demo S.A., Pharmaceutical Industry Completed





erythromycin powder for oral suspension, Hovid SDN. BHN. Completed125 mg (as stearate or ethylsuccinate)


fluoxetine capsule, 20 mg Remedica Ltd. Completed

itraconazole capsule, 100 mg Intas Pharmaceuticals Ltd Completed

ketoconazole tablet, 200 mg Aspen Pharmacare In Process


metoclopramide tablet, 10 mg (as hydrochloride) Aspen Pharmacare Completed

miconazole cream/ointment 2% (as nitrate) 15 g tube Hovid SDN. BHN. Completed



nystatin pessary, 100,000 IU Pharmadrug Completed

ofloxacin tablet, 200 mg Hovid SDN. BHN. Completed




52


China

Macau


azithromycin tablet/capsule, 250 mg (dihydrate) Cipla Ltd. Completed

erythromycin powder for oral suspension, Purna Pharmaceuticals NV Completed125 mg (as stearate or ethylsuccinate)




metoclopramide tablet, 10 mg (as hydrochloride) Genepharm SA Completed

ofloxacin tablet, 200 mg Cipla Ltd. Completed

omeprazole capsule, 20 mg Laboratorios Cinfa S.A. In Process

Taiwan





clotrimazole cream, 1% Aspen Pharmacare Completed






Colombia
















zalcitabine (ddC) tablet, 0.75 mg Lab. Filaxis International S.A. Completed


Comoros (the)



53


Congo (the)












methotrimepazine / tablet, 25 mg Aventis Intercontinental Completedlevomepromazine










zidovudine (AZT or ZDV) capsule, 100 mg Cipla Ltd. Completed

Costa Rica


abacavir (ABC) tablet, 300 mg Glaxo SmithKline Completed


aciclovir cream, 5% Apotex Mexico (Protein, S.A. de C.V.) Completed


ciprofloxacin tablet, 250 mg (as hydrochloride) Apotex Mexico (Protein, S.A. de C.V.) Completed


didanosine (ddI) buffered chewable tablet, 100 mg Apotex Mexico (Protein, S.A. de C.V.) Completed




fluoxetine capsule, 20 mg Apotex Mexico (Protein, S.A. de C.V.) Completed


indinavir (IDV) capsule, 400 mg Aurobindo Pharma Ltd. Completed


ketoconazole cream, 2% Apotex Mexico (Protein, S.A. de C.V.) Completed




54


Costa Rica


metoclopramide injection 5 mg/ml in 2-ml ampoule Aspen Pharmacare Completed

metronidazole injection, 500 mg in 100-ml vial Aspen Pharmacare Completed





omeprazole capsule, 10 mg Apotex Mexico (Protein, S.A. de C.V.) Completed

pethidine injection, 50 mg/ml (hydrochloride) Aspen Pharmacare Completedin 2-ml ampoule

stavudine (d4T) capsule, 40 mg Apotex Mexico (Protein, S.A. de C.V.) Completed

sulfamethoxazole+trimethoprim tablet, 100+20 mg Apotex Mexico (Protein, S.A. de C.V.) Completed

zidovudine (AZT or ZDV) capsule, 100 mg Apotex Mexico (Protein, S.A. de C.V.) Completed

Côte D’Ivoire






cefixime tablet, 200 mg Aventis Intercontinental Completed


ciprofloxacin tablet, 250 mg (as hydrochloride) IPCA Laboratories Ltd. Completed










omeprazole capsule, 20 mg Aurobindo Pharma Ltd. Completed


zidovudine (AZT or ZDV) capsule, 100 mg Combino Pharm, S.L. Completed

Croatia

benzylpenicillin powder for injection, Pliva d.d. Completed600 mg (=1 million IU) (as potasium salt) in vial






55


Cuba




Cyprus

aciclovir tablet, 200 mg Genepharm SA Completed


cefixime tablet, 400 mg Genepharm SA Completed



clarithromycin tablet, 250 mg Remedica Ltd. Completed

clotrimazole cream, 1% Remedica Ltd. Completed


erythromycin powder for oral suspension, Remedica Ltd. Completed125 mg (as stearate or ethylsuccinate)

fluconazole capsule, 200 mg Remedica Ltd. Completed

fluoxetine tablet, 20 mg Genepharm SA Completed



metoclopramide tablet, 10 mg (as hydrochloride) Remedica Ltd. Completed




ofloxacin tablet, 200 mg Genepharm SA Completed

omeprazole capsule, 20 mg Genepharm SA Completed

pethidine injection, 50 mg/ml (hydrochloride) Martindale Pharmaceuticals Ltd. Completedin 1-ml ampoule

prochlorperazine tablet, 5 mg Remedica Ltd. Completed

sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Remedica Ltd. Completed

tinidazole tablet, 500 mg Remedica Ltd. Completed

Czech Republic (the)


ceftriaxone powder for injection, 1 g (as sodium salt) in vial Lupin Ltd.. Completed







Democratic Republicof the Congo (the)



azithromycin tablet/capsule, 250 mg (dihydrate) Lyka Labs Ltd. Completed

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Lyka Labs Ltd. Completed



56


Democratic Republicof the Congo (the)

ciprofloxacin tablet, 250 mg (as hydrochloride) Lyka Labs Ltd. Completed

erythromycin tablet/capsule, Lyka Labs Ltd. Completed250 mg (as stearate or ethylsuccinate)


metoclopramide tablet, 10 mg (as hydrochloride) IPCA Laboratories Ltd. Completed






sulfamethoxazole+trimethoprim tablet, 100+20 mg Lyka Labs Ltd. Completed


Denmark

aciclovir tablet, 200 mg Alpharma Completed





metronidazole suppository, 1 g Aventis Intercontinental Completed





silver nitrate solution (eye drops), 1% Gracure Pharmaceuticals Ltd. Completed

sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Scanpharm A/S Completed

Djibouti



Dominica





Dominican Republic (the)






57


Dominican Republic (the)





efavirenz (EFZ) capsule, 200 mg Aurobindo Pharma Ltd. Completed



fluoxetine capsule, 20 mg IVAX Pharmaceuticals Mexico, In ProcessS.A. de C.V.





metoclopramide tablet, 10 mg (as hydrochloride) Apotex Mexico (Protein, S.A. de C.V.) Completed

miconazole cream/ointment 2% (as nitrate) 20 g tube Apotex Mexico (Protein, S.A. de C.V.) Completed






sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Apotex Mexico (Protein, S.A. de C.V.) Completed


Ecuador












Egypt




methotrexate tablet, 2.5 mg Aventis Intercontinental Completed





58


Egypt



El Salvador





amphotericin B powder for injection, 50 mg in vial Neon Antibiotics PVT. Ltd. In Process













nystatin tablet, 500,000 IU Apotex Mexico (Protein, S.A. de C.V.) Completed




sulfamethoxazole+trimethoprim tablet, 100+20 mg Hovid SDN. BHN. Completed


Equatorial Guinea



Eritrea

albendazole chewable tablet, 400 mg Shiba Pharmaceuticals & Chemicals Ltd. In Process

azithromycin oral suspension, 200 mg/5 ml (dihydrate) Shiba Pharmaceuticals & Chemicals Ltd. In Process

ciprofloxacin tablet, 250 mg (as hydrochloride) Shiba Pharmaceuticals & Chemicals Ltd. In Process

clindamycin capsule, 150 mg Shiba Pharmaceuticals & Chemicals Ltd. In Process

doxycycline capsule/tablet, 100 mg (hydrochloride) Shiba Pharmaceuticals & Chemicals Ltd. In Process

erythromycin powder for oral suspension, Shiba Pharmaceuticals & Chemicals Ltd. In Process125 mg (as stearate or ethylsuccinate)

fluconazole capsule, 150 mg Shiba Pharmaceuticals & Chemicals Ltd. In Process


ofloxacin tablet, 200 mg Shiba Pharmaceuticals & Chemicals Ltd. In Process

59


Eritrea

omeprazole capsule, 10 mg Shiba Pharmaceuticals & Chemicals Ltd. In Process

pyrimethamine tablet, 25 mg Shiba Pharmaceuticals & Chemicals Ltd. In Process


sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Shiba Pharmaceuticals & Chemicals Ltd. In Process

Estonia


ciprofloxacin tablet, 250 mg (as hydrochloride) Lupin Ltd.. Completed





Ethiopia




ceftriaxone powder for injection, Lupin Ltd.. Completed250 mg (as sodium salt) in vial

ciprofloxacin tablet, 250 mg (as hydrochloride) IPCA Laboratories Ltd. In Process


clindamycin capsule, 150 mg Bilim Pharmaceutical Ind. In Process




fluconazole capsule, 150 mg IPCA Laboratories Ltd. In Process









ofloxacin tablet, 200 mg Hovid SDN. BHN. In Process

omeprazole capsule, 10 mg Aurobindo Pharma Ltd. In Process




sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml IPCA Laboratories Ltd. In Process



European Union





60


European Union




morphine injection, 10 mg/ml Molteni Farmaceutici Completed(sulfate or HCl), in 1-ml ampoule




Fiji

aciclovir tablet, 200 mg SM Pharmaceuticals Sdn Bhd Completed



sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml SM Pharmaceuticals Sdn Bhd Completed

Finland








France




ceftriaxone powder for injection, 1 g (as sodium salt) in vial Panpharma Completed

didanosine (ddI) buffered chewable tablet, 100 mg Bristol-Myers Squibb ( FR) Completed



metoclopramide injection 5 mg/ml in 2-ml ampoule Lab. Renaudin Completed


morphine injection, 10 mg/ml Lab. Renaudin Completed(sulfate or HCl), in 1-ml ampoule





pethidine injection, 50 mg/ml (hydrochloride) in 2-ml ampoule Lab. Renaudin Completed

stavudine (d4T) capsule, 15 mg Bristol-Myers Squibb ( FR) Completed

61


Gabon























Gambia (the)





Georgia




clarithromycin tablet, 250 mg Intas Pharmaceuticals Ltd Completed


doxycycline capsule/tablet, 100 mg (hydrochloride) Sanavita Aktiengesellschaft & Co. Completed





miconazole cream/ointment 2% (as nitrate) 30 g tube Purna Pharmaceuticals NV Completed





62


Georgia




Germany


calcium folinate (leucovorin) tablet, 15 mg Medac GmbH, International Operations Completed




doxorubicine HCl powder for injection, 10 mg in 5-ml vial Medac GmbH, International Operations Completed


etoposide injection, 20 mg/ml in 5-ml ampoule Medac GmbH, International Operations Completed


gentamicin injection, 40 mg (as sulfate) in 2-ml vial Rotexmedica Completed

metronidazole injection, 500 mg in 100-ml vial Rotexmedica Completed





sulfadiazine tablet, 500 mg Heyl Chemisch.-pharmazeutische CompletedFabrik GmbH & Co KG

sulfamethoxazole+trimethoprim tablet, 400+80 mg Alpharma Completed

Ghana







azithromycin oral suspension, 200 mg/5 ml (dihydrate) Cipla Ltd. Completed

cefixime tablet, 200 mg Cipla Ltd. Completed

ciprofloxacin tablet, 250 mg (as hydrochloride) Lupin Ltd.. Completed


fluconazole capsule, 200 mg IPCA Laboratories Ltd. Completed










63


Ghana


sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Hovid SDN. BHN. Completed



Greece

aciclovir tablet, 200 mg Genepharm SA Completed

cefixime tablet, 400 mg Genepharm SA Completed


ciprofloxacin tablet, 250 mg (as hydrochloride) Demo S.A., Pharmaceutical Industry Completed

clarithromycin tablet, 250 mg Genepharm SA Completed

fluconazole solution for injection, 2 mg/ml in ampoule Genepharm SA Completed

fluoxetine tablet, 20 mg Genepharm SA Completed







omeprazole capsule, 20 mg Demo S.A., Pharmaceutical Industry Completed


spectinomycin powder for injection, 2 g (as hydrochloride) in vial Demo S.A., Pharmaceutical Industry Completed

Guadeloupe

ceftriaxone powder for injection, IVAX Pharmaceuticals Mexico, Completed500 mg (as sodium salt) in vial S.A. de C.V.

Guatemala

3TC/AZT tablet, 300/150 mg Aurobindo Pharma Ltd. Completed




albendazole chewable tablet, 400 mg Beltapharm SpA Completed













64


Guatemala




nelfinavir (NFV) capsule, 250 mg Aurobindo Pharma Ltd. Completed










Guinea


















Guinea-Bissau



Guyana

3TC/AZT tablet, 300/150 mg New GPC Inc Completed

3TC/d4T/NVP tablet, 150/40/200 mg New GPC Inc Completed

aciclovir tablet, 800 mg Remedica Ltd. Completed

indinavir (IDV) capsule, 200 mg New GPC Inc Completed


65


Guyana

lamivudine (3TC) tablet, 150 mg New GPC Inc Completed

nevirapine (NVP) tablet, 200 mg New GPC Inc Completed


stavudine (d4T) capsule, 30 mg New GPC Inc Completed

zidovudine (AZT or ZDV) capsule, 100 mg New GPC Inc Completed

Haiti




ciprofloxacin tablet, 250 mg (as hydrochloride) IVAX Pharmaceuticals Mexico, CompletedS.A. de C.V.








lamivudine (3TC) tablet, 150 mg Aurobindo Pharma Ltd. Completed





nevirapine (NVP) tablet, 200 mg Aurobindo Pharma Ltd. Completed









Honduras







66


Honduras





erythromycin powder for oral suspension, Alembic Ltd. Completed125 mg (as stearate or ethylsuccinate)












sulfamethoxazole+trimethoprim tablet, 100+20 mg Aurobindo Pharma Ltd. Completed


Hungary





Iceland






India



abacavir (ABC) tablet, 300 mg Cipla Ltd. Completed

ABC/3TC/ZDV tablet, 300/150/300 mg Ranbaxy Laboratories Ltd Completed



amitriptyline tablet, 25 mg (as hydrochloride) Gracure Pharmaceuticals Ltd. Completed

67

India

amphotericin B powder for injection, 50 mg in vial Neon Antibiotics PVT. Ltd. Completed

azithromycin oral suspension, 200 mg/5 ml (dihydrate) Alembic Ltd. Completed

AZT/3TC/NVP tablet, 300/150/200 mg Aurobindo Pharma Ltd. Completed


benzylpenicillin powder for injection, 3 g (=5 million IU) Alembic Ltd. Completed(as sodium or potassium salt) in vial

bleomycin powder for injection, 15 mg (as sulfate) in vial Neon Antibiotics PVT. Ltd. Completed

capreomycin powder for injection, 1 g in vial Neon Antibiotics PVT. Ltd. Completed

cefixime paediatric oral suspension, 100 mg/5 ml Cipla Ltd. Completed

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Alembic Ltd. Completed




chloramphenicol oral suspension, 125 mg/5 ml (as palmitate) Gracure Pharmaceuticals Ltd. Completed



clarithromycin tablet, 250 mg Alembic Ltd. Completed

clotrimazole cream, 1% Cipla Ltd. Completed


doxorubicine HCl powder for injection, 10 mg in 5-ml vial Neon Antibiotics PVT. Ltd. Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Cipla Ltd. Completed

efavirenz (EFZ) capsule, 200 mg Aurobindo Pharma Ltd. Completed

erythromycin powder for oral suspension, Alembic Ltd. Completed125 mg (as stearate or ethylsuccinate)

etoposide capsule, 50 mg Cipla Ltd. Completed

fluconazole capsule, 50 mg Alembic Ltd. Completed


gentamicin injection, 10 mg (as sulfate) in 2-ml vial Gracure Pharmaceuticals Ltd. Completed


indinavir (IDV) capsule, 400 mg Strides Arcolab Ltd. Completed

itraconazole capsule, 100 mg Glenmark Pharmaceuticals Ltd Completed

ketoconazole cream, 2% Gracure Pharmaceuticals Ltd. Completed


lamivudine (3TC) tablet, 150 mg Strides Arcolab Ltd. Completed

methotrexate injection, 25 mg/ml (as sodium salt) in 2-ml vial Cipla Ltd. Completed


miconazole cream/ointment 2% (as nitrate) 30 g tube Gracure Pharmaceuticals Ltd. Completed

naltrexone HCl tablet, 50 mg Intas Pharmaceuticals Ltd Completed


nevirapine (NVP) syrup, 50 mg/5 ml Aurobindo Pharma Ltd. Completed


nystatin pessary, 100,000 IU Cipla Ltd. Completed






68


India

pentamidine powder for injection, 200 mg (isetionate) in vial Neon Antibiotics PVT. Ltd. Completed

pethidine injection, 50 mg/ml (hydrochloride) Neon Laboratories Ltd. Completedin 1-ml ampoule


pyrimethamine tablet, 25 mg Gracure Pharmaceuticals Ltd. Completed

rifabutin capsule, 150 mg Lupin Ltd.. Completed

silver nitrate solution (eye drops), 1% Gracure Pharmaceuticals Ltd. Completed

spectinomycin powder for injection, 2 g (as hydrochloride) in vial Neon Antibiotics PVT. Ltd. Completed





tetracycline tablet, 500 mg Gracure Pharmaceuticals Ltd. Completed

tinidazole tablet, 500 mg Gracure Pharmaceuticals Ltd. Completed




zidovudine (AZT or ZDV) tablet, 300 mg Strides Arcolab Ltd. Completed

Indonesia







metoclopramide tablet, 10 mg (as hydrochloride) Alpharma Completed






Iran (Islamic Republic of)






Iraq

aciclovir tablet, 200 mg Cipla Ltd. Completed


azithromycin oral suspension, 200 mg/5 ml (dihydrate) Aleppo Pharmaceutical Industries (Alpha) In Process


69


Iraq


ceftriaxone powder for injection, Aleppo Pharmaceutical Industries (Alpha) Completed250 mg (as sodium salt) in vial

ciprofloxacin tablet, 250 mg (as hydrochloride) Aleppo Pharmaceutical Industries (Alpha) In Process


clotrimazole cream, 1% Pharmadrug Completed







ofloxacin tablet, 200 mg Cipla Ltd. In Process


pethidine injection, 50 mg/ml (hydrochloride) in 2-ml ampoule Aspen Pharmacare Completed







Ireland










pethidine injection, 50 mg/ml (hydrochloride) in 1-ml ampoule Martindale Pharmaceuticals Ltd. Completed

Israel

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Rekah Pharmaceutical Group Completed


codeine tablet, 30 mg (phosphate) Rekah Pharmaceutical Group Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Rekah Pharmaceutical Group Completed







70


Israel


sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Rekah Pharmaceutical Group Completed

Italy

aciclovir cream, 5% Ecobi Farmaceutici S.a.s. Completed

calcium folinate (leucovorin) tablet, 15 mg Ecobi Farmaceutici S.a.s. Completed


ketoconazole tablet, 200 mg Beltapharm SpA Completed


morphine injection, 10 mg/ml (sulfate or HCl), Molteni Farmaceutici Completedin 1-ml ampoule




pethidine injection, 50 mg/ml (hydrochloride) Molteni Farmaceutici Completedin 2-ml ampoule

sulfadiazine tablet, 500 mg Ecobi Farmaceutici S.a.s. Completed


Jamaica





amitriptyline tablet, 25 mg (as hydrochloride) Intas Pharmaceuticals Ltd Completed


ciprofloxacin tablet, 250 mg (as hydrochloride) Intas Pharmaceuticals Ltd Completed













Japan


Jordan




71


Jordan


erythromycin tablet/capsule, 250 mg Hovid SDN. BHN. Completed(as stearate or ethylsuccinate)









Kazakhstan


benzathine benzylpenicillin powder for injection, Sanavita Aktiengesellschaft & Co. Completed1.44 g (=2.4 million IU) in 24-ml vial

benzylpenicillin powder for injection, 3 g (=5 million IU) Sanavita Aktiengesellschaft & Co. Completed(as sodium or potassium salt) in vial











procaine benzylpenicillin powder for injection, 3 g (=3 million IU) in vial Sanavita Aktiengesellschaft & Co. Completed


Kenya








benzathine benzylpenicillin powder for injection, 1.44 g (=2.4 million IU) Alembic Ltd. Completedin 5-ml vial


ciprofloxacin tablet, 250 mg (as hydrochloride) Aurobindo Pharma Ltd. Completed


clotrimazole cream, 1% Gracure Pharmaceuticals Ltd. Completed

erythromycin tablet/capsule, Alembic Ltd. Completed250 mg (as stearate or ethylsuccinate)



72


Kenya

etoposide injection, 20 mg/ ml in 5 ml ampoule Cipla Ltd. Completed
















Kiribati



Kuwait












Kyrgyzstan

benzathine benzylpenicillin powder for injection, 1.44 g (=2.4 million IU) Sanavita Aktiengesellschaft & Co. Completedin 24-ml vial

benzylpenicillin powder for injection, 3 g (=5 million IU) Sanavita Aktiengesellschaft & Co. Completed(as sodium or potassium salt) in vial





73


Lao People’s DemocraticRepublic (the)






Latvia





doxycycline capsule/tablet, 100 mg (hydrochloride) Intas Pharmaceuticals Ltd Completed





Lebanon


benzathine benzylpenicillin powder for injection, 1.44 g (=2.4 million IU) Aventis Intercontinental Completed in 5-ml vial

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Aleppo Pharmaceutical Industries (Alpha) Completed

ciprofloxacin tablet, 250 mg (as hydrochloride) Aleppo Pharmaceutical Industries (Alpha) Completed


methotrexate powder for injection, 50 mg (as sodium salt) Aventis Intercontinental Completedin 2-ml vial





pethidine injection, 50 mg/ml (hydrochloride) Lab. Renaudin Completedin 2-ml ampoule


Lesotho



Liberia






Libyan Arab Jamahiriya (the)




74


Lithuania








Luxembourg








Madagascar

benzathine benzylpenicillin powder for injection, 1.44 g (=2.4 million IU) Aventis Intercontinental Completedin 24-ml vial














pethidine injection, 50 mg/ml (hydrochloride) Lab. Renaudin Completedin 2-ml ampoule




Malawi






75


Malawi






erythromycin tablet/capsule, Alembic Ltd. Completed250 mg (as stearate or ethylsuccinate)







nevirapine (NVP) syrup, 50 mg/5 ml Aurobindo Pharma Ltd. Completed










Malaysia







chloramphenicol powder for injection, 1 g (sodium succinate) in vial SM Pharmaceuticals Sdn Bhd Completed


clarithromycin tablet, 250 mg Alpharma In Process


crotamiton cream/lotion 10% SM Pharmaceuticals Sdn Bhd Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Hovid SDN. BHN. Completed


etoposide injection, 20 mg/ml in 5-ml ampoule Cipla Ltd. Completed




itraconazole capsule, 100 mg SM Pharmaceuticals Sdn Bhd Completed

ketoconazole tablet, 200 mg Hovid SDN. BHN. Completed



76


Malaysia












tetracycline tablet, 500 mg Hovid SDN. BHN. Completed




Maldives

erythromycin tablet/capsule, 500 mg Alembic Ltd. Completed(as stearate or ethylsuccinate)



Mali







ciprofloxacin tablet, 250 mg (as hydrochloride) Gracure Pharmaceuticals Ltd. Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Gracure Pharmaceuticals Ltd. Completed

erythromycin tablet/capsule, 250 mg Gracure Pharmaceuticals Ltd. Completed(as stearate or ethylsuccinate)













77


Mali




Malta







Mauritania












Mauritius








erythromycin tablet/capsule, 250 mg SM Pharmaceuticals Sdn Bhd Completed(as stearate or ethylsuccinate)





metoclopramide tablet, 10 mg (as hydrochloride) Aspen Pharmacare Completed









78


Mauritius





zidovudine (AZT or ZDV) tablet, 300 mg Glaxo SmithKline Completed

Mexico











dimenhydrinate tablet, 50 mg Apotex Mexico (Protein, S.A. de C.V.) Completed


erythromycin tablet/capsule, 250 mg Strides Arcolab Ltd. Completed(as stearate or ethylsuccinate)

erythromycin tablet/capsule, 500 mg Strides Arcolab Ltd. Completed(as stearate or ethylsuccinate)







methotrexate powder for injection, 50 mg (as sodium salt) Lab. Filaxis International S.A. Completedin 2-ml vial

metoclopramide tablet, 10 mg (as hydrochloride) Apotex Mexico (Protein, S.A. de C.V.) Completed











zalcitabine (ddC) tablet, 0.375 mg Apotex Mexico (Protein, S.A. de C.V.) Completed


79


Mongolia


clindamycin capsule, 150 mg Bilim Pharmaceutical Ind. Completed

doxorubicine HCl powder for injection, 10 mg in 5-ml vial Neon Antibiotics PVT. Ltd. In Process


methotrexate injection, 25 mg/ml (as sodium salt) in 2-ml vial Neon Antibiotics PVT. Ltd. Completed

Morocco














Mozambique

3TC/AZT tablet, 300/150 mg Ranbaxy Laboratories Ltd Completed





zidovudine (AZT or ZDV) capsule, 100 mg Ranbaxy Laboratories Ltd Completed

Myanmar







ceftriaxone powder for injection, 1 g (as sodium salt) in vial Alembic Ltd. In Process

chloramphenicol oral suspension, 125 mg/5 ml (as palmitate) Gracure Pharmaceuticals Ltd. Completed








80


Myanmar




gentamicin injection, 40 mg (as sulfate) in 2-ml vial Neon Laboratories Ltd. In Process


ketoconazole tablet, 200 mg Hovid SDN. BHN. In Process


metoclopramide injection 5 mg/ml in 2-ml ampoule Aventis Ltd. Completed





nevirapine (NVP) syrup, 50 mg/5 ml Cipla Ltd. Completed







sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Aventis Ltd. Completed



vincristine injection, 1 mg/ml (sulfate) in vial Cipla Ltd. In Process


Namibia

gentamicin injection, 40 mg (as sulfate) in 2-ml vial Aspen Pharmacare Completed





Nepal

azithromycin tablet/capsule, 250 mg (dihydrate) The Acme Laboratories Ltd. Completed


ciprofloxacin tablet, 250 mg (as hydrochloride) Gracure Pharmaceuticals Ltd. Completed

clarithromycin tablet, 250 mg The Acme Laboratories Ltd. Completed


gentamicin injection, 40 mg (as sulfate) in 2-ml vial Neon Laboratories Ltd. In Process


omeprazole capsule, 20 mg Gracure Pharmaceuticals Ltd. Completed

pethidine tablet, 50 mg Martindale Pharmaceuticals Ltd. Completed


81


Netherlands (the)


albendazole chewable tablet, 400 mg Remedica Ltd. Completed




clotrimazole pessary, 500 mg Gracure Pharmaceuticals Ltd. Completed

erythromycin powder for oral suspension, Gracure Pharmaceuticals Ltd. Completed125 mg (as stearate or ethylsuccinate)




miconazole cream/ointment 2% (as nitrate) 30 g tube Gracure Pharmaceuticals Ltd. Completed




omeprazole capsule, 20 mg Gracure Pharmaceuticals Ltd. Completed



pyrimethamine tablet, 25 mg Gracure Pharmaceuticals Ltd. Completed


Netherlands Antilles








New Zealand


ceftriaxone powder for injection, 1 g (as sodium salt) in vial Laboratorio Reig Jofre S.A. Completed




Nicaragua










82


Nicaragua















Niger (the)






erythromycin tablet/capsule, 250 mg Phyto-Riker Pharmaceuticals Ltd. Completed(as stearate or ethylsuccinate)









Nigeria








efavirenz (EFZ) capsule, 200 mg Cipla Ltd. Completed



83


Nigeria












Norway








Oman


ceftriaxone powder for injection, 250 mg Ranbaxy Laboratories Ltd Completed(as sodium salt) in vial



erythromycin tablet/capsule, 250 mg Remedica Ltd. Completed(as stearate or ethylsuccinate)








sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Remedica Ltd. Completed


Pakistan









84


Panama



aciclovir tablet, 200 mg Apotex Mexico (Protein, S.A. de C.V.) Completed







erythromycin powder for oral suspension, 125 mg Beltapharm SpA Completed(as stearate or ethylsuccinate)












sulfamethoxazole+trimethoprim tablet, 400+80 mg Apotex Mexico (Protein, S.A. de C.V.) Completed


Papua New Guinea

aciclovir tablet, 200 mg SM Pharmaceuticals Sdn Bhd Completed




Paraguay










85


Peru




aciclovir cream, 5% Gracure Pharmaceuticals Ltd. Completed

albendazole chewable tablet, 400 mg Gracure Pharmaceuticals Ltd. Completed




ceftriaxone powder for injection, 1 g (as sodium salt) in vial Aurobindo Pharma Ltd. Completed

chloramphenicol powder for injection, 1 g (sodium succinate) in vial Neon Laboratories Ltd. Completed






gentamicin injection, 40 mg (as sulfate) in 2-ml vial Gracure Pharmaceuticals Ltd. Completed











tetracycline tablet, 500 mg Gracure Pharmaceuticals Ltd. Completed


Philippines (the)










metoclopramide tablet, 10 mg (as hydrochloride) The Acme Laboratories Ltd. Completed






86


Poland




fluconazole capsule, 50 mg Pliva d.d. Completed






Portugal







omeprazole capsule, 10 mg Laboratorios Andr—maco S.A. Completed


Qatar









Republic of Korea (the)

3TC/AZT tablet, 300/150 mg Cheil Jedang Corp. Completed

3TC/d4T/NVP tablet, 150/40/200 mg Cheil Jedang Corp. Completed


aciclovir tablet, 200 mg Samchully Pharm. Co., Ltd. Completed

capreomycin powder for injection, 1 g in vial Cheil Jedang Corp. Completed



cycloserine capsule, 250 mg Cheil Jedang Corp. Completed

lamivudine (3TC) tablet, 150 mg Cheil Jedang Corp. Completed

metronidazole injection, 500 mg in 100-ml vial Cheil Jedang Corp. Completed



nevirapine (NVP) tablet, 200 mg Cheil Jedang Corp. Completed

stavudine (d4T) capsule, 40 mg Cheil Jedang Corp. Completed

zidovudine (AZT or ZDV) capsule, 100 mg Cheil Jedang Corp. Completed

87


Republic of Moldova (the)











Romania










ofloxacin tablet, 200 mg Genepharm SA Completed

omeprazole capsule, 10 mg Genepharm SA Completed

Russian Federation (the)



benzathine benzylpenicillin powder for injection, 1.44 g (=2.4 million IU) Aventis Intercontinental Completed in 5-ml vial

capreomycin powder for injection, 1 g in vial Cheil Jedang Corp. In Process




cycloserine capsule, 250 mg Cheil Jedang Corp. In Process














88

Russian Federation (the)






Rwanda



Samoa



Sao Tome and Principe



Saudi Arabia











Senegal



3TC/d4T/NVP tablet, 150/40/200 mg Strides Arcolab Ltd. Completed











indinavir (IDV) capsule, 400 mg Strides Arcolab Ltd. Completed


89


Senegal

















Serbia and Montenegro


ceftriaxone powder for injection, Demo S.A., Pharmaceutical Industry Completed250 mg (as sodium salt) in vial






Sierra Leone












zidovudine (AZT or ZDV) oral solution, 50 mg/5 ml Cipla Ltd. Completed

Singapore






90


Singapore

aciclovir tablet, 200 mg Beacons Pharmaceuticals Pte Ltd. Completed




clotrimazole cream, 1% Beacons Pharmaceuticals Pte Ltd. Completed

codeine tablet, 30 mg (phosphate) Beacons Pharmaceuticals Pte Ltd. Completed

dimenhydrinate tablet, 50 mg Beacons Pharmaceuticals Pte Ltd. Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Beacons Pharmaceuticals Pte Ltd. Completed

erythromycin powder for oral suspension, 125 mg Beacons Pharmaceuticals Pte Ltd. Completed(as stearate or ethylsuccinate)


ketoconazole cream, 2% Beacons Pharmaceuticals Pte Ltd. Completed



miconazole cream/ointment 2% (as nitrate) 15 g tube Beacons Pharmaceuticals Pte Ltd. Completed





sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Beacons Pharmaceuticals Pte Ltd. Completed



Slovakia

ceftriaxone powder for injection, 250 mg Lupin Ltd.. Completed(as sodium salt) in vial


Slovenia




Solomon Islands



Somalia



South Africa




aciclovir tablet, 200 mg Aspen Pharmacare Completed

amitriptyline tablet, 25 mg (as hydrochloride) Aspen Pharmacare Completed

91


South Africa


ciprofloxacin tablet, 250 mg (as hydrochloride) Aspen Pharmacare Completed


codeine tablet, 30 mg (phosphate) Aspen Pharmacare Completed

cycloserine capsule, 250 mg Cheil Jedang Corp. In Process

didanosine (ddI) buffered chewable tablet, 100 mg Bristol-Myers Squibb (SA) Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Aspen Pharmacare Completed

erythromycin tablet/capsule, 250 mg SM Pharmaceuticals Sdn Bhd Completed(as stearate or ethylsuccinate)


fluoxetine capsule, 20 mg Aspen Pharmacare Completed

gentamicin injection, 10 mg (as sulfate) in 2-ml vial Aspen Pharmacare Completed

ketoconazole cream, 2% Aspen Pharmacare In Process




morphine injection, 10 mg(hydrochloride) in 1-ml ampoule Aspen Pharmacare Completed





ofloxacin tablet, 200 mg Aspen Pharmacare Completed


prochlorperazine tablet, 5 mg Aspen Pharmacare Completed


stavudine (d4T) capsule, 20 mg Aspen Pharmacare Completed



Spain

aciclovir powder for injection, 250 mg (as sodium salt) Alpharma Completedin 10-ml vial

amphotericin B powder for injection, 50 mg in vial Combino Pharm, S.L. Completed

azithromycin tablet/capsule, 500 mg (dihydrate) Laboratorio Reig Jofre S.A. Completed


ciprofloxacin tablet, 250 mg (as hydrochloride) Laboratorios Cinfa S.A. Completed

clarithromycin tablet, 250 mg Orios Juventus S.A. Completed

clindamycin injection, 150 mg/ml (as phosphate) Combino Pharm, S.L. Completedin 2-ml ampoule


fluconazole solution for injection, 2 mg/ml in ampoule Laboratorio Reig Jofre S.A. Completed

fluoxetine capsule, 20 mg Combino Pharm, S.L. Completed






92


Spain

omeprazole capsule, 20 mg Laboratorios Andr—maco S.A. Completed

pentamidine powder for injection, 300 mg (isetionate) in vial Combino Pharm, S.L. Completed

sulfadiazine tablet, 500 mg Laboratorio Reig Jofre S.A. Completed


Sri Lanka


aciclovir powder for injection, 250 mg (as sodium salt) Hovid SDN. BHN. In Processin 10-ml vial


amphotericin B powder for injection, 50 mg in vial Neon Antibiotics PVT. Ltd. In Process


bleomycin powder for injection, 15 mg (as sulfate) in vial Neon Antibiotics PVT. Ltd. In Process







erythromycin powder for oral suspension, 125 mg Alembic Ltd. Completed(as stearate or ethylsuccinate)

etoposide injection, 20 mg/ml in 5-ml ampoule Cipla Ltd. In Process


gentamicin injection, 40 mg (as sulfate) in 2-ml vial Neon Laboratories Ltd. Completed



methotrexate injection, 25 mg/ml (as sodium salt) in 2-ml vial Neon Antibiotics PVT. Ltd. Completed




omeprazole capsule, 20 mg Alembic Ltd. In Process

pethidine injection, 50 mg/ml (hydrochloride) Neon Laboratories Ltd. In Processin 1-ml ampoule





vincristine powder for injection, 1 mg (sulfate) in 1-ml vial Neon Antibiotics PVT. Ltd. In Process


Sudan (the)




azithromycin oral suspension, 200 mg/5 ml (dihydrate) Aleppo Pharmaceutical Industries (Alpha) In Process


93


Sudan (the)

ciprofloxacin tablet, 250 mg (as hydrochloride) Aleppo Pharmaceutical Industries (Alpha) In Process

clarithromycin tablet, 250 mg Intas Pharmaceuticals Ltd In Process


doxycycline capsule/tablet, 100 mg (hydrochloride) Remedica Ltd. In Process

erythromycin powder for oral suspension, 125 mg Hovid SDN. BHN. In Process(as stearate or ethylsuccinate)


fluconazole capsule, 50 mg Cipla Ltd. In Process







omeprazole capsule, 10 mg Genepharm SA In Process






Suriname


chloramphenicol powder for injection, 1 g (sodium succinate) in vial Sanavita Aktiengesellschaft & Co. Completed




sulfamethoxazole+trimethoprim tablet, 400+80 mg Sanavita Aktiengesellschaft & Co. Completed

Swaziland



Sweden








Switzerland





94


Switzerland


nelfinavir (NFV) capsule, 250 mg Hoffmann-La Roche Completed





saquinavir (SQV) capsule, 200 mg Hoffmann-La Roche Completed

Syrian Arab Republic (the)



ceftriaxone powder for injection, 250 mg Aleppo Pharmaceutical Industries (Alpha) Completed(as sodium salt) in vial



Thailand


3TC/d4T/NVP tablet, 150/40/200 mg The Government Pharmaceutical CompletedOrganization



aciclovir tablet, 200 mg Cipla Ltd. Completed

amitriptyline tablet, 25 mg (as hydrochloride) The Government Pharmaceutical CompletedOrganization




dimenhydrinate tablet, 50 mg The Government Pharmaceutical CompletedOrganization




ketoconazole tablet, 200 mg The Government Pharmaceutical CompletedOrganization







stavudine (d4T) capsule, 30 mg The Government Pharmaceutical CompletedOrganization

sulfamethoxazole+trimethoprim tablet, 400+80 mg The Government Pharmaceutical CompletedOrganization


95


The former Yugoslav Republicof Macedonia



Togo




















Trinidad and Tobago






clarithromycin tablet, 250 mg Ranbaxy Laboratories Ltd In Process

fluconazole capsule, 50 mg Ranbaxy Laboratories Ltd Completed















96


Trinidad and Tobago




Tunisia








methotrexate tablet, 2.5 mg Aventis Intercontinental Completed


morphine injection, 10 mg/ml (sulfate or HCl), Lab. Renaudin Completedin 1-ml ampoule



Turkey







clindamycin capsule, 150 mg Bilim Pharmaceutical Ind. Completed








Turkmenistan





Tuvalu



97


Uganda










doxycycline capsule/tablet, 100 mg (hydrochloride) Aspen Pharmacare Completed

















sulfamethoxazole+trimethoprim tablet, 400+80 mg Aspen Pharmacare Completed


Ukraine



abacavir (ABC) tablet, 300 mg Ranbaxy Laboratories Ltd Completed

aciclovir powder for injection, 250 mg (as sodium salt) Neon Antibiotics PVT. Ltd. In Processin 10-ml vial


bleomycin powder for injection, 15 mg (as sulfate) in vial Neon Antibiotics PVT. Ltd. In Process




didanosine (ddI) buffered chewable tablet, 100 mg Ranbaxy Laboratories Ltd Completed


efavirenz (EFZ) capsule, 200 mg Ranbaxy Laboratories Ltd Completed



98


Ukraine




itraconazole capsule, 100 mg Glenmark Pharmaceuticals Ltd Completed








omeprazole capsule, 20 mg Intas Pharmaceuticals Ltd In Process




vincristine powder for injection, 1 mg (sulfate) in 1-ml vial Neon Antibiotics PVT. Ltd. In Process

zidovudine (AZT or ZDV) capsule, 100 mg Ranbaxy Laboratories Ltd Completed

United Arab Emirates (the)





ciprofloxacin tablet, 250 mg (as hydrochloride) Bayer Healthcare AG In Process



erythromycin powder for oral suspension, 125 mg Shiba Pharmaceuticals & Chemicals Ltd. In Process(as stearate or ethylsuccinate)






omeprazole capsule, 10 mg Mepha Ltd In Process




United Kingdom (the)





amitriptyline tablet, 25 mg (as hydrochloride) Pharmchem International Ltd. Completed

azithromycin tablet/capsule, 500 mg (dihydrate) Pharmchem International Ltd. Completed

99


United Kingdom (the)

benzathine benzylpenicillin powder for injection, 1.44 g (=2.4 million IU) Pharmchem International Ltd. Completedin 5-ml vial

benzylpenicillin powder for injection, 3 g (=5 million IU) Pharmchem International Ltd. Completed(as sodium or potassium salt) in vial


ceftriaxone powder for injection, 1 g (as sodium salt) in vial Pharmchem International Ltd. Completed

chloramphenicol oily suspension for injection, 0.5 g/ml Pharmchem International Ltd. Completed(as sodium succinate) in 2-ml ampoule



clotrimazole cream, 1% Pharmchem International Ltd. Completed

codeine tablet, 30 mg (phosphate) Pharmchem International Ltd. Completed

doxorubicine HCl powder for injection, 10 mg in 5-ml vial Medac GmbH, International Operations Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Pharmchem International Ltd. Completed

erythromycin powder for oral suspension, 125 mg Pharmchem International Ltd. Completed(as stearate or ethylsuccinate)


fluoxetine capsule, 20 mg Pharmchem International Ltd. Completed

gentamicin injection, 10 mg (as sulfate) in 2-ml vial Pharmchem International Ltd. Completed

ketoconazole tablet, 200 mg Pharmchem International Ltd. Completed


methadone tablet, 5 mg Pharmchem International Ltd. Completed


miconazole cream/ointment 2% (as nitrate) 15 g tube Pharmchem International Ltd. Completed

morphine injection, 10 mg(hydrochloride) in 1-ml ampoule Martindale Pharmaceuticals Ltd. Completed





pethidine injection, 50 mg/ml (hydrochloride) in 1-ml ampoule Martindale Pharmaceuticals Ltd. Completed

procaine benzylpenicillin powder for injection, 3 g (=3 million IU) in vial Pharmchem International Ltd. Completed

spectinomycin powder for injection, 2 g (as hydrochloride) in vial Pharmchem International Ltd. Completed

sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Alpharma Completed

tetracycline tablet, 500 mg Pharmchem International Ltd. Completed

vincristine injection, 1 mg/ml (sulfate) in vial Pharmchem International Ltd. Completed


United Republic of Tanzania (the)





albendazole chewable tablet, 400 mg Beltapharm SpA In Process


azithromycin oral suspension, 200 mg/5 ml (dihydrate) Alembic Ltd. In Process




100


United Republic of Tanzania (the)


ciprofloxacin tablet, 250 mg (as hydrochloride) Aurobindo Pharma Ltd. In Process



clotrimazole pessary, 500 mg Gracure Pharmaceuticals Ltd. Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Intas Pharmaceuticals Ltd In Process


erythromycin powder for oral suspension, 125 mg Beltapharm SpA In Process(as stearate or ethylsuccinate)

fluconazole capsule, 150 mg IPCA Laboratories Ltd. In Process









ofloxacin tablet, 200 mg Cipla Ltd. In Process







USA





ceftriaxone powder for injection, 250 mg (as sodium salt) Lupin Ltd.. Completedin vial







Uruguay






101

Uruguay




methotrexate powder for injection, 50 mg (as sodium salt) Lab. Filaxis International S.A. Completedin 2-ml vial









Uzbekistan






erythromycin tablet/capsule, 250 mg Sanavita Aktiengesellschaft & Co. Completed(as stearate or ethylsuccinate)




nystatin pessary, 100,000 IU The Acme Laboratories Ltd. Completed



sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Sanavita Aktiengesellschaft & Co. Completed

Vanuatu



Venezuela









fluoxetine capsule, 20 mg Laboratorios Cinfa S.A. In Process





102


Venezuela







omeprazole capsule, 20 mg Laboratorios Cinfa S.A. In Process



Viet Nam



albendazole chewable tablet, 400 mg Strides Arcolab Ltd. Completed

azithromycin oral suspension, 200 mg/5 ml (dihydrate) Alembic Ltd. Completed

cefixime tablet, 200 mg Lyka Labs Ltd. In Process

ceftriaxone powder for injection, 1 g (as sodium salt) in vial Alembic Ltd. In Process






ketoconazole tablet, 200 mg Remedica Ltd. In Process













Yemen



azithromycin oral suspension, 200 mg/5 ml (dihydrate) Aleppo Pharmaceutical Industries (Alpha) Completed




clindamycin capsule, 150 mg Shiba Pharmaceuticals & Chemicals Ltd. Completed

doxycycline capsule/tablet, 100 mg (hydrochloride) Shiba Pharmaceuticals & Chemicals Ltd. Completed

103

Yemen

erythromycin powder for oral suspension, 125 mg Hovid SDN. BHN. Completed(as stearate or ethylsuccinate)




miconazole cream/ointment 2% (as nitrate) 15 g tube Lachifarma, SRL Completed








pyrimethamine tablet, 25 mg Shiba Pharmaceuticals & Chemicals Ltd. Completed


sulfamethoxazole+trimethoprim oral suspension, 200+40 mg/5 ml Aurobindo Pharma Ltd. Completed


Zambia


















Zimbabwe










104

Zimbabwe




doxycycline capsule/tablet, 100 mg (hydrochloride) Intas Pharmaceuticals Ltd Completed




lamivudine (3TC) tablet, 150 mg IPCA Laboratories Ltd. Completed







ofloxacin tablet, 200 mg Remedica Ltd. Completed



sulfamethoxazole+trimethoprim tablet, 400+80 mg Aspen Pharmacare Completed



105

Table 1. Anti-infective medicines

Anthelminthics Manufacturer

albendazole

chewable tablet, 400 mg Artesan Pharma GmbH & Co. KG, Beltapharm SpA, CiplaLtd., Gracure Pharmaceuticals Ltd., IPCA Laboratories Ltd.,Lachifarma SRL, Lyka Labs Ltd., Remedica Ltd., ShibaPharmaceuticals & Chemicals Ltd., Strides Arcolab Ltd.

Antibacterials, beta lactam medicines

benzathine benzylpenicillin

powder for injection, 1.44 g (=2.4 million IU) in 24–ml vial Sanavita Aktiengesellschaft & Co.

powder for injection, 1.44 g (=2.4 million IU) in 5–ml vial Alembic Ltd., Aventis Intercontinental,Pharmchem International Ltd.

benzylpenicillin

powder for injection, 3 g (=5 million IU) Alembic Ltd., Pharmchem International Ltd., Sanavita(as sodium or potassium salt) in vial Aktiengesellschaft & Co.

powder for injection, 600 mg (=1 million IU) Pliva d.d.(as potasium salt) in vial

cefixime

paediatric oral suspension, 100 mg/5 ml Aventis Intercontinental, Bilim Pharmaceutical Ind.,Lyka Labs Ltd.

paediatric oral suspension, 40 mg/5 ml Aventis Intercontinental

tablet, 200 mg Aventis Intercontinental, Cipla Ltd., Lyka Labs Ltd.

tablet, 400 mg Bilim Pharmaceutical Ind., Genepharm SA

ceftriaxone

powder for injection, 1 g (as sodium salt) in vial Alembic Ltd., Aurobindo Pharma Ltd., Aventis Ltd., BilimPharmaceutical Ind.,Cheil Jedang Corp., Cipla Ltd., DemoS.A., Pharmaceutical Industry, IVAX Pharmaceuticals Mexico,(S.A. de C.V.), Laboratorio Reig Jofre S.A., Lyka Labs Ltd.,Mepha Ltd., Neon Laboratories Ltd., Panpharma,Pharmchem International Ltd., Pliva d.d., RanbaxyLaboratories Ltd., Rekah Pharmaceutical Group,Strides Arcolab Ltd.

powder for injection, 250 mg (as sodium salt) in vial Aleppo Pharmaceutical Industries (Alpha), Aurobindo PharmaLtd., Aventis Ltd., Cheil Jedang Corp., Cipla Ltd., CombinoPharm, S.L., Demo S.A., *Hoffman-La Roche Ltd, Pharma-ceutical Industry, Lupin Ltd., Mepha Ltd., Neon LaboratoriesLtd., Pharmchem International Ltd., Ranbaxy LaboratoriesLtd., Strides Arcolab Ltd.

ANNEX 2B

Sources of medicinesPrequalified16 sources of specific products are marked in bold with an asterisk

16 Procurement Quality and Sourcing Project, list of manufacturers and suppliers http://mednet3.who.int/prequal/hiv/hiv-suppliers.doc



106

Antibacterials, beta lactam medicines Manufacturer

ceftriaxone

powder for injection, 500 mg (as sodium salt) in vial Aurobindo Pharma Ltd., Aventis Ltd., Bilim PharmaceuticalInd., Cheil Jedang Corp., Cipla Ltd., Demo S.A.,*Hoffman-La Roche Ltd., Pharmaceutical Industry,IVAX Pharmaceuticals Mexico (S.A. de C.V.), Lyka Labs Ltd.,Mepha Ltd., Pharmchem International Ltd., Strides Arcolab Ltd.

procaine benzylpenicillin

powder for injection, 3 g (=3 million IU) in vial Alembic Ltd., Pharmchem International Ltd.,Sanavita Aktiengesellschaft & Co., Strides Arcolab Ltd.

Antibacterials, others

azithromycin

oral suspension, 200 mg/5 ml (dihydrate) Alembic Ltd., Shiba Pharmaceuticals & Chemicals Ltd.

capsule/tablet, 250 mg (dihydrate) Alembic Ltd., Aleppo Pharmaceutical Industries (Alpha), Cipla Ltd.,IPCA Laboratories Ltd., Lyka Labs Ltd., Shiba Pharmaceuticals &Chemicals Ltd., Strides Arcolab Ltd., The Acme Laboratories Ltd.

capreomycin

powder for injection, 1 g in vial Cheil Jedang Corp., Neon Antibiotics PVT. Ltd.

chloramphenicol

oily suspension for injection,0.5 g/ml (as sodium succinate) Pharmchem International Ltd.in 2–ml ampoule

oral suspension, 150 mg/5 ml (as palmitate) Pharmchem International Ltd.

powder for injection, 1 g (sodium succinate) in vial Neon Laboratories Ltd., Pharmchem International Ltd.,Sanavita Aktiengesellschaft & Co., SM Pharmaceuticals Sdn Bhd,Strides Arcolab Ltd.

ciprofloxacin

tablet, 250 mg (as hydrochloride) Alembic Ltd., Alpharma, Apotex Mexico Protein, (S.A. de C.V.),tablet, 500 mg (as hydrochloride) Aspen Pharmacare, Aurobindo Pharma Ltd., Aventis Ltd., Bayertablet, 750 mg (as hydrochloride) Healthcare AG, Cheil Jedang Corp., *Cipla Ltd., Genepharm SA,

Glenmark Pharmaceuticals Ltd., Gracure Pharmaceuticals Ltd.,Intas Pharmaceuticals Ltd., IPCA Laboratories Ltd.,IVAX Pharmaceuticals Mexico (S.A. de C.V.),*Laboratorios Cinfa S.A., Lupin Ltd., Lyka Labs Ltd., MephaLtd., Orios Juventus S.A., Pharmchem International Ltd.,Phyto-Riker Pharmaceuticals Ltd., Pliva d.d.,*Ranbaxy Laboratories Ltd., Remedica Ltd.,Shiba Pharmaceuticals & Chemicals Ltd., SM PharmaceuticalsSdn Bhd, Strides Arcolab Ltd., The Acme Laboratories Ltd.

clarithromycin

powder for injection, 500 mg Strides Arcolab Ltd.

tablet, 250 mg Alembic Ltd., Alpharma, Bilim Pharmaceutical Ind., Genepharm SA,Intas Pharmaceuticals Ltd., IPCA Laboratories Ltd., IVAX Pharma-ceuticals Mexico, (S.A. de C.V.), Lyka Labs Ltd., Orios JuventusS.A., *Ranbaxy Laboratories Ltd., Remedica Ltd.,SM Pharmaceuticals Sdn Bhd, Strides Arcolab Ltd., The AcmeLaboratories Ltd., The Government Pharmaceutical Organization

107

Antibacterials, others Manufacturer

clindamycin

capsule, 150 mg Bilim Pharmaceutical Ind., Shiba Pharmaceuticals & Chemicals Ltd.

injection, 150 mg/ml (as phosphate) in 2–ml ampoule Combino Pharm, S.L.

injection, 150 mg/ml (as phosphate) in 4–ml ampoule Strides Arcolab Ltd.

cycloserine

capsule, 250 mg Cheil Jedang Corp., Pharmadrug

doxycycline

capsule/tablet, 100 mg (hydrochloride) Aspen Pharmacare, Beacons Pharmaceuticals Pte Ltd., Cipla Ltd.,Gracure Pharmaceuticals Ltd., Hovid SDN. BHN., Intas Pharmaceu-ticals Ltd., Pharmadrug, Pharmchem International Ltd., RekahPharmaceutical Group, Remedica Ltd., Sanavita Aktiengesellschaft& Co., Shiba Pharmaceuticals & Chemicals Ltd.,The Acme Laboratories Ltd.

erythromycin

powder for oral suspension, 125mg (as stearate or ethylsuccinate) Aventis Ltd., Beacons Pharmaceuticals Pte Ltd., Beltapharm SpA,Gracure Pharmaceuticals Ltd., Lachifarma SRL, Pharmadrug,Pharmchem International Ltd., Purna Pharmaceuticals NV,Remedica Ltd., Shiba Pharmaceuticals & Chemicals Ltd.

capsule/tablet, 250 mg (as stearate or ethylsuccinate) Alembic Ltd., Artesan Pharma GmbH & Co. KG, Aurobindo PharmaLtd., Aventis Ltd., Beacons Pharmaceuticals Pte Ltd., BeltapharmSpA, Cipla Ltd., Gracure Pharmaceuticals Ltd., Hovid SDN. BHN.,IPCA Laboratories Ltd., Lachifarma SRL, Lyka Labs Ltd.,Pharmchem International Ltd., Phyto-Riker Pharmaceuticals Ltd.,Remedica Ltd., Sanavita Aktiengesellschaft & Co., Shiba Pharma-ceuticals & Chemicals Ltd., SM Pharmaceuticals Sdn Bhd,Strides Arcolab Ltd.

capsule/tablet, 500 mg (as stearate or ethylsuccinate) Alembic Ltd., Artesan Pharma GmbH & Co. KG, Aventis Ltd., CiplaLtd., Gracure Pharmaceuticals Ltd., Hovid SDN. BHN., IPCALaboratories Ltd., Pharmchem International Ltd., Remedica Ltd.,Sanavita Aktiengesellschaft & Co., Shiba Pharmaceuticals &Chemicals Ltd., Strides Arcolab Ltd.

gentamicin

injection, 10 mg (as sulfate) in 2–ml vial Aspen Pharmacare, Intas Pharmaceuticals Ltd.,Pharmchem International Ltd., Rotexmedica

injection, 40 mg (as sulfate) in 2–ml vial Aspen Pharmacare, Gracure Pharmaceuticals Ltd., Intas Pharma-ceuticals Ltd., Neon Laboratories Ltd., Pharmchem InternationalLtd., Rotexmedica, Sanavita Aktiengesellschaft & Co.

metronidazole

injection, 500 mg in 100–ml vial Aspen Pharmacare, Aventis Intercontinental, Cheil Jedang Corp.,Demo S.A., Pharmaceutical Industry, Pharmchem InternationalLtd., Rotexmedica

suppository, 1 g Aventis Intercontinental

ANNEX 2B. SOURCES OF MEDICINES


108


ofloxacin

IV infusion, 2 mg/ml (hydrochloride) Genepharm SA

IV infusion, 5 mg/ml (hydrochloride) Aventis Intercontinental

tablet, 200 mg Aspen Pharmacare, Aventis Intercontinental, Cipla Ltd., GenepharmSA, Gracure Pharmaceuticals Ltd., Hovid SDN. BHN., IntasPharmaceuticals Ltd., IPCA Laboratories Ltd., Lyka Labs Ltd.,Ranbaxy Laboratories Ltd., Remedica Ltd., Shiba Pharmaceuticals& Chemicals Ltd., Strides Arcolab Ltd.

tablet, 400 mg Aspen Pharmacare, Cipla Ltd., Remedica Ltd.,Shiba Pharmaceuticals & Chemicals Ltd., Strides Arcolab Ltd.

rifabutin

capsule, 150 mg Lupin Ltd.

silver nitrate

solution (eye drops), 1% Gracure Pharmaceuticals Ltd.

spectinomycin

powder for injection, 2 g (as hydrochloride) in vial Demo S.A., Pharmaceutical Industry, Neon Antibiotics PVT. Ltd.,Pharmchem International Ltd.

sulfadiazine

tablet, 500 mg *Doms RecordatiNPI, Ecobi Farmaceutici S.a.s., Far Manguinhos,Heyl Chemisch.-pharmazeutische Fabrik GmbH & Co KG,Laboratorio Reig Jofre S.A., Strides Arcolab Ltd.

sulfamethoxazole+trimethoprim

oral suspension, 200+40 mg/5 ml Apotex Mexico Protein, (S.A. de C.V.), Aspen Pharmacare, AventisLtd., Beacons Pharmaceuticals Pte Ltd., Ecobi Farmaceutici S.a.s.,*Hoffman-La Roche Ltd, Hovid SDN. BHN., Lachifarma SRL,Pharmchem International Ltd., Remedica Ltd., Scanpharm A/S,Shiba Pharmaceuticals & Chemicals Ltd., SM PharmaceuticalsSdn Bhd, The Acme Laboratories Ltd.

tablet, 100+20 mg Artesan Pharma GmbH & Co. KG, Ecobi Farmaceutici S.a.s.,Gracure Pharmaceuticals Ltd., IVAX Pharmaceuticals Mexico, (S.A.de C.V.), Lachifarma SRL, Lyka Labs Ltd., Pharmchem Interna-tional Ltd., Rekah Pharmaceutical Group, Shiba Pharmaceuticals &Chemicals Ltd.

tablet, 400+80 mg Alpharma, Apotex Mexico Protein, (S.A. de C.V.), Artesan PharmaGmbH & Co. KG, Aspen Pharmacare, Aurobindo Pharma Ltd.,Aventis Ltd., Beacons Pharmaceuticals Pte Ltd., EcobiFarmaceutici S.a.s., Far Manguinhos, Gracure PharmaceuticalsLtd., *Hoffman-La Roche Ltd., Hovid SDN. BHN., IntasPharmaceuticals Ltd., IPCA Laboratories Ltd., IVAX Pharmaceuti-cals Mexico, (S.A. de C.V.), Pharmchem International Ltd.,Remedica Ltd., Sanavita Aktiengesellschaft & Co., Shiba Pharma-ceuticals & Chemicals Ltd., SM Pharmaceuticals Sdn Bhd, StridesArcolab Ltd. The Acme Laboratories Ltd., The GovernmentPharmaceutical Organization

tablet, 800+160 mg Alpharma, Apotex Mexico Protein, (S.A. de C.V.), AspenPharmacare, Aurobindo Pharma Ltd., Aventis Ltd.,*Hoffman-La Roche Ltd, Hovid SDN. BHN., Intas Pharmaceuti-cals Ltd., Pharmchem International Ltd., Rekah PharmaceuticalGroup, Shiba Pharmaceuticals & Chemicals Ltd.,Strides Arcolab Ltd.

NPI No price information

109


tetracycline

tablet, 500 mg Gracure Pharmaceuticals Ltd., Hovid SDN. BHN., PharmchemInternational Ltd.

Antifilarials

crotamiton

cream/lotion 10% SM Pharmaceuticals Sdn Bhd

Antifungal medicines

amphotericin B

powder for injection, 50 mg in vial Combino Pharm, S.L., Neon Antibiotics PVT. Ltd.

clotrimazole

cream, 1% Aspen Pharmacare, Beacons Pharmaceuticals Pte Ltd., Cipla Ltd.,Gracure Pharmaceuticals Ltd., Pharmadrug, PharmchemInternational Ltd., Purna Pharmaceuticals NV, Remedica Ltd., SMPharmaceuticals Sdn Bhd, The Acme Laboratories Ltd.,The Government Pharmaceutical Organization,

pessary, 500 mg Gracure Pharmaceuticals Ltd., Remedica Ltd.

fluconazole

capsule, 50 mg Cipla Ltd., Pliva d.d., *Ranbaxy Laboratories Ltd.

capsule, 150 mg Bilim Pharmaceutical Ind., Cipla Ltd., Gracure PharmaceuticalsLtd., Intas Pharmaceuticals Ltd., Pliva d.d., *Ranbaxy Labor-atories Ltd., Shiba Pharmaceuticals & Chemicals Ltd.

capsule, 200 mg Cipla Ltd., IPCA Laboratories Ltd., Pliva d.d.,*Ranbaxy Laboratories Ltd., Remedica Ltd.,Shiba Pharmaceuticals & Chemicals Ltd., The GovernmentPharmaceutical Organization

solution for injection, 2mg/ml in ampoule Genepharm SA, Laboratorio Reig Jofre S.A.

itraconazole

capsule, 100 mg Intas Pharmaceuticals Ltd., IVAX Pharmaceuticals Mexico,(S.A. de C.V.), SM Pharmaceuticals Sdn Bhd

ketoconazole

cream, 2% Apotex Mexico Protein, (S.A. de C.V.), Aspen Pharmacare,Beacons Pharmaceuticals Pte Ltd., Gracure Pharmaceuticals Ltd.,IVAX Pharmaceuticals Mexico, (S.A. de C.V.), Purna Pharmaceuti-cals NV

tablet, 200 mg Artesan Pharma GmbH & Co. KG, Aspen Pharmacare, BeltapharmSpA, Bilim Pharmaceutical Ind., Far Manguinhos, Gracure Pharma-ceuticals Ltd., Hovid SDN. BHN., Intas Pharmaceuticals Ltd., IVAXPharmaceuticals Mexico, (S.A. de C.V.), Lachifarma SRL,Pharmadrug, Pharmchem International Ltd., Remedica Ltd., SMPharmaceuticals Sdn Bhd, Strides Arcolab Ltd., The GovernmentPharmaceutical Organization



110

Antifungal medicines Manufacturer

miconazole

cream/ointment 2% (as nitrate) 15 g tube Beacons Pharmaceuticals Pte Ltd., Hovid SDN. BHN., LachifarmaSRL, Pharmchem International Ltd., Purna Pharmaceuticals NV

cream/ointment 2% (as nitrate) 20 g tube Apotex Mexico Protein, (S.A. de C.V.)

cream/ointment 2% (as nitrate) 30 g tube Beltapharm SpA, Ecobi Farmaceutici S.a.s., Gracure Pharmaceuti-cals Ltd., Lachifarma SRL, Pharmadrug, Pharmchem InternationalLtd., Purna Pharmaceuticals NV

cream/ointment 2% (as nitrate) 40 g tube IVAX Pharmaceuticals Mexico, (S.A. de C.V.)

nystatin

pessary, 100,000 IU Artesan Pharma GmbH & Co. KG, Cipla Ltd., Pharmadrug, SMPharmaceuticals Sdn Bhd, The Acme Laboratories Ltd.

tablet, 100,000 IU Artesan Pharma GmbH & Co. KG, Cipla Ltd.

tablet, 500,000 IU Apotex Mexico Protein, (S.A. de C.V.), Artesan Apotex MexicoProtein, (S.A. de C.V.), Artesan Pharma GmbH & Co. KG, CiplaLtd., Pharmadrug, Sanavita Aktiengesellschaft & Co., The AcmeLaboratories Ltd.

Antiprotozoal medicines

pentamidine

powder for injection, 200 mg (isetionate) in vial Neon Antibiotics PVT. Ltd.

powder for injection, 300 mg (isetionate) in vial Aventis Intercontinental, Combino Pharm, S.L., Lab.Filaxis International S.A., Neon Antibiotics PVT. Ltd.

pyrimethamine

tablet, 25 mg Gracure Pharmaceuticals Ltd., Shiba

tinidazole

tablet, 500 mg Gracure Pharmaceuticals Ltd., Intas Pharmaceuticals Ltd.,Remedica Ltd.

Antiviral medicines

aciclovir

cream, 5% *Cipla Ltd., Ecobi Farmaceutici S.a.s., Gracure PharmaceuticalsLtd., IVAX Pharmaceuticals Mexico, (S.A. de C.V.)

powder for injection, 250 mg (as sodium salt) in 10–ml vial Combino Pharm, S.L., Lab. Filaxis International S.A., NeonAntibiotics PVT. Ltd.

tablet, 200 mg Alpharma, Apotex Mexico Protein, (S.A. de C.V.), AspenPharmacare, Beacons Pharmaceuticals Pte Ltd., *Cipla Ltd.,Hovid SDN. BHN., IPCA Laboratories Ltd., IVAX PharmaceuticalsMexico, (S.A. de C.V.), Lab. Filaxis International S.A., Pharmadrug,*Ranbaxy Laboratories Ltd., Remedica Ltd., Samchully Pharm.Co., Ltd., SM Pharmaceuticals Sdn Bhd

tablet, 400 mg Alpharma, Aspen Pharmacare, Beacons Pharmaceuticals Pte Ltd.,*Cipla Ltd., Ecobi Farmaceutici S.a.s., Hovid SDN. BHN., IPCALaboratories Ltd., *Ranbaxy Laboratories Ltd., Remedica Ltd.,Samchully Pharm. Co., Ltd., SM Pharmaceuticals Sdn Bhd

tablet, 800 mg *Cipla Ltd., Combino Pharm, S.L., Ecobi Farmaceutici S.a.s.,IPCA Laboratories Ltd., Lab. Filaxis International S.A., LaboratoriosCinfa S.A., *Ranbaxy Laboratories Ltd., Remedica Ltd.

111

Antiviral medicines Manufacturer

ganciclovir

powder for IV infusion, 500 mg in vial *Hoffmann-La Roche Ltd., Lab. Filaxis International S.A.

Antiviral medicines – Antiretrovirals

abacavir (ABC)

syrup, 20 mg/ml *Glaxo SmithKline

tablet, 300 mg Cipla Ltd., *Glaxo SmithKline

didanosine (ddI)

buffered chewable tablet, 100 mg Apotex Mexico Protein, (S.A. de C.V.), Aurobindo Pharma Ltd.,*Bristol-Myers Squibb (FR), Bristol-Myers Squibb (SA), CiplaLtd., Donato y Zurlo S.A., Far Manguinhos, Ranbaxy LaboratoriesLtd., Strides Arcolab Ltd.

buffered chewable tablet, 25 mg Apotex Mexico Protein, (S.A. de C.V.),*Bristol-Myers Squibb (FR),Bristol-Myers Squibb ( SA), Cipla Ltd., Far Manguinhos,Strides Arcolab Ltd.

syrup, 2 g *Bristol-Myers Squibb ( FR), Bristol-Myers Squibb (SA)

unbuffered enteric coated capsule, 250 mg Bristol-Myers Squibb ( FR), Cipla Ltd., Ranbaxy Laboratories Ltd.

unbuffered enteric coated capsule, 400 mg Bristol-Myers Squibb ( FR), Cipla Ltd., Ranbaxy Laboratories Ltd.

efavirenz (EFZ)

capsule, 200 mg Aurobindo Pharma Ltd., Cipla Ltd., Lab. Filaxis International S.A.,Ranbaxy Laboratories Ltd.

tablet, 600 mg Aurobindo Pharma Ltd., Cipla Ltd., Ranbaxy Laboratories Ltd.

indinavir (IDV)

capsule, 200 mg Cipla Ltd., Donato y Zurlo S.A., *Hetero Drugs Ltd.NPI,New GPC Inc.

capsule, 400 mg Aurobindo Pharma Ltd., Cipla Ltd., Far Manguinhos, Lab. FilaxisInternational S.A., Strides Arcolab Ltd.,*Ranbaxy Laboratories Ltd.

lamivudine (3TC)

syrup, 50 mg/5 ml *Cipla Ltd., *Glaxo SmithKline,The Government Pharmaceutical Organization

tablet, 150 mg Aurobindo Pharma Ltd., Cheil Jedang Corp., *Cipla Ltd.,Donato y Zurlo S.A., Far Manguinhos, *Glaxo SmithKline,*Hetero Drugs Ltd.NPI, Intas Pharmaceuticals Ltd., IPCALaborato-ries Ltd., Lab. Filaxis International S.A., New GPC Inc,*Ranbaxy Laboratories Ltd., Strides Arcolab Ltd. ,The Government Pharmaceutical Organization

tablet, 300 mg Ranbaxy Laboratories Ltd.

nelfinavir (NFV)

capsule, 250 mg Aurobindo Pharma Ltd., Cipla Ltd., Donato y Zurlo S.A., F.*Hoffmann-La Roche Ltd., Lab. Filaxis International S.A.

powder for oral solution, 50 mg/g *Hoffmann-La Roche Ltd

nevirapine (NVP)

syrup, 50 mg/5 ml *Boehringer Ingelheim Gmbh, Cipla Ltd., The GovernmentPharmaceutical Organization




112

Antiviral medicines – Antiretrovirals Manufacturer

tablet, 200 mg Aurobindo Pharma Ltd., *Boehringer Ingelheim Gmbh , CheilJedang Corp.,*Cipla Ltd.,Far Manguinhos,*Hetero Drugs LtdNPI

Lab. Filaxis International S.A., New GPC Inc, *Ranbaxy Labora*Ranbaxy Laboratories Ltd., Strides Arcolab Ltd. ,The Government Pharmaceutical Organization

saquinavir (SQV)

(hard gel and soft gel) capsule, 200 mg *F. Hoffmann-La Roche Ltd.

stavudine (d4T)

capsule, 15 mg *Bristol-Myers Squibb ( FR),The Government Pharmaceutical Organization

capsule, 20 mg Aspen Pharmacare, *Bristol-Myers Squibb ( FR), Bristol-MyersSquibb ( SA), The Government Pharmaceutical Organization

capsule, 30 mg Aspen Pharmacare, Aurobindo Pharma Ltd., *Bristol-MyersSquibb ( FR), Bristol-Myers Squibb (SA), Cipla Ltd., Donato yZurlo S.A., Far Manguinhos, *Hetero Drugs Ltd§, New GPC Inc,*Ranbaxy Laboratories Ltd., Strides Arcolab Ltd.,The Government Pharmaceutical Organization

capsule, 40 mg Apotex Mexico Protein, (S.A. de C.V.), Aspen Pharmacare,Aurobindo Pharma Ltd., *Bristol-Myers Squibb ( FR), Bristol-Myers Squibb (SA), Cheil Jedang Corp., Cipla Ltd., Donato y ZurloS.A., Far Manguinhos, *Hetero Drugs LtdNPI, Lab. FilaxisInternational S.A., New GPC Inc, Ranbaxy Laboratories Ltd.,Samchully Pharm. Co., Ltd., Strides Arcolab Ltd.,The Government Pharmaceutical Organization

syrup, 1 mg/ml Bristol-Myers Squibb ( FR), Bristol-Myers Squibb (SA),The Government Pharmaceutical Organization

zalcitabine (ddC)

tablet, 0.375 mg Apotex Mexico Protein, (S.A. de C.V.), *Hoffman-La Roche Ltd

tablet, 0.75 mg Apotex Mexico Protein, (S.A. de C.V.), *Hoffman-La Roche Ltd,Lab. Filaxis International S.A.

zidovudine (AZT or ZDV)

capsule, 100 mg Apotex Mexico Protein, (S.A. de C.V.), Aurobindo Pharma Ltd.,Cheil Jedang Corp., *Cipla Ltd., *Combino Pharm, S.L.,Donato y Zurlo S.A., Far Manguinhos, *Glaxo SmithKline, IPCALaboratories Ltd., Lab. Filaxis International S.A., New GPC Inc,Ranbaxy Laboratories Ltd., Samchully Pharm. Co., Ltd., StridesArcolab Ltd. , The Government Pharmaceutical Organization

capsule, 250 mg Apotex Mexico Protein, (S.A. de C.V.), Cheil Jedang Corp.,*Combino Pharm, S.L., Donato y Zurlo S.A.,*Glaxo Smith Kline, Lab. Filaxis International S.A.,Samchully Pharm. Co., Ltd.

injection, 10 mg/ml in 20–ml vial *Glaxo SmithKline

oral solution, 50 mg/5 ml *Cipla Ltd., *Combino Pharm, S.L., *Glaxo SmithKline

tablet, 300 mg Aurobindo Pharma Ltd., *Cipla Ltd., *Combino Pharm, S.L.,*Glaxo SmithKline, *Hetero Drugs LtdNPI, New GPC Inc,*Ranbaxy Laboratories Ltd., Samchully Pharm. Co., Ltd.,Strides Arcolab Ltd., The Government Pharmaceutical Organization


113

Antiviral medicines - Antiretrovirals (combinations) Manufacturer

3TC/AZT

tablet, 300/150 mg Aurobindo Pharma Ltd., Cheil Jedang Corp., *Cipla Ltd.,Donato y Zurlo S.A., Far Manguinhos, *Glaxo SmithKline,*Hetero Drugs LtdNPI Lab. Filaxis International S.A.,New GPC Inc, *Ranbaxy Laboratories Ltd.,Strides Arcolab Ltd., The Government Pharmaceutical Organization

3TC/d4T/NVP

tablet, 150/30/200 mg *Ranbaxy Laboratories Ltd.

tablet, 150/40/200 mg Cheil Jedang Corp., *Cipla Ltd., New GPC Inc, *RanbaxyLaboratories Ltd., Strides Arcolab Ltd., The GovernmentPharmaceutical Organization

ABC/3TC/ZDV

tablet, 300/150/300 mg *Glaxo SmithKline, Ranbaxy Laboratories Ltd.

AZT/3TC/NVP

tablet, 300/150/200 mg Aurobindo Pharma Ltd., Cipla Ltd.

Table 2. Antineoplastic medicines

Cytotoxic medicines Manufacturer

bleomycin

powder for injection, 15 mg 15 mg (as sulfate) in vial Aventis Intercontinental, Neon Antibiotics PVT. Ltd.

calcium folinate (leucovorin)

tablet, 15 mg Ecobi Farmaceutici S.a.s., Lab. Filaxis International S.A.,Medac GmbH, International Operations

doxorubicine HCl

powder for injection, 10 mg in 5–ml vial Lab. Filaxis International S.A., Medac GmbH, InternationalOperations, Neon Antibiotics PVT. Ltd.,Pharmchem International Ltd.

powder for injection, 50 mg in 25–ml vial Lab. Filaxis International S.A., Medac GmbH, InternationalOperations, Neon Antibiotics PVT. Ltd.,Pharmchem International Ltd.

etoposide

injection, 20 mg/ ml in 5–ml ampoule Cipla Ltd., Intas Pharmaceuticals Ltd., Lab. Filaxis InternationalS.A., Medac GmbH, International Operations,Neon Antibiotics PVT. Ltd.

methotrexate

injection, 25 mg/ml (as sodium salt) in 2–ml vial Aventis Intercontinental, Neon Antibiotics PVT. Ltd.

powder for injection, 50 mg (as sodium salt) in 2–ml vial Aventis Intercontinental, Lab. Filaxis International S.A., NeonAntibiotics PVT. Ltd.

tablet, 2.5 mg Aventis Intercontinental, Cipla Ltd., Neon Antibiotics PVT. Ltd.,Remedica Ltd.

vinblastine

powder for injection, 10 mg (sulfate) in 10–ml vial *Cipla Ltd., Lab. Filaxis International S.A.,Neon Antibiotics PVT.Ltd.



114

Cytotoxic medicines Manufacturer

vincristine

injection, 1 mg/ml (sulfate) in vial *Cipla Ltd., Lab. Filaxis International S.A., PharmchemInternational Ltd.

powder for injection, 1 mg (sulfate) in 1–ml vial Neon Antibiotics PVT. Ltd.

vinorelbine

injection concentrate 10 mg/ml in vial

Table 3. Medicines used for the treatmentof mental and substance abuse disorders

Medicines used in depressive disorders Manufacturer

amitriptyline

tablet, 25 mg (as hydrochloride) Aspen Pharmacare, Gracure Pharmaceuticals Ltd., Intas Pharma-ceuticals Ltd., Pharmchem International Ltd., Remedica Ltd.,The Government Pharmaceutical Organization

fluoxetine

tablet, 20 mg Apotex Mexico Protein, (S.A. de C.V.), Aspen Pharmacare,CombinoPharm, S.L., Genepharm SA, IVAX Pharmaceuticals Mexico, (S.A.de C.V.), Laboratorios Cinfa S.A., Pharmchem International Ltd.,Ranbaxy Laboratories Ltd., Remedica Ltd.

Medicines used in generalized anxietyand sleep disorders

methotrimepazine/levomepromazine

tablet, 25 mg Aventis Intercontinental, Pharmadrug

Medicines used in treatment of opioid dependence

naltrexone HCl

tablet, 50 mg Intas Pharmaceuticals Ltd., Lachifarma SRL

Table 4. Analgesics

Opioid analgesics Manufacturer

codeine

tablet, 30 mg (phosphate) Aspen Pharmacare, Beacons Pharmaceuticals Pte Ltd.,Pharmchem International Ltd., Rekah Pharmaceutical Group,Remedica Ltd.

methadone

tablet, 5 mg Pharmchem International Ltd.

morphine

injection, 10 mg/ml (sulfate or HCl), in 1–ml ampoule Aspen Pharmacare, Lab. Renaudin, Martindale PharmaceuticalsLtd., Molteni Farmaceutici, Pharchem International Ltd.

oral solution, 10 mg/5 ml (sulfate or HCl) Molteni Farmaceutici, Pharmchem International Ltd.

115

Opioid analgesics Manufacturer

pethidine

injection, 50 mg/ml (hydrochloride) in 1–ml ampoule Aspen Pharmacare, Martindale Pharmaceuticals Ltd., NeonLaboratories Ltd., Pharmchem International Ltd.

injection, 50 mg/ml (hydrochloride) in 2–ml ampoule Aspen Pharmacare, Lab. Renaudin, Martindale PharmaceuticalsLtd., Molteni Farmaceutici, Neon Laboratories Ltd., Pharmadrug,Pharmchem International Ltd.

tablet, 50 mg Martindale Pharmaceuticals Ltd., Pharmchem International Ltd.

tablet, 100 mg Pharmchem International Ltd.

Table 5. Gastrointestinal medicines

Antacids and other antiulcer medicines Manufacturer

omeprazole

capsule, 10 mg Aventis Ltd., Cipla Ltd., IVAX Pharmaceuticals Mexico, (S.A. deC.V.), Lyka Labs Ltd., Mepha Ltd., Shiba Pharmaceuticals &Chemicals Ltd., SM Pharmaceuticals Sdn Bhd

capsule, 20 mg Alembic Ltd., Apotex Mexico Protein, (S.A. de C.V.), AurobindoPharma Ltd., Aventis Ltd., Cipla Ltd., Demo S.A., PharmaceuticalIndustry, Genepharm SA, Gracure Pharmaceuticals Ltd., HovidSDN. BHN., Intas Pharmaceuticals Ltd., IVAX PharmaceuticalsMexico, (S.A. de C.V.), Laboratorios Andr—maco S.A.,Laboratorios Cinfa S.A., Mepha Ltd., Remedica Ltd., ShibaPharmaceuticals & Chemicals Ltd., SM Pharmaceuticals Sdn Bhd,Strides Arcolab Ltd. , The Acme Laboratories Ltd.

capsule, 40 mg Aurobindo Pharma Ltd., Aventis Ltd., IVAX PharmaceuticalsMexico, (S.A. de C.V.), Laboratorios Andr—maco S.A., MephaLtd., Shiba Pharmaceuticals & Chemicals Ltd., The AcmeLaboratories Ltd.

powder for injection, 40 mg (as sodium salt) in vial Neon Antibiotics PVT. Ltd.,

powder for IV infusion, 40 mg (as sodium salt) in vial Genepharm SA, Neon Antibiotics PVT. Ltd.

Antiemetic medicines

dimenhydrinate

tablet, 50 mg Apotex Mexico Protein, (S.A. de C.V.), Beacons PharmaceuticalsPte Ltd., Laboratorios Cinfa S.A., The Government PharmaceuticalOrganization

metoclopramide

injection 5 mg/ml in 2–ml ampoule Aspen Pharmacare, Aventis Ltd., CLARIS Lifesciences Ltd., Lab.Renaudin, The Government Pharmaceutical Organization

tablet, 10 mg (as hydrochloride) Alpharma, Apotex Mexico Protein, (S.A. de C.V.), AspenPharmacare, Aventis Ltd., Genepharm SA, IPCA Laboratories Ltd.,Remedica Ltd., The Acme Laboratories Ltd.

prochlorperazine

injection, 12.5 mg/ml Aventis Ltd., Pharmadrug

tablet, 5 mg Aspen Pharmacare, Aventis Ltd., Remedica Ltd.

tablet, 10 mg Pharmadrug



116116

ANNEX 3

Further reading, referencesand contacts

http://dcc2.bumc.bu.edu/richardl/IH820/Resource_materials/Web_Resources/Levison-hiddencosts.doc

• A commitment to action for expanded access to HIV/AIDS treatment. International HIV Treatment AccessCoalition, WHO, Geneva, 2002 (WHO/HIV/2002.24).

http://www.who.int/hiv/pub/prev_care/who_hiv_2002_24.pdf

• Berwick D. “We All Have AIDS”: The case for reducingthe cost of HIV medicines to zero. British Medical Jour-nal, 2002, 324: 214–218.

• Guidelines on interaction with commercial enterprisesto achieve health outcomes. Annex to guidelines onworking with the private sector to achieve health out-comes. WHO, Geneva, 2000 (EB107/20).

http://www.who.int/gb/EB_WHA/PDF/EB107/ee20.pdf

• Guidelines for drug donations (interagency document).WHO, Geneva, 1999 (WHO/EDM/PAR/99.4).

http://www.who.int/medicines/docs/pagespublications/ supplypub.htm.

Treatment guidelines

• Antiretroviral drugs and the prevention of mother-to-child transmission of HIV infection in resource-limitedsettings. Draft document. WHO, Geneva, 2004.

http://www.who.int/3by5/publications/documents/pmtct/en/

• Integrated management of adolescent and adult illness(IMAI) modules. WHO, Geneva, 2004 (WHO/CDS/IMAI/2004.1).

http://www.who.int/3by5/publications/documents/imai/en/

• WHO Model Formulary 2004. WHO, Geneva, 2004.

http://mednet3.who.int/mf/intro.asp

• A public health approach for scaling up antiretroviral(ARV) treatment. A toolkit for programme managers.WHO, Geneva, 2003.

http://www.who.int/3by5/publications/documents/isbn9241591161/en/

General

• Two pills a day saving lives: Fixed-dose combinations(FDCs) of antiretroviral drugs. MSF, Geneva, 2004.

http://www.accessmed-msf.org/documents/factsheetfdc.pdf

• AIDS epidemic update. UNAIDS/WHO, Geneva, 2003.

http://www.unaids.org/Unaids/EN/Resources/Publications/Corporate+publications/AIDS+epidemic+update+-+December+2003.asp

• Treating 3 million by 2005: Making it happen. UNAIDS/WHO, Geneva, 2003.

http://www.who.int/3by5/publications/documents/isbn9241591129/en/

• Guidelines for price discounts of single-source phar-maceuticals (interagency document). WHO, Geneva,2003 (WHO/EDM/PAR/2003.3).

http://www.who.int/medicines/library/docseng_from_a_to_z.shtml#g

• Human capacity-building plan for scaling up HIV/AIDStreatment. WHO, Geneva, 2003.

http://www.who.int/3by5/publications/documents/capacity_building/en/

• Partnership work: the health service-community inter-face for the prevention, care and treatment of HIV/AIDS. Report of a WHO consultation, 5-6 December2002. WHO, Geneva, 2003.

http://www.who.int/hiv/pub/prev_care/hivpub43/en/

• Handbook on access to HIV/AIDS-related treatment. Acollection of information, tools and resources for NGOs,CBOs and PLWA groups. Joint publication UNAIDS, WHOand International AIDS Alliance, Geneva, 2003.

http://www.unaids.org/publications/documents/health/access/NGOtoolkit/index.html

http://www.who.int/hiv/pub/prev_care/pub29/en/

• Levison L Policy and programming options for reduc-ing the procurement costs of essential medication indeveloping countries. Boston University School of Pub-lic Health, 2003.

117

ANNEX 3. FURTHER READING, REFERENCES AND CONTACTS

• The selection and use of essential medicines. Reportof the WHO Expert Committee, 2003 (including the13th Model List of Essential Medicines). WHO,Geneva, 2003 (WHO Technical Report Series, No. 920).

http://www.who.int/medicines/organization/par/edl/expertcomm.shtml

• Saving mothers, saving families: The MTCT-Plus Initia-tive. Perspectives and practice in antiretroviral treat-ment. Case study. WHO, Geneva, 2003.

http://www.who.int/hiv/pub/prev_care/pub40/en/

• Guidelines for the management of sexually transmit-ted infections. WHO, Geneva, 2003.

http://www.who.int/hiv/pub/sti/pub6/en/

• Scaling up antiretroviral therapy in resource limited set-tings: Treatment guidelines for a public health approach.WHO, Geneva, 2003.

http://www.who.int/3by5/publications/documents/arv_guidelines/en/

• Emergency scale-up of antiretroviral therapy in re-source-limited settings: Technical and operational rec-ommendations to achieve 3 by 5. Report of the WHO/UNAIDS consultation,18-21 November 2003, Zambia.WHO, Geneva, 2003.

http://www.who.int/3by5/publications/documents/zambia/en/

• Provision of antiretroviral therapy in resource-limitedsettings: A review of experience up to August 2003.WHO and UK Department for International Development,2003.

http://www.who.int/3by5/publications/documents/dfid/en/

• Monitoring and evaluating of national ART programmesin the rapid scale-up to 3 by 5. Draft document. WHO,Geneva, 2003.

http://www.who.int/3by5/publications/documents/artindicators/en/

• Guidelines for surveillance of HIV drug resistance. Draftdocument for review. WHO, Geneva, 2003.

http://www.who.int/3by5/publications/documents/hivdrugsurveillance/en/

• HIV/AIDS care and treatment: A clinical course for peo-ple caring for people living with HIV/AIDS. Family HealthInternational, Arlington, VA, 2003.

http://www.fhi.org/en/HIVAIDS/Publications/manualsguidebooks/careandtreatmentclinicalcourse.htm

• AIDS Palliative Care: UNAIDS Technical Update, Octo-ber 2000.

http://www.unaids.org/publications/documents/care/general/JC-PalliCare-TU-E.pdf

Substance abuse

• Evidence for action: Effectiveness of community-basedoutreach in preventing HIV/AIDS among injecting drugusers. WHO, Geneva, 2004.

http://www.who.int/hiv/pub/prev_care/idu/en/

• Training guide for HIV prevention outreach to injectingdrug users. Workshop Manual. WHO, Geneva, 2004.

http://www.who.int/hiv/pub/prev_care/hivpubidu/en/

• Substitution maintenance therapy in the managementof opioid dependence and HIV/AIDS prevention. WHO/UNODC/UNAIDS position paper. WHO, Geneva, 2004.

http://www.who.int/substance_abuse/publications/psychoactives/en/

HIV testing

• Rapid HIV tests. Draft guidelines for use in HIV testingand counselling services in resource-constrained set-tings. WHO, Geneva, 2004.

http://www.who.int/hiv/pub/vct/rapidhivtests/en/

• Increasing access to HIV testing and counselling. Re-port of a WHO Consultation, 19-21 November 2002.WHO, Geneva, 2003.

http://www.who.int/hiv/pub/vct/pub36/en/

• The right to know. New approaches to HIV testing andcounselling. WHO, Geneva, 2003 (WHO/HIV/2003.08).


• Increasing Access to Knowledge of HIV Status. Con-clusions of a WHO Consultation, 3-4 December 2001.WHO, Geneva, 2002 (WHO/HIV/2002.09).


TB/HIV

• Interim policy on collaborative TB/HIV activities. WHO,Geneva, 2004 (WHO/HTM/HIV/2004.1).

http://www.who.int/hiv/pub/prev_care/tbhiv/en/

Procurement guides

• HIV/AIDS Medicines and related supplies: Contempo-rary context and procurement. Technical Guide. WorldBank, Washington, DC, 2004.

http://siteresources.worldbank.org/INTPROCUREMENT/Resources/Technical-Guide-HIV-AIDS.pdf

• Surmounting challenges: Procurement of antiretroviralmedicines in low- and middle-income countries, WHO/MSF, Geneva, 2003.

http://www.accessmed-msf.org/documents/procurementreport.pdf

• Managing Drug Supply. 3rd edition. WHO and Manage-ment Sciences for Health, Arlington, VA, 2003.

http://www.msh.org/what_MSH_does/cpm/resources.html#top

• Operational principles for good pharmaceutical procure-ment (interagency document). WHO, Geneva, 1999(WHO/EDM/PAR/99.5).

http://www.who.int/medicines/library/par/who-edm-par-99-5/who-edm-par-99-5.shtml

Intellectual Property rights andpharmaceuticals

• HIV/AIDS medicines and related supplies: Contempo-rary context and procurement. Technical guide. Chap-ter 2 and Annex B. World Bank, Washington, DC, 2004.

http://siteresources.worldbank.org/INTPROCUREMENT/Resources/Technical-Guide-HIV-AIDS.pdf

• Drug patents under the spotlight: sharing practicalknowledge about pharmaceutical patents. MSF, Ge-neva, 2003.

http://www.accessmed-msf.org/prod/publications.asp?scntid=225200385263&contenttype=PARA&

• Globalization, patents and drugs. An annotated bibli-ography. Health Economics and Drugs Series number9. WHO, Geneva, 2002 (EDM/PAR/2002.1).

http://www.who.int/medicines/library/par/who-edm-par-2001-1/who-edm-par-2001-1.htm

• Implications of the DOHA Declaration on the TRIPSAgreement and public health. WHO, Geneva, 2002(WHO/EDM/PAR/2002.3).

http://www.who.int/medicines/library/docseng_from_a_to_z.shtml#p

• Network for monitoring the impact of globalization and

TRIPS on access to medicines. Health Economics andDrugs Series number 11. WHO, Geneva, 2002 (WHO/EDM/PAR/2002.1).

http://www.who.int/medicines/library/docseng_from_a_to_z.shtml#n

• Globalization, TRIPS and access to pharmaceuticals.WHO Policy Perspectives on Medicines number 3.WHO, Geneva, 2001.

http://www.who.int/medicines/organization/ood/ood6pagers.shtml

• Patent situation of HIV/AIDS-related drugs in 80 coun-tries. UNAIDS/WHO, Geneva, 2000.

http://www.who.int/medicines/library/docseng_from_a_to_z.shtml#g

• Globalization and access to drugs: Perspectives onthe WTO/TRIPS Agreement. Health Economics andDrugs Series number 7 (revised). WHO, Geneva, 1998(WHO/DAP/98.9).

http://www.who.int/medicines/library/dap/who-dap-98-9-rev/who-dap-98-9.shtml

Pricing strategies

• Drug Price Information Services: What is WHO doingto improve drug price information? WHO InformationSheet.

http://www.who.int/medicines/organization/par/ipc/drugpriceinfo.shtml

• The Consumer Project on Technology. Fact sheet.

http://cptech.org/ip/health/econ/pricingstudies.html

• Medicine prices: a new approach to measurement.WHO and Health Action International, Geneva,2003(WHO/EDM/PAR/2003.2).

http://www.who.int/medicines/library/prices.shtml

• Cost-containment mechanisms for essential medicines,including antiretrovirals, in China. WHO, Geneva, 2003(WHO/EDM/PAR/2003.6).

http://www.who.int/medicines/library/docseng_from_a_to_z.shtml#c

• Overview of pharmaceutical pricing and reimbursementregulation in Europe. Panos Kanavos, LSE Health andSocial Care, 2001.

• Policies on pricing and reimbursement of medicines inEurope: Networking for information exchange amongpolicy makers. Annex: Comparative Review of DrugPrices. WHO Regional Office for Europe, Copenhagen,2000.


118

• Public-private roles in the pharmaceutical sector. Im-plications for equitable access and rational drug use.WHO, Geneva, 1997 (WHO/DAP/99.12).

http://www.who.int/medicines/library/dap/who-dap-97-12/who-dap-97-12.shtml

• Alternative drug pricing policies in the Americas.WHO, Geneva, 1995 (WHO/DAP/95.6).

http://www.who.int/medicines/library/dap/who-dap-95-6/who-dap-95-6.shtml

Websites

Partner sitesUNAIDS: www.unaids.org

UNICEF: www.unicef.org

WHO: www.who.int

MSF: www.msf.org

Others websites for information relatedto HIV/AIDSAIDS Education Global Information System:

http://www.aegis.com

AVERT (an international HIV/AIDS charity):

http://www.avert.org

DOTS-plus for multidrug resistant TB:

http://www.who.int/gtb/policyrd/DOTSplus.htm

Health Action International. http://www.haiweb.org:

International HIV/AIDS Alliance. http://www. aidsalliance .org/

John Snow Inc/DELIVER:

http://deliver.jsi.com

Management Sciences for Health:

http://www.msh.org/

Sexually Transmitted Infections:

http://www.who.int/hiv/pub/sti/en/

Stop TB Partnership:

http://www.stoptb.org

The Global Fund to Fight AIDS, Tuberculosisand Malaria:

http://www.theglobalfund.org/en/

The Global TB Drug Facility:

http://www.stoptb.org/GDF/

Contacts• For further information about suppliers or

products, please contact:

Sources of Medicines for HIV/AIDS SurveyPharmaceutical and Micronutrients TeamUNICEF Supply DivisionFax: +45 35 269421 E-mail: [email protected]

• For further information on HIV test kit evalua-tion or the bulk procurement scheme, contact:Essential Health and Technologies (EHT)World Health OrganizationFax +41 22 791 4836

• For any comments on this document, oradditional information that could be useful tothis project, please complete the feedbackform, Annex 5, and return it to:Sources of medicines for HIV/AIDS SurveyPharmaceutical and Micronutrient TeamUNICEF Supply DivisionUnicef plads Freeport DK-2100 CopenagenDenmarkFax: +45 35 269421Email: [email protected]

ANNEX 3. FURTHER READING, REFERENCES AND CONTACTS

119

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RVS SIDE OF PAGE 119

ANNEX 4.FURTHER READING, REFERENCES, AND CONTACTS

ANNEX 4

Untangling the web of pricereductions: a pricing guidefor the purchase of ARVsfor developing countries.

BLANK PAGE -

RVS SIDE ANNEX 4INTRODUCTION PAGE

Please fill out this form and fax it to UNICEF Supply Division +45 35 26 94 21, e-mail: [email protected], or post it to:UNICEF SD, Pharmaceutical and Micronutrient Group – HIV/AIDS Survey, Freeport DK-2100 Copenhagen Ø, Denmark

1. GENERAL INFORMATION

Your name

Occupation

Company name/Organization name

Address

Telephone Fax

Email (required)

Internet address

2. FEEDBACKWhat did you think of the publication in general?

■ Excellent, very useful ■ Good, quite useful ■ Satisfactory, reasonably useful

■ Poor, not useful—please indicate why:

What did you think of the medicines included in the publication?

■ Good selection of medicines

■ More medicines required, for example:

■ Fewer medicines required, remove:

What did you think of the pricing information?

■ Good, enough information on the prices of drugs of interest

■ Poor, not enough information

Have you contacted any of the manufacturers listed?

■ Yes ■ No

Other comments:

3. ENQUIRY■ I would like to participate in the next Survey (Manufacturing companies only)

■ I would like to receive more copies of the Publication

Other enquiry:

✁

Feedback and enquiry form


BLANK PAGE -

RVS SIDE FEED BACK

BLANK -

INSIDE BACK COVER

ISBN 92 4 159179 X

19th

Apr

il 20

04

a pr

icin

g gu

ide

for th

e pu

rcha

se o

f ARV

s fo

r de

velo

ping

cou

ntries

priceUn

tang

ling

the

web

of p

rice

redu

ctio

ns:

6th

Editi

on

coun

tries

redu

ctio

ns

price

eligibility

priceco

untries

redu

ctions

compa

ny

3Ta

ble

of c

onte

nts

4Gen

eral

bac

kgro

und

and

obje

ctiv

es4

Met

hodo

logy

5Pr

ices

5Bar

riers

to

acce

ssin

g pr

ice

offe

rs6

Evol

utio

n of

pric

es s

ince

Aug

ust 20

01 o

f W

HO rec

omm

ende

d fir

st lin

e re

gim

ens

7Th

e ch

alle

nges

of pa

edia

tric for

mul

atio

ns7

Rese

arch

and

dev

elop

men

t fo

r HIV

/AID

S8

How

to

use

thes

e ta

bles

?9

Prac

tical

exa

mpl

e: p

rice

and

elig

ibili

ty o

f th

ree

prod

ucts

fro

m thr

ee d

iffer

ent co

mpa

nies

in

four

cou

ntrie

s11

Tabl

es11

Ta

ble

1: S

umm

ary

of b

est AR

V p

rice

offe

rs b

y se

lect

ed p

harm

aceu

tical

com

pani

es for

elig

ible

dev

elop

ing

coun

trie

s11

Ta

ble

1a –

Nuc

leos

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NRT

Is)

12

Tabl

e 1b

– N

on-N

ucle

osid

e Re

vers

e Tr

ansc

ripta

se Inh

ibito

rs (NNRT

Is)

13Ta

ble

1c –

Nuc

leot

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NtR

TIS)

14

Tabl

e 1d

– P

rote

ase

Inhi

bito

rs (PI

s)15

Ta

ble

1e –

Fixed

Dos

e Co

mbi

natio

ns (FD

Cs)

16

Tabl

e 1f

– C

ombi

ned

blis

ters

17

Tabl

e 1g

– P

aedi

atric

For

mul

atio

ns18

Ta

ble

2: C

ompa

ny A

RV o

ffer

s an

d re

stric

tions

for

dev

elop

ing

coun

trie

s, a

dult

and

paed

iatric for

mul

atio

ns18

Ta

ble

2a –

Nuc

leos

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NRT

Is)

22 Ta

ble

2b –

Non

-Nuc

leos

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NNRT

Is)

23 Ta

ble

2c –

Nuc

leot

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NtR

TIs)

24Ta

ble

2d –

Pro

teas

e In

hibi

tors

(PI

s)27

Tabl

e 2e

– F

ixed

Dos

e Co

mbi

natio

ns (FD

Cs)

29Ta

ble

2f –

Sel

ecte

d ge

neric

com

pani

es’A

RV o

ffers

and

res

trictio

ns for

dev

elop

ing

coun

trie

s30

An

nexe

s30

An

nex

1: L

east

Dev

elop

ed C

ount

ries

(LDCs

)30

An

nex

2: H

uman

Dev

elop

men

t In

dex

(HDI)

31 An

nex

3: S

ub-S

ahar

an c

ount

ries

31 An

nex

4: W

orld

Ban

k lo

w-in

com

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d lo

w-m

iddl

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com

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untrie

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An

nex

5: C

ompa

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onta

cts

33Glo

ssar

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Refe

renc

es

Tabl

e of

con

tent

s

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

3

Gen

eral

bac

kgro

und

and

obje

ctiv

es

This

is

the

sixt

h ed

itio

n of

“ Unt

angl

ing

the

web

of pr

ice

redu

ctio

ns:

a pr

icin

g gu

ide

for

the

purc

hase

of AR

Vs for

dev

elop

ing

coun

trie

s ”. Th

e fir

st e

dition

was

publ

ishe

d in

Oct

ober

200

1[1] .

The

lack

of cl

ear

info

rmat

ion

onph

arm

aceu

tica

l pr

ices

on

the

inte

rnat

iona

l m

arke

t is

a s

igni

fican

tba

rrie

r to

im

prov

ing

acce

ss t

oes

sent

ial m

edic

ines

in

deve

lopi

ngco

untrie

s. T

he s

itua

tion

is

partic

ular

ly c

ompl

ex in

the

case

of

antire

trov

iral

s (A

RVs)

.

The

data

in

this

gui

de o

n ARV

price

sof

fere

d by

origi

nato

r co

mpa

nies

and

som

e ge

neric

com

pani

es in

low

- an

dm

iddl

e-in

com

e co

untrie

s ar

e m

eant

to p

rovi

de p

oten

tial

buy

ers

with

clea

r an

d ve

rifie

d da

ta. Th

isin

form

atio

n is

int

ende

d fo

r us

e by

gove

rnm

ent

and

non-

prof

itpr

ocur

emen

t ag

enci

es, as

wel

l as

othe

r bu

lk p

urch

aser

s of

ARV

s,in

clud

ing

heal

th fac

ilities

and

non

-go

vern

men

tal or

gani

sation

s (N

GOs)

.

This

doc

umen

t in

clud

es p

rici

ngin

form

atio

n on

bot

h ad

ult

and

paed

iatric

for

mul

atio

ns, an

d is

mea

nt t

o be

use

d in

tan

dem

with

Not

all

the

prod

ucts

in

this

docu

men

t ha

ve b

een

pre-

qual

ified

by W

HO o

r ap

prov

ed b

y M

SF.

Ther

efor

e, p

rocu

rem

ent

agen

cies

shou

ld fol

low

the

ir o

wn

proc

edur

esin

thi

s re

spec

t. U

ltim

atel

y it is

nation

al r

egul

ator

y au

thor

itie

s th

atar

e re

spon

sibl

e fo

r ap

prov

ing

the

use

of a

giv

en d

rug

from

a g

iven

man

ufac

ture

r.

Pric

ing

info

rmat

ion

on o

ther

esse

ntia

l dr

ugs

and

diag

nost

ics

used

for

HIV

/AID

S ca

n be

fou

nd in

the

last

ver

sion

of “ S

ourc

es a

nd P

rices

of S

elec

ted

Med

icin

es a

ndDia

gnos

tics

for

Peop

le L

ivin

g w

ithHIV

/AID

S ”[3

] .

We

have

ind

icat

ed fix

ed-d

ose

com

bina

tion

s (F

DCs

) in

thi

s re

port

sinc

e M

SF h

as fou

nd t

hat

usin

gth

ese

prod

ucts

fac

ilita

tes

prog

ram

impl

emen

tation

and

pat

ient

the

pre-

qual

ifica

tion

rep

ort

calle

d“P

ilot

Proc

urem

ent, Q

ualit

y an

dSo

urci

ng P

roje

ct:

Acce

ss t

o HIV

/AID

SDru

gs a

nd D

iagn

ostic

s of

Acc

epta

ble

Qua

lity ”

, a

proj

ect

initia

ted

by W

HO

and

deve

lope

d in

col

labo

ration

with

othe

r Uni

ted

Nat

ions

Org

anis

atio

ns(U

NAID

S, U

NIC

EF, UNFP

A). T

his

pre-

qual

ifica

tion

pro

ject

eva

luat

esph

arm

aceu

tica

l m

anuf

actu

rers

and

prod

ucts

acc

ordi

ng t

o W

HO

reco

mm

ende

d st

anda

rds

of q

ualit

yan

d co

mpl

ianc

e w

ith

Goo

dM

anuf

actu

ring

Pra

ctic

es. W

HO p

re-

qual

ifica

tion

is

give

n to

spe

cific

prod

ucts

pro

duce

d by

spe

cific

com

pani

es a

t sp

ecifi

c m

anuf

actu

ring

site

s. It

is p

art

of a

n on

goin

gpr

oces

s th

at w

ill e

xpan

d as

the

partic

ipat

ion

of s

uppl

iers

inc

reas

es.

An

upda

ted

list

of p

rodu

cts

isre

gula

rly

post

ed o

n th

e w

ebsi

tes

ofW

HO a

nd o

ther

UN-c

olla

bora

ting

agen

cies

[2] ;

prod

ucts

on

this

lis

t ar

eco

mm

only

ref

erre

d to

as

“ WHO p

re-

qual

ified

” . T

his

list

of “

pre-

qual

ified

”dr

ugs

is a

n im

portan

t to

ol for

NGOs

and

Gov

ernm

ents

to

assi

st t

hem

with

drug

pro

cure

men

t.

In a

ll th

e ta

bles

in

this

rep

ort, p

re-

qual

ified

pro

duct

s ar

e in

dica

ted

inbo

ld a

nd w

ith

an a

ster

isk.

com

plia

nce.

For

fur

ther

inf

orm

atio

nse

e M

SFBrief

ing

Not

e on

FDCs

[4] .

The

new

edi

tion

of W

HO T

reat

men

tGui

delin

es s

peci

ally

men

tion

s th

eus

eful

ness

of FD

Cs in

reso

urce

-poo

rse

ttin

gs. Not

onl

y ar

e FD

Csad

vant

ageo

us fro

m a

med

ical

poi

ntof

vie

w, bu

t th

ey a

re a

lso

the

mos

taf

ford

able

opt

ion

in m

ost

case

s. T

hetrip

le F

DC

d4T/

3TC/

NVP

from

tw

oge

neric

man

ufac

ture

rs h

as r

ecen

tly

been

pre

-qua

lifie

d by

WHO.

Met

hodo

logy

In o

rder

to

obta

in a

ccur

ate

info

rmat

ion

on d

isco

unte

d pr

ice

offe

rs b

y bo

th o

rigi

nato

r an

d ge

neric

com

pani

es, fir

ms

wer

e co

ntac

ted

and

aske

d to

pro

vide

inf

orm

atio

nab

out

drug

, do

sage

and

phar

mac

eutica

l fo

rm, pr

ice

per

unit

(or

daily

dos

e), re

strict

ions

tha

tap

ply

to t

he o

ffers

(el

igib

ility

), a

nd

This

six

th e

ditio

n pr

ovid

es:

•up

date

d in

form

atio

non

price

s fo

r el

igib

le c

ount

ries

, in

clud

ing

both

price

per

unit a

nd p

rice

per

pat

ient

per

yea

r fo

r ad

ult

and

paed

iatric

form

ulat

ions

•up

date

d in

form

atio

n an

d cl

arifi

catio

nson

the

con

dition

s an

d re

strict

ions

appl

ying

to

thes

e of

fers

•pr

actic

al e

xam

ples

4 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

5

addi

tion

al c

omm

ents

. Th

e lis

t of

gene

ric

com

pani

es inc

lude

d in

thi

sre

port is

by n

o m

eans

exh

aust

ive[5

] .All

gene

ric

drug

s in

clud

ed in

this

pric

ing

guid

e ha

ve a

t le

ast

been

clea

red

for

mar

keting

in

thei

rco

untrie

s of

origi

n.

•All

pric

es a

re q

uote

d in

US

dolla

rs

and

conv

ersi

ons

wer

e m

ade

on

the

day

the

pric

e w

as r

ecei

ved.

•All

pric

es w

ere

chec

ked

and

verifie

d by

com

pani

es.

•In

tab

le 1

, pr

ices

are

rou

nded

. Th

e ex

act

pric

es inc

ludi

ng d

ecim

als

are

in t

able

2.

The

annu

al c

ost

of t

hera

py w

asca

lcul

ated

acc

ordi

ng t

o W

HO

[6] an

dCe

ntre

s fo

r Dis

ease

Con

trol

and

Prev

ention

(CD

C)[7

]do

sing

sch

edul

es(for

tho

se p

rodu

cts

not re

com

men

ded

in t

he W

HO G

uide

lines

).

Pric

es

Sinc

e 20

00, th

e in

tern

atio

nal pr

ices

of s

ome

first

-line

ARV

s ha

vetu

mbl

ed, du

e to

com

petition

fro

mge

neric

com

pani

es, su

stai

ned

publ

icpr

essu

re, di

scou

nt o

ffers

fro

mor

igin

ator

com

pani

es, an

d th

e

grow

ing

polit

ical

atten

tion

pai

d to

the

AID

S ep

idem

ic. Se

vera

l m

ajor

even

ts h

ave

play

ed a

key

rol

e,be

ginn

ing

with

a pr

eced

ent

set

byBra

zil w

hich

mad

e a

trip

le d

rug

com

bina

tion

pos

sibl

e at

les

s th

anUS$

3000

per

pat

ient

per

yea

r (p

py)

in t

he 9

0s.

Publ

ic p

ress

ure

on t

heph

arm

aceu

tica

l co

mpa

nies

bui

lt u

pov

er t

he fol

low

ing

year

s, a

nd in

May

2000

, fiv

e or

igin

ator

com

pani

esan

noun

ced

a ne

w p

artn

ersh

ip, th

eAc

cele

rating

Acc

ess

Initia

tive

(AAI). It

was

the

first

tim

e th

at t

hese

com

pani

es h

ad ini

tiat

ed d

iffer

ential

pric

ing

polic

ies

for ARV

s. In

Febr

uary

2001

, th

e In

dian

gen

eric

s fir

m C

ipla

shat

tere

d th

e pr

ice

barrie

r w

hen

itpu

blic

ly a

nnou

nced

tha

t it w

ould

sell

a trip

le c

ombi

nation

for

US$

350

ppy. D

ue t

o th

is t

ype

of c

ompe

tition

,pr

ices

con

tinu

e to

fal

l. To

day, t

hech

eape

st t

ripl

e co

mbi

nation

(FD

C)pr

equa

lifie

d by

WHO c

osts

US$

244/

year

.

The

grap

h on

pag

e 6

show

s th

eev

olut

ion

of p

rices

sin

ce A

ugus

t20

01 for

WHO r

ecom

men

ded

first

line

regi

men

s.

Oth

er ini

tiat

ives

, lik

e th

e And

ean

initia

tive

or

mor

e re

cent

ly t

heCl

into

n Fo

unda

tion

ann

ounc

emen

t,ar

e al

so b

ring

ing

dow

n pr

ices

. Th

eAnd

ean

initia

tive

, th

roug

h re

gion

alne

gotiat

ions

with

phar

mac

eutica

lco

mpa

nies

, ha

s fix

ed a

ref

eren

cepr

ice

for

all th

e co

untrie

s in

the

regi

on. Th

e Cl

into

n Fo

unda

tion

has

brok

ered

a d

eal w

ith

gene

ric

mak

ers

whi

ch b

ring

s fix

ed d

ose

trip

leco

mbi

nation

s do

wn

to U

S$14

0 pe

rye

ar. Th

ese

initia

tive

s al

thou

gh n

otw

idel

y av

aila

ble

will

affe

ct s

ome

spec

ific

coun

trie

s.

Pric

es c

ited

in

this

doc

umen

t ar

e th

ebe

st int

erna

tion

al o

ffers

mad

e by

com

pani

es, bu

t de

liver

y co

nditio

nsm

ust

be t

aken

int

o ac

coun

t. B

oth

gene

rics

and

origi

nato

r co

mpa

nies

impo

se r

estric

tion

s on

the

ir o

ffers

,bu

t on

ly o

rigi

nato

r co

mpa

nies

app

lyge

ogra

phic

al lim

its

(a d

iffer

ential

pric

ing

polic

y).

Bar

rier

s to

acc

essi

ng p

rice

offer

s

Info

rmat

ion

is p

rese

nted

in

a ta

ble

form

at t

o fa

cilit

ate

the

com

pariso

nof

price

offe

rs. Th

is for

mat

hig

hlig

hts

the

lack

of st

anda

rdis

atio

n am

ong

diffe

rent

com

pani

es o

n el

igib

ility

and

term

s an

d co

nditio

ns. Fo

rin

stan

ce, so

me

com

pani

es u

seUNCT

AD (

Leas

t Dev

elop

ed C

ount

ries

)cr

iter

ia, ot

hers

UNDP,

som

e ot

hers

Wor

ld B

ank

clas

sific

atio

n (H

uman

Dev

elop

men

t In

dex)

.

It sh

ould

be

note

d th

at s

ome

deve

lopi

ng c

ount

ries

have

bee

nex

clud

ed b

y so

me

or a

ll co

mpa

nies

.It

mea

ns tha

t so

me

coun

trie

s ca

nnot

bene

fit fro

m a

ny d

iffer

entia

l pr

ice.

In

regi

ons

like

East

ern

Euro

pe, on

ly24

% o

f th

e co

untrie

s ca

n be

nefit

from

the

bes

t pr

ice

and

in L

atin

Amer

ica

and

Carib

bean

, on

ly 3

1%.*

It is

im

portan

t to

men

tion

tha

tge

ogra

phic

al lim

itat

ions

do

not

conc

ern

FDCs

, si

nce

mos

t FD

Cs a

repr

oduc

ed b

y ge

neric

com

pani

es.

Even

whe

n a

spec

ific

coun

try

isel

igib

le, al

l pu

rcha

sers

with

in the

coun

try

may

not

be

elig

ible

for

redu

ced

prices

. Th

e co

nditi

ons

ofso

me

offe

rs c

an b

e re

stric

tive

and

som

etim

es o

nly

NGOs,

Gov

ernm

ents

and

natio

nal an

d in

tern

atio

nal

inst

itutio

ns a

re e

ligib

le.

* W

e re

fer

to b

est

poss

ible

price

s (tho

se in

Tabl

e 1)

, bu

t w

e no

te t

hat

som

e co

mpa

nies

(Ro

che

and

Mer

ck &

Co.

Inc

.) o

ffer

also

a s

econ

d di

ffere

ntia

l pr

ice.

The

con

dition

s fo

r th

ese

seco

nd p

rice

s ar

e le

ss r

estric

tive

and

can

be

foun

d in

Tab

le 2

.

1200

US$

1000

US$

800U

S$

600U

S$

400U

S$

200U

S$

0

Evol

utio

n of

price

s si

nce

Augu

st 2

001

of W

HO r

ecom

men

ded

first

lin

e re

gim

ens

cost of treatment (US$/year)

Aug

01

Oct

01

Dec

01

Feb

02

Apr

02

Ju

n 02

Au

g 02

O

ct 0

2 D

ec 0

2 F

eb 0

3 A

pr 0

3 Jun

03

Au

g 03

Oct

03

Dec

03

Jan

04

Fe

b 04

A

pr 0

4

d4T/

3TC/

NVP

d4T/

3TC+

EFV

ZDV/3

TC/N

VP

ZDV/3

TC+E

FV

6 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

The

char

t ab

ove

show

s th

at e

favi

renz

con

tain

ing

regi

men

s ar

e m

ore

expe

nsiv

e. In

addi

tion

ther

e is

no

EFV

cont

aini

ng trip

leFD

C av

aila

ble

on the

mar

ket ye

t.

Trip

le F

DC

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

7

Del

iver

y co

nditi

ons

also

affe

ct p

rices

.In

man

y ca

ses

clea

ranc

e fe

es,

impo

rtat

ion

taxe

s (w

hen

they

exi

st)

and

tran

spor

t ar

e no

t in

clud

ed.

Ano

ther

bar

rier

to

acce

ssin

g th

ebe

st p

rice

is

drug

ava

ilabi

lity

in a

coun

try. S

ince

ARV

s ar

e no

t al

way

sre

gist

ered

and

/or

avai

labl

e in

“sel

ecte

d co

untrie

s”, m

any

offe

rsfrom

pha

rmac

eutica

l co

mpa

nies

may

rem

ain

“the

oret

ical

”.

In a

dditio

n, p

rice

s ci

ted

in t

his

repo

rt m

ay n

ot c

orre

spon

d to

end

-us

er p

rice

s (p

rice

s to

pat

ient

s),

sinc

e ot

her

fact

ors

may

inc

reas

epr

ices

suc

h as

nat

iona

l di

stribu

tion

and

hand

ling

char

ges,

mar

k-up

rate

s, a

nd n

atio

nal an

d/or

im

port

and

sale

s ta

xes.

Pate

nts

and

use

of fle

xibi

litie

sex

isting

in

TRIP

S an

d re

info

rced

by

the

Doh

a Dec

lara

tion

on

TRIP

S an

dPu

blic

Hea

lth

(suc

h as

com

puls

ory

licen

ce, go

vern

men

t us

e) c

an a

lso

influ

ence

the

ava

ilabi

lity

ofm

edic

ines

in

a co

untry. P

aten

tin

form

atio

n is

not

inc

lude

d in

the

pres

ent

anal

ysis

. So

me

info

rmat

ion

abou

t th

e pa

tent

sta

tus

of A

RVs

inso

me

coun

trie

s ca

n be

fou

nd in

“ Pat

ent

Situ

atio

n of

HIV

/AID

Sre

late

d dr

ugs

in 8

0 co

untrie

s ”,

WHO/U

NAID

S, 2

000[8

]an

d th

e M

SFre

port “

Dru

g pa

tent

s un

der

the

spot

light

: sh

arin

g pr

actica

lkn

owle

dge

abou

t ph

arm

aceu

tica

lpa

tent

s ”, M

ay 2

003[9

] . Fo

r fu

rthe

rde

tails

, re

fer

to t

he p

ract

ical

gui

de“ H

IV/A

IDS

med

icin

es a

nd r

elat

edsu

pplie

s: c

onte

mpo

rary

con

text

and

proc

urem

ent ”

, in

par

ticu

lar

Chap

ter

4 an

d Ann

ex B

(Th

e W

orld

Ban

k,W

ashi

ngto

n, F

ebru

ary

2004

).

The

chal

leng

e of

pae

diat

ricfo

rmul

atio

ns

Ther

e is

an

urge

nt n

eed

to d

evel

opfix

ed-d

ose

com

bina

tion

s fo

r us

e in

child

ren.

Pro

toco

ls for

pae

diat

ric

patien

ts a

re c

ompl

icat

ed a

ndex

pens

ive.

The

price

s of

pae

diat

ric

form

ulat

ions

rem

ain

high

er t

han

thos

e fo

r ad

ults

, es

peci

ally

for

seco

nd lin

e trea

tmen

ts. Fo

rex

ampl

e, a

pae

diat

ric

patien

t w

ould

have

to

pay

USD

284

per

yea

r fo

r a

d4T+

3TC+

NVP

regi

men

usi

ng t

hree

diffe

rent

syr

ups

whi

le a

n ad

ult

will

take

the

sam

e re

gim

en in

a FD

C fo

rUSD

244

. Fo

r a

seco

nd lin

e(Z

DV+d

dI+N

FV), t

he c

ost

oftrea

tmen

t fo

r a

child

wou

ld b

e USD

3150

/yea

r w

hile

for

the

adu

lt it

wou

ld b

e USD

109

6 pe

r ye

ar. In

thi

sca

se, no

ne o

f th

em w

ould

be

able

to u

se a

FDC.

**

Rese

arch

and

dev

elop

men

t (R

&D)

for

HIV

/AID

S

Paed

iatric

for

mul

atio

ns a

re n

ot t

heon

ly a

rea

whe

re t

here

is

a ne

ed for

R&

D. Fo

r bo

th a

dults

and

child

ren,

new

dru

gs, di

agno

stic

too

ls, an

dva

ccin

es a

re n

eede

d fo

r HIV

/AID

S.Pha

rmac

eutica

l in

vest

men

t in

rese

arch

and

dev

elop

men

t la

rgel

yre

spon

ds t

o m

arke

t po

tent

ial in

the

indu

strial

ised

wor

ld. W

e ne

ed t

oen

sure

tha

t R&

D a

lso

resp

onds

to

the

need

s of

pat

ient

s in

dev

elop

ing

and

leas

t de

velo

ped

coun

trie

s.

** F

or t

hese

exa

mpl

es w

e us

ed t

he c

ase

of a

10

kg, 3

year

old

pat

ient

in

an M

SF p

roje

ct, fo

llow

ing

the

prot

ocol

s of

thi

s pr

ojec

t. W

hen

com

paring

price

s w

e us

ed t

he b

est

poss

ible

price

for

eve

ry m

olec

ule.

Pric

es:

tabl

e 1

show

s th

e be

st p

rice

offe

rs o

f so

me

gene

ric

and

orig

inat

orpr

oduc

ers

for

each

ant

iretrov

iral

dru

g, (

incl

udin

g fix

ed-d

ose

com

bina

tion

s),

rega

rdle

ss o

f el

igib

ility

con

dition

s. F

igur

es w

ithi

n br

acke

ts ind

icat

e pr

ice

inUS$

per

uni

t (c

apsu

les,

tab

lets

etc

.). Pr

ices

per

pat

ient

per

yea

r ha

ve b

een

calc

ulat

ed a

ccor

ding

to

daily

dos

es g

iven

eithe

r in

WHO g

uide

lines

or

in C

DC

guid

elin

es (

for

thos

e pr

oduc

ts n

ot r

ecom

men

ded

in W

HO g

uide

lines

). P

rice

sca

n be

use

d as

a r

efer

ence

with

supp

liers

. Origi

nato

r co

mpa

nies

set

diff

eren

tpr

ices

dep

endi

ng o

n th

e co

untry. W

hich

cou

ntry

is

elig

ible

and

the

con

dition

sto

ben

efit fro

m t

hese

diff

eren

tial

price

s ar

e sp

ecifi

ed in

Tabl

e 2.

Rest

rict

ions

: ta

ble

2 sh

ows

rest

rict

ions

im

pose

d by

gen

eric

(2f

) an

dor

igin

ator

(2a

to

2e)

com

pani

es a

nd p

rovi

des

indi

cation

s ab

out

the

avai

labi

lity

of o

ffers

in

indi

vidu

al c

ount

ries

. Th

ere

is n

o un

iform

diff

eren

tial

pric

ing

syst

em a

nd e

ach

orig

inat

or c

ompa

ny s

ets

geog

raph

ical

lim

its

to t

heir

prog

ram

mes

. Gen

eric

com

pani

es h

ave

no g

eogr

aphi

cal lim

its

but

may

hav

equ

antity

rel

ated

con

dition

s.

Plea

se r

efer

to

Ann

exes

1, 2

and

4 fo

r up

date

d co

untry

clas

sific

atio

n by

UNCT

AD (

Leas

t Dev

elop

ed C

ount

ries

), U

NDP

(Hum

an D

evel

opm

ent

Inde

x) a

ndW

orld

Ban

k (L

ow inc

ome

Coun

trie

s). Ann

ex 3

lis

ts s

ub-S

ahar

an c

ount

ries

.

This

doc

umen

t is

als

o av

aila

ble

in F

renc

h an

d Sp

anis

h on

w

ww.a

cces

smed

-msf

.org

The

follo

win

g ta

ble

(pag

es 9

and

10)

sum

mar

ises

price

s an

d el

igib

ility

cond

itio

ns o

f th

ree

prod

ucts

fro

m t

hree

diff

eren

t co

mpa

nies

in

four

cou

ntries

.

How

to

use

thes

eta

bles

8 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

COM

PANIE

S an

d OFF

ERS

MAL

AWI

It is

a L

DC1

Low

HDI2

Low

Inc

ome

Econ

omy3

It is

a S

ub-S

ahar

an c

ount

ry4

Adul

t HIV

pre

vale

nce

15%

5

CAM

BODIA

It is

a L

DC1

Med

ium

HDI2

Low

Inc

ome

Econ

omy3

It is

not

a S

ub-S

ahar

an c

ount

ry4

Mer

ck S

tocr

in®

(ef

avire

nz)

600

mg

Pric

es a

nd e

ligib

ility

(co

untrie

s):

– US$

346

.75/

year

for

Low

Hum

anDev

elop

men

t In

dex

(HDI) c

ount

ries

plu

sm

ediu

m H

DI co

untrie

s w

ith

adul

t HIV

prev

alen

ce o

f 1%

or

grea

ter[1

0]

– US$

767

/yea

r fo

r m

ediu

m H

DI

coun

trie

s w

ith

adul

t HIV

pre

vale

nce

less

than

1%

[11]

Del

iver

y of

goo

ds:

CIF[1

0]

Elig

ibili

ty (

bodi

es):

Gov

ernm

ents

, in

tern

atio

nal

orga

niza

tion

s, N

GOs,

priva

te s

ecto

ror

gani

zation

s (e

.g. em

ploy

ers,

hos

pita

lsan

d in

sure

rs).

Mer

ck a

nd C

o., In

c. d

oes

not

rule

out

supp

lyin

g ARV

s to

pat

ient

s th

roug

hre

tail

phar

mac

ies.

Is M

alaw

i an

elig

ible

cou

ntry

?Ye

s, for

the

first

price

Am I a

n el

igib

le p

urch

aser

?Ye

s, if G

over

nmen

t, int

erna

tion

alor

gani

zation

, NGO o

r pr

ivat

e se

ctor

orga

niza

tion

How

muc

h w

ill S

tocr

in 6

00 c

ost

in m

yco

untry?

US$

346

.75/

year

Will

del

iver

y co

nditi

ons

incr

ease

thi

spr

ice?

Yes,

I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

ltran

spor

t

Is C

ambo

dia

an e

ligib

le c

ount

ry?

Yes,

for

the

first

price

Am I a

n el

igib

le p

urch

aser

?Ye

s, if Gov

ernm

ent, int

erna

tion

alor

gani

zation

, NGO, pr

ivat

e se

ctor

orga

niza

tion

Ranb

axy

Triv

iro

LNS®

(d4

T/3T

C/NVP)

40

mg+

150

mg+

200

mg

Pric

es a

nd e

ligib

ility

(co

untrie

s):

US$

292

/yea

r. All

coun

trie

s ar

e el

igib

leDel

iver

y of

goo

ds:

FOB D

elhi

/Mum

bai (Ind

ia)[1

0]

Pric

es a

pply

to

orde

rs for

a m

inim

um o

f1.

5 m

illio

n un

its.

Diff

eren

t pr

ices

are

offe

red

for

smal

ler

quan

tities

(50

0 00

0or

1 m

illio

n un

its)

.El

igib

ility

(bo

dies

):NGOs

and

Gov

ernm

ents

or

Prog

ram

ssu

ppor

ted

by t

hem

.

Is M

alaw

i an

elig

ible

cou

ntry

?Ye

sAm

I a

n el

igib

le p

urch

aser

?Ye

s, if an

NGO, Gov

ernm

ent

or a

prog

ram

sup

ported

by

them

How

muc

h w

ill T

rivi

ro L

NS

cost

in

my

coun

try?

US$

292

/yea

r if

I or

der

mor

e th

an 1

.5m

illio

n un

its

Will

del

iver

y co

nditi

ons

incr

ease

thi

spr

ice?

Yes,

I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

lan

d in

tern

atio

nal tran

spor

t

Is C

ambo

dia

an e

ligib

le c

ount

ry?

Yes

Am I a

n el

igib

le p

urch

aser

?Ye

s, if an

NGO, Gov

ernm

ent

or a

prog

ram

sup

ported

by

them

Roch

e Vi

race

pt®

(ne

lfina

vir) 2

50 m

g

Pric

es a

nd e

ligib

ility

(co

untrie

s):

– CH

F 11

94 /ye

ar =

US$

942

/yea

r fo

r al

lco

untrie

s in

sub

-Sah

aran

Afric

a an

d al

l UN

defin

ed L

east

Dev

elop

ed C

ount

ries

– CH

F 40

55/y

ear=

US$

320

1/ye

ar in

Low

inco

me

coun

trie

s an

d lo

wer

mid

dle

inco

me

coun

trie

s –

as c

lass

ified

by

the

Wor

ld B

ank.

Del

iver

y of

goo

ds:

Term

s an

d co

nditio

ns:

Effe

ctiv

e da

te 1

stM

arch

200

3.

FCA

Bas

el (

CH), C

AD (

Cash

Aga

inst

Doc

umen

ts)

30 d

ays

at s

ight

.M

inim

um o

rder

and

del

iver

y am

ount

per

ship

men

t is

CHF

10,0

00 (

US$

789

1)[10]

Elig

ibili

ty (

bodi

es):

Gov

ernm

ents

, Non

Pro

fit Ins

titu

tion

alPr

ovid

ers

of H

IV c

are,

NGOs.

Is M

alaw

i an

elig

ible

cou

ntry

?Ye

s, for

the

first

price

Am I a

n el

igib

le p

urch

aser

?Ye

s, if Gov

ernm

ent, N

on P

rofit

Ins

titu

tion

alPr

ovid

ers

of H

IV c

are

or N

GO

How

muc

h w

ill V

irac

ept

cost

in

my

coun

try?

US$

942

/yea

rW

ill d

eliv

ery

cond

ition

s in

crea

se t

his

pric

e?Ye

s, I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

lan

d in

tern

atio

nal tran

spor

t

Is C

ambo

dia

an e

ligib

le c

ount

ry?

Yes,

for

the

first

price

Am I a

n el

igib

le p

urch

aser

?Ye

s, if Gov

ernm

ent, N

on P

rofit

Ins

titu

tion

alPr

ovid

ers

of H

IV c

are

or N

GO

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

9

Prac

tical

exa

mpl

es:

Pric

e an

d el

igib

ility

of th

ree

prod

ucts

fro

m t

hree

diffe

rent

com

pani

es in

four

cou

ntries

1 LD

C: L

east

Dev

elop

ed C

ount

ry a

ccor

ding

to

UNCT

AD c

lass

ifica

tion

. Se

e an

nex

1 of

thi

s do

cum

ent

for

full

list

of L

DCs

. 2

HDI: H

uman

Dev

elop

men

t In

dex

acco

rdin

g to

UNDP

clas

sific

atio

n. C

ount

ries

are

cla

ssifi

ed o

n Lo

w H

DI,

Med

ium

HDI an

d Hig

h HDI (thi

s la

st o

ne d

oes

not

conc

ern

diffe

rent

ial pr

ices

). L

ow a

nd M

iddl

e HDI lis

ts o

f co

untrie

s ar

e in

the

Ann

ex 2

of th

is d

ocum

ent.

3 W

orld

Ban

k cl

assi

ficat

ion

depe

nds

on inc

ome.

Cou

ntries

are

cla

ssifi

ed a

s Lo

w Inc

ome

Econ

omie

s, M

iddl

e-Lo

w Inc

ome

Econ

omie

s, M

iddl

e In

com

e Ec

onom

ies

and

Upp

er. M

iddl

e In

com

e Ec

onom

ies

(the

se las

t tw

o do

not

con

cern

diff

eren

tial

price

s). Lo

w Inc

ome

Econ

omy

and

Low

er-M

iddl

e In

com

e Ec

onom

y co

untrie

s ar

e lis

ted

in t

he A

nnex

4 o

f th

is d

ocum

ent.

4 Se

e an

nex

3 of

thi

s do

cum

ent

for

full

list

of s

ub-S

ahar

an A

fric

an c

ount

ries

pub

lishe

d by

the

Wor

ld B

ank.

5

Mer

ck p

rice

s de

pend

on

Adul

t HIV

pre

vale

nce,

whi

ch is

period

ical

ly r

evie

wed

by

UNAID

S (w

ww.w

ho.in

t/em

c-hi

v/fa

ct_s

heet

s/All_

coun

trie

s.ht

ml).

Adul

t HIV

pre

vale

nce

2.7%

5

UKRA

INE

It is

not

a L

DC1

Med

ium

HDI2

Low

er-M

iddl

e In

com

e Ec

onom

y3

It is

not

a S

ub-S

ahar

an c

ount

ry4

Adul

t HIV

pre

vale

nce

1%5

COLO

MBIA

It is

not

a L

DC1

Med

ium

HDI2

Low

er-M

iddl

e In

com

e Ec

onom

y3

It is

not

a S

ub-S

ahar

an c

ount

ry4

Adul

t HIV

pre

vale

nce

o.4%

5

How

muc

h w

ill S

tocr

in 6

00 c

ost

in m

yco

untry?

US$

346

.75/

year

Will

del

iver

y co

nditi

ons

incr

ease

thi

spr

ice?

Yes,

I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

ltran

spor

t

Is t

he U

krai

ne a

n el

igib

le c

ount

ry?

Yes,

for

the

first

price

Am I a

n el

igib

le p

urch

aser

?Ye

s, if G

over

nmen

t, int

erna

tion

alor

gani

zation

, NGO o

r pr

ivat

e se

ctor

orga

niza

tion

How

muc

h w

ill S

tocr

in 6

00 c

ost

in m

yco

untry?

US$

346

.75/

year

Will

del

iver

y co

nditi

ons

incr

ease

thi

spr

ice?

Yes,

I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

ltran

spor

t

Is C

olom

bia

an e

ligib

le c

ount

ry?

Yes,

for

the

sec

ond

pric

eAm

I a

n el

igib

le p

urch

aser

?Ye

s, if G

over

nmen

t, int

erna

tion

alor

gani

zation

, NGO o

r pr

ivat

e se

ctor

orga

niza

tion

How

muc

h w

ill S

tocr

in 6

00 c

ost

in m

yco

untry?

US$

767

/yea

rW

ill d

eliv

ery

cond

ition

s in

crea

se t

his

pric

e?Ye

s, I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

ltran

spor

t

How

muc

h w

ill T

rivi

ro L

NS

cost

in

my

coun

try?

US$

292

/yea

r if

I or

der

mor

e th

an 1

.5m

illio

n un

its

Will

del

iver

y co

nditi

ons

incr

ease

thi

spr

ice?

Yes,

I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

lan

d in

tern

atio

nal tran

spor

t

Is t

he U

krai

ne a

n el

igib

le c

ount

ry?

Yes

Am I a

n el

igib

le p

urch

aser

?Ye

s, if an

NGO, Gov

ernm

ent

or a

prog

ram

sup

ported

by

them

How

muc

h w

ill T

rivi

ro L

NS

cost

in

my

coun

try?

US$

292

/yea

r if

I or

der

mor

e th

an 1

.5m

illio

n un

its

Will

del

iver

y co

nditi

ons

incr

ease

thi

spr

ice?

Yes,

I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

lan

d in

tern

atio

nal tran

spor

t

Is C

olom

bia

an e

ligib

le c

ount

ry?

Yes

Am I a

n el

igib

le p

urch

aser

?Ye

s, if an

NGO, Gov

ernm

ent

or a

prog

ram

sup

ported

by

them

How

muc

h w

ill T

rivi

ro L

NS

cost

in

my

coun

try?

US$

292

/yea

r if

I or

der

mor

e th

an 1

.5m

illio

n un

its

Will

del

iver

y co

nditi

ons

incr

ease

thi

spr

ice?

Yes,

I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

lan

d in

tern

atio

nal tran

spor

t

How

muc

h w

ill V

irac

ept

cost

in

my

coun

try?

US$

942

/yea

rW

ill d

eliv

ery

cond

ition

s in

crea

se t

his

pric

e?Ye

s, I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

lan

d in

tern

atio

nal tran

spor

t

Is t

he U

krai

ne a

n el

igib

le c

ount

ry?

Yes,

for

the

sec

ond

pric

eAm

I a

n el

igib

le p

urch

aser

?Ye

s, if Gov

ernm

ent, N

on P

rofit

Inst

itut

iona

l Pr

ovid

ers

of H

IV c

are

or N

GO

How

muc

h w

ill V

irac

ept

cost

in

my

coun

try?

US$

320

1/ye

arW

ill d

eliv

ery

cond

ition

s in

crea

se t

his

pric

e?Ye

s, I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

lan

d in

tern

atio

nal tran

spor

t

Is C

olom

bia

an e

ligib

le c

ount

ry?

Yes,

for

the

sec

ond

pric

eAm

I a

n el

igib

le p

urch

aser

?Ye

s, if Gov

ernm

ent, N

on P

rofit

Inst

itut

iona

l Pr

ovid

ers

of H

IV c

are

or N

GO

How

muc

h w

ill V

irac

ept

cost

in

my

coun

try?

US$

320

1/ye

arW

ill d

eliv

ery

cond

ition

s in

crea

se t

his

pric

e?Ye

s, I h

ave

to a

dd c

lear

ance

fee

s +

impo

rtat

ion

taxe

s (w

hen

exis

ting

) +

loca

lan

d in

tern

atio

nal tran

spor

t

10 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

abac

avir

(ABC)

300

2 821

(1.1

25/u

nit)

887*

(1.2

15/u

nit)

803

(1.1

00/u

nit)

1314

(1.8

00/u

nit)

stav

udin

e(d

4T)

30 2 48*

(0.0

66/u

nit)

47 (0.0

65/u

nit)

60 (0.0

82/u

nit)

21*

(0.0

29/u

nit)

36*

(0.0

49/u

nit)

35 (0.0

48/u

nit)

Tabl

e 1a

– N

ucle

osid

e Re

vers

eTr

ansc

ripta

se Inh

ibito

rs (NRT

Is)

All

pric

es a

re in

US$

. Pr

ices

are

give

n bo

th for

a y

early

adul

t do

sean

d by

uni

t.

For

deta

ils o

n el

igib

ility

and

offe

rre

strict

ions

for

cou

ntries

and

inst

itut

ions

, pl

ease

ref

er t

o ta

ble

2aan

d 2f

.

Prod

ucts

on

the

WHO lis

t of

“Pi

lot

Proc

urem

ent, Q

ualit

y an

d So

urci

ng P

roje

ct:

Acce

ss t

o HIV

/AID

S dr

ugs

and

diag

nost

ics

ofac

cept

able

qua

lity”

(14t

h ed

itio

n, 2

8 Ja

nuar

y20

04)[2

]ar

e in

bol

dan

d ha

ve a

n as

terisk

*ne

xt t

o th

e pr

ice.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. B

est

pric

es a

re in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ngto

man

ufac

ture

rs.[1

0]

Ann

ual co

st is

calc

ulat

ed a

ccor

ding

to

the

daily

dos

es g

iven

in

the

WHO “

Scal

ing-

upAn

tiret

rovi

ral Th

erap

y in

Res

ourc

e Li

mite

dSe

ttin

gs:

Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch”

(Jun

e 20

02)[6

] an

d/or

the

“ Gui

delin

es for

the

Use

of An

tiret

rovi

ral

Agen

ts in

HIV

-1-In

fect

ed A

dults

and

Adol

esce

nts ”

[7] ,

by t

he P

anel

on

Clin

ical

Prac

tice

s fo

r th

e Tr

eatm

ent

of H

IV, Ju

ly 2

003.

(§) B

MS

sells

ddI

(di

dano

sine

) in

oth

er

dose

s (p

er m

g pr

ice

rem

ains

the

sam

e)

Tabl

e 1:

Sum

mar

y of

bes

t AR

V pr

ice

offe

rs b

y se

lect

ed p

harm

aceu

tical

com

pani

es for

elig

ible

dev

elop

ing

coun

trie

s

NRT

I(A

bbre

viat

ion)

Stre

ngth

(m

g)

Dai

ly d

ose

Auro

bind

o(Ind

ia)

BM

S(U

S)

Cipl

a(Ind

ia)

Com

bino

phar

m(S

pain

)

GPO

(Tha

iland

)

GSK

(UK)

Het

ero

(Ind

ia)

Ran

baxy

(Ind

ia)

Stride

s(Ind

ia)

dida

nosi

ne(d

dI)

100

(§)

4 197

(0.135

/uni

t)

310*

(0.2

12/u

nit)

292

(0.2

00/u

nit)

146

(0.1

00/u

nit)

415

(0.2

84/u

nit)

dida

nosi

ne(d

dI)

EC 4

00

1 Not

appl

icab

le

270

(0.7

41/u

nit)

168

(0.4

60/u

nit)

335

(0.9

17/u

nit)

lam

ivud

ine

(3TC

)

300

1 102

(0.2

80/u

nit)

Not

ap

plicab

le

100

(0.2

74un

it)

lam

ivud

ine

(3TC

)

150

2 66 (0.0

90/u

nit)

88*

(0.1

20/u

nit)

171

(0.2

34/u

nit)

69*

(0.0

95/u

nit)

55*

(0.0

75/u

nit)

100*

(0.1

37/u

nit)

97 (0.133

/uni

t)

stav

udin

e(d

4T)

40 2 31 (0.0

43/u

nit)

55*

(0.0

75/u

nit)

53 (0.0

72/u

nit)

77 (0.105

/uni

t)

26*

(0.0

35/u

nit)

47 (0.0

64/u

nit)

46 (0.0

63/u

nit)

zido

vudi

ne(Z

DV o

r AZ

T)

300

2 140

(0.1

92/u

nit)

161*

(0.2

20/u

nit)

292*

(0.4

00/u

nit)

290

(0.3

97/u

nit)

212*

(0.2

90/u

nit)

140*

(0.1

92/u

nit)

180*

(0.2

46/u

nit)

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

11

Tabl

e 1b

– N

on-N

ucle

osid

e Re

vers

eTr

ansc

ripta

se Inh

ibito

rs (NNRT

Is)

All

pric

es a

re in

US$

. Pr

ices

are

give

n bo

th for

a y

early

adul

t do

sean

d by

uni

t.

For

deta

ils o

n el

igib

ility

and

offe

rre

strict

ions

for

cou

ntries

and

inst

itut

ions

, pl

ease

ref

er t

o ta

ble

2ban

d 2f

.

Prod

ucts

on

the

WHO lis

t of

“Pi

lot

Proc

urem

ent, Q

ualit

y an

d So

urci

ng P

roje

ct:

Acce

ss t

o HIV

/AID

S dr

ugs

and

diag

nost

ics

ofac

cept

able

qua

lity”

(14t

h ed

itio

n, 2

8 Ja

nuar

y20

04)[2

]ar

e in

bol

dan

d ha

ve a

n as

terisk

*ne

xt t

o th

e pr

ice.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. B

est

pric

es a

re in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ngto

man

ufac

ture

rs.[1

0]

Ann

ual co

st is

calc

ulat

ed a

ccor

ding

to

the

daily

dos

es g

iven

in

the

WHO “

Scal

ing-

upAn

tiret

rovi

ral Th

erap

y in

Res

ourc

e Li

mite

dSe

ttin

gs:

Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch”

(Jun

e 20

02)[6

] an

d/or

the

“ Gui

delin

es for

the

Use

of An

tiret

rovi

ral

Agen

ts in

HIV

-1-In

fect

ed A

dults

and

Adol

esce

nts ”

[7] ,

by t

he P

anel

on

Clin

ical

Prac

tice

s fo

r th

e Tr

eatm

ent

of H

IV, Ju

ly 2

003.

NNRT

Ief

avire

nzef

avire

nzne

vira

pine

(Abb

revi

atio

n)(E

FV)

(EFV

)(N

VP)

Stre

ngth

(m

g)

200

600

200

Dai

ly d

ose

3 1

2

Auro

bind

o43

811

2(In

dia)

(0.4

00/u

nit)

(0.153

/uni

t)

Boe

hrin

ger-I

ngel

heim

438*

(Ger

man

y)

(0.6

00/u

nit)

Cipl

a 46

246

212

4*(In

dia)

(0.4

22/u

nit)

(1.2

67/u

nit)

(0.1

70/u

nit)

GPO

256

(Tha

iland

)(0

.350

/uni

t)

Het

ero

329

347

80*

(Indi

a)(0

.300

/uni

t)(0

.950

/uni

t)(0

.110

/uni

t)

Mer

ck

500

347

(US)

(0.4

57/u

nit)(†

)(0

.950

/uni

t)(†

)

Ranb

axy

427

427

166*

(Indi

a)(0

.390

/uni

t)(1

.170

/uni

t)(0

.228

/uni

t)

Strid

es16

2(In

dia)

(0.2

22/u

nit)

(†)

Pric

es g

iven

in

this

tab

le a

re for

Low

Hum

an D

evel

opm

ent

Inde

x (H

DI) c

ount

ries

plu

s m

ediu

m H

DI co

untrie

s w

ith

adul

tHIV

pre

vale

nce

of 1

% o

r gr

eate

r. Ta

ble

2b g

ives

price

s fo

r m

ediu

m H

DI co

untrie

s w

ith

adul

t HIV

pre

vale

nce

of les

s th

an 1

%[11]

12 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Tabl

e 1c

- N

ucle

otid

e Re

vers

eTr

ansc

ripta

se Inh

ibito

rs (NtR

TIs)

The

pric

e is

in

US$

. Pr

ice

is g

iven

both

for

a y

early

adul

t do

se a

nd b

yun

it.

For

deta

ils o

n el

igib

ility

and

offe

rre

strict

ions

for

cou

ntries

and

inst

itut

ions

, pl

ease

ref

er t

o ta

ble

2c.

Prod

ucts

on

the

WHO lis

t of

“Pi

lot

Proc

urem

ent, Q

ualit

y an

d So

urci

ng P

roje

ct:

Acce

ss t

o HIV

/AID

S dr

ugs

and

diag

nost

ics

ofac

cept

able

qua

lity”

(14t

h ed

itio

n, 2

8 Ja

nuar

y20

04)[2

]ar

e in

bol

dan

d ha

ve a

n as

terisk

*ne

xt t

o th

e pr

ice.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. B

est

pric

es a

re in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ngto

man

ufac

ture

rs.[1

0]

Ann

ual co

st is

calc

ulat

ed a

ccor

ding

to

the

daily

dos

es g

iven

in

the

WHO “

Scal

ing-

upAn

tiret

rovi

ral Th

erap

y in

Res

ourc

e Li

mite

dSe

ttin

gs:

Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch”

(Jun

e 20

02)[6

] an

d/or

the

“ Gui

delin

es for

the

Use

of An

tiret

rovi

ral

Agen

ts in

HIV

-1-In

fect

ed A

dults

and

Adol

esce

nts ”

[7] ,

by t

he P

anel

on

Clin

ical

Prac

tice

s fo

r th

e Tr

eatm

ent

of H

IV, Ju

ly 2

003.

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

13

NtR

TI (Ab

brev

iatio

n)te

nofo

vir

(TDF)

Stre

ngth

(m

g)30

0 m

g

Dai

ly d

ose

1

Gile

ad (US)

475

(1.3

00/u

nit)

PIin

dina

vir

nelfi

navi

rrit

onav

ir sa

quin

avir

(Abb

revi

atio

n)

(IDV

) (N

FV)

(r)

hard

gel

cap

sule

s(S

QV

hgc)

Stre

ngth

(m

g)

400

250

100

200

Dai

ly d

ose

4 (*

*)

10 (**

*)

2 (§

) 10

(#)

Abbo

tt83

*(U

S)

(0

.114

/uni

t)

Auro

bind

o39

315

3333

6(In

dia)

(0.2

69/u

nit)

(0.4

20/u

nit)

(0.4

60/u

nit)

Cipl

a36

517

8939

4(In

dia)

(0.2

50/u

nit)

(0.4

90/u

nit)

(0.5

40/u

nit)

GPO

1621

(Tha

iland

)(0

.444

/uni

t)

Het

ero

321*

1132

204

1022

(Indi

a)

(0.2

20/u

nit)

(0.3

10/u

nit)

(0.2

80/u

nit)

(0.2

80/u

nit)

Mer

ck40

0(U

S)

(0.2

74/u

nit)

Ranb

axy

467*

(Indi

a)(0

.320

/uni

t)

Roch

e94

2*95

6*(S

witz

erla

nd)

0.25

8/un

it(†)

0.26

2/un

it(†)

Strid

es46

3(In

dia)

(0.3

17/u

nit)

Tabl

e 1d

- P

rote

ase

Inhi

bito

rs (PI

s)

All

pric

es a

re in

US$

. Pr

ices

are

give

n bo

th for

a y

early

adul

t do

sean

d by

uni

t.

For

deta

ils o

n el

igib

ility

and

offe

rre

strict

ions

for

cou

ntries

and

inst

itut

ions

, pl

ease

ref

er t

o ta

ble

2dan

d 2f

.

Prod

ucts

on

the

WHO lis

t of

“Pi

lot

Proc

urem

ent, Q

ualit

y an

d So

urci

ng P

roje

ct:

Acce

ss t

o HIV

/AID

S dr

ugs

and

diag

nost

ics

ofac

cept

able

qua

lity”

(14t

h ed

itio

n, 2

8 Ja

nuar

y20

04)[2

]ar

e in

bol

dan

d ha

ve a

n as

terisk

*ne

xt t

o th

e pr

ice.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. B

est

pric

es a

re in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ngto

man

ufac

ture

rs.[1

0]

Ann

ual co

st is

calc

ulat

ed a

ccor

ding

to

the

daily

dos

es g

iven

in

the

WHO “

Scal

ing-

upAn

tiret

rovi

ral Th

erap

y in

Res

ourc

e Li

mite

dSe

ttin

gs:

Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch”

(Jun

e 20

02)[6

] an

d/or

the

“ Gui

delin

es for

the

Use

of An

tiret

rovi

ral

Agen

ts in

HIV

-1-In

fect

ed A

dults

and

Adol

esce

nts ”

[7] ,

by t

he P

anel

on

Clin

ical

Prac

tice

s fo

r th

e Tr

eatm

ent

of H

IV, Ju

ly 2

003.

For

Roch

e, p

rice

s w

ere

prov

ided

in

Swis

sFr

ancs

and

wer

e co

nver

ted

into

US$

(1

US$

= 1

.267

20 C

HF

on 1

Apr

il 20

04)

(**)

The

dai

ly d

ose

refe

rred

to

is 8

00m

g ID

V t

wic

e da

ily w

ith

rito

navi

r 10

0mg

twic

e da

ily a

s bo

oste

r. Th

e pr

escr

ibin

g in

form

atio

n gi

ven

by t

hem

anuf

actu

rer

is 8

00m

g th

ree

tim

es d

aily

(***

) Th

e da

ily d

ose

refe

rred

to

is 1

250

mg

twic

e da

ily a

ltho

ugh

the

dosa

ge o

f 9

tabl

ets

(3 t

able

ts t

hree

tim

es a

day

) ca

n al

so b

e us

ed.

(§)

The

daily

dos

e re

ferred

to

is 1

00m

g tw

ice

daily

, fo

r us

e as

a b

oost

er m

edic

atio

n. T

his

dose

is

not

indi

cate

d in

the

man

ufac

ture

r’s lab

el.

(#)

Saqu

inav

ir h

gc s

houl

d be

use

d in

com

bina

tion

with

low

-dos

e rito

navi

r as

saq

uina

vir/rito

navi

r 10

00m

g/10

0mg

twic

e da

ily(†

) Pr

ices

giv

en in

this

tab

le a

re for

sub

-Sah

aran

Afric

a an

d Le

ast

Dev

elop

ed C

ount

ries

as

UN d

efin

ed. Se

e ta

ble

2d for

price

s fo

r Lo

w Inc

ome

and

Low

er M

iddl

e In

com

e Co

untrie

s, a

s cl

assi

fied

by t

he W

orld

Ban

k.

14 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Prod

ucts

on

the

WHO lis

t of

“Pi

lot

Proc

urem

ent, Q

ualit

y an

d So

urci

ng P

roje

ct:

Acce

ss t

o HIV

/AID

S dr

ugs

and

diag

nost

ics

of a

ccep

tabl

e qu

ality

”(1

4th

editio

n, 2

8 Ja

nuar

y 20

04)[2

]ar

e in

bold

and

have

an

aste

risk

*ne

xt t

o th

e pr

ice.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. B

est

pric

es a

re in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ng t

o m

anuf

actu

rers

.[10]

Ann

ual co

st is

calc

ulat

ed a

ccor

ding

to

the

daily

dos

es g

iven

in

the

WHO “

Scal

ing-

up A

ntire

trov

iral Th

erap

y in

Res

ourc

e Li

mite

d Se

ttin

gs:

Gui

delin

es for

a P

ublic

Hea

lth A

ppro

ach”

(Ju

ne20

02)[6

] an

d/or

the

“Gui

delin

es for

the

Use

of An

tiret

rovi

ral Ag

ents

in

HIV

-1-In

fect

ed A

dults

and

Ado

lesc

ents

”[7] ,

by t

he P

anel

on

Clin

ical

Pra

ctic

es for

the

Tre

atm

ent

of H

IV, Ju

ly 2

003.

Tabl

e 1e

– F

ixed

Dos

e Co

mbi

natio

ns (FD

Cs)

All

pric

es a

re in

US$

. Pr

ices

are

giv

en b

oth

for

a ye

arly

adu

lt d

ose

and

by u

nit.

For

deta

ils o

n el

igib

ility

and

offe

r re

strict

ions

for

cou

ntries

and

ins

titu

tion

s, p

leas

e re

fer

to t

able

s 2.

C om

bina

tion

lopi

navi

r+3T

C+d4

T3T

C+d4

TZD

V+3T

CZD

V+3T

C+NVP

ABC+

3TC+

ZDV

3TC+

d4T+

NVP

3TC+

d4T+

NVP

riton

avir

(LPV

/r)

Stre

ngth

133.

3 +

33.3

150

+ 30

150

+ 40

300

+ 15

030

0 +

150

300

+ 15

0 +

200

1

50 +

30

+ 20

0

150

+ 4

0 +

200

(m

g)+

200

Ther

apeu

tic

PI

NRT

I NRT

INRT

I 2N

RTI +

3NRT

I 2N

RTI +

2NRT

I +

clas

s(es

)NNRT

I

NNRT

I NNRT

I

Dai

ly d

ose

6 2

22

2 2

2 2

Abbo

tt

50

0*(U

S)(0

.228

/uni

t)

Auro

bind

o20

4(In

dia)

(0

.280

/uni

t)

Cipl

a 13

114

619

7*36

523

424

4*(In

dia)

(0

.180

/uni

t)(0

.200

/uni

t)(0

.270

/uni

t)(0

.500

/uni

t)(0

.320

/uni

t)(0

.334

/uni

t)

GPO

426

341

375

(Tha

iland

)(0

.584

/uni

t)(0

.467

/uni

t)(0

.514

/uni

t)

GSK

23

7*12

41*

(US)

(0.3

25/u

nit)

(1.7

00/u

nit)

Het

ero

1971

7380

197*

277

1029

153

168

(Indi

a)

(0.9

00/u

nit)

(0.1

00/u

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(0.1

10/u

nit)

(0.2

70/u

nit)

(0.3

80/u

nit)

(1.4

10/u

nit)

(0.2

10/u

nit)

(0.2

30/u

nit)

Ranb

axy

125*

135*

265*

416

1579

285*

292*

(Indi

a)

(0.1

71/u

nit)

(0.1

85/u

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(0.3

63/u

nit)

(0.5

70/u

nit)

(2.163

/uni

t)(0

.390

/uni

t)(0

.400

/uni

t)

Strid

es12

213

326

1(In

dia)

(0.167

/uni

t)(0

.182

/uni

t)(0

.358

/uni

t)

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

15

Tabl

e 1f

– C

ombi

ned

blis

ters

The

thre

e dr

ugs

are

pres

ente

d in

the

sam

e bl

iste

r. Dru

gs m

ust

be t

aken

once

a d

ay.

Pric

e is

in

US$

. Pr

ice

is g

iven

bot

hfo

r a

year

ly a

dult d

ose

and

by u

nit.

For

deta

ils o

n el

igib

ility

, of

fer

rest

rict

ions

for

cou

ntries

and

inst

itut

ions

, In

cote

rm a

nd w

ays

toap

ply, p

leas

e re

fer

to t

able

2f.

Prod

ucts

on

the

WHO lis

t of

“Pi

lot

Proc

urem

ent, Q

ualit

y an

d So

urci

ng P

roje

ct:

Acce

ss t

o HIV

/AID

S dr

ugs

and

diag

nost

ics

ofac

cept

able

qua

lity”

(14t

h ed

itio

n, 2

8 Ja

nuar

y20

04)[2

]ar

e in

bol

dan

d ha

ve a

n as

terisk

*ne

xt t

o th

e pr

ice.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. B

est

pric

es a

re in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ngto

man

ufac

ture

rs.[1

0]

Ann

ual co

st is

calc

ulat

ed a

ccor

ding

to

the

daily

dos

es g

iven

in

the

WHO “

Scal

ing-

upAn

tiret

rovi

ral Th

erap

y in

Res

ourc

e Li

mite

dSe

ttin

gs:

Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch”

(Jun

e 20

02)[6

] an

d/or

the

“ Gui

delin

es for

the

Use

of An

tiret

rovi

ral

Agen

ts in

HIV

-1-In

fect

ed A

dults

and

Adol

esce

nts ”

[7] ,

by t

he P

anel

on

Clin

ical

Prac

tice

s fo

r th

e Tr

eatm

ent

of H

IV, Ju

ly 2

003.

NNRT

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C+dd

l (E

C)EF

V+3T

C+dd

l (E

C)

Stre

ngth

(m

g)

600

+ 30

0 +

250

600

+ 30

0 +

400

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ly d

ose

1 +

1 +

11

+ 1

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a93

194

9(2

.550

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t)(2

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t)

16 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

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-msf

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•M

édec

ins

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Fro

ntiè

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ARV

Com

pany

Stre

ngth

/Dos

age

form

Pr

esen

tatio

nPr

ice

per

pack

Ad

ditio

nal in

form

atio

n

abac

avir

GSK

20

mg/

ml or

al s

olut

ion

240m

l US$

31.

32*

Cost

per

day

as

indi

cate

d by

the

m

anuf

actu

rer: U

S$ 2

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nosi

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act

ive

prin

cipl

e US$

14.

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ld in

loca

l cu

rren

cy in

Sout

hern

Africa

– so

ld a

s a

bottle

for

Ra

nd a

nd E

ast Af

rica

- sh

illin

gs.

Sold

in

Euro

re

-con

stitu

tion

with

wat

er a

nd

to W

est Af

rican

cou

ntrie

s.w

ith a

ntac

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al s

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6Ci

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al s

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l US$

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t Af

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cou

ntrie

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BM

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0 US$

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0.6

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per

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indi

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d by

man

ufac

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sed

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aver

age

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0ml

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17.

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a 50

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5ml su

spen

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0ml &

25m

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2.4

5 &

US$

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ml.

(P

MTC

T)(P

MTC

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10

mg/

ml or

al s

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spen

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31.

17*

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(/)

rito

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olut

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41.

67*

rito

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60m

l)US$

41.

67*

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On

1 Ap

ril 20

04, 1

US$

= 1

.267

2 CH

F. (

/) A

ll pr

ices

of Ro

che

prod

ucts

are

in

Swis

s fran

cs (

CHF)

. Pr

ices

giv

en in

this

tab

le a

re for

sub

-Sah

aran

Afric

a an

d Le

ast

Dev

elop

ed C

ount

ries

as

UN d

efin

ed. Se

e ta

ble

2c for

price

s fo

r Lo

w Inc

ome

and

Low

erM

iddl

e In

com

e Co

untrie

s, a

s cl

assi

fied

by t

he W

orld

Ban

k.Pr

oduc

ts o

n th

e W

HO lis

t of

“Pi

lot

Proc

urem

ent, Q

ualit

y an

d So

urci

ng P

roje

ct:

Acce

ss t

o HIV

/AID

S dr

ugs

and

diag

nost

ics

of a

ccep

tabl

e qu

ality

”(1

4th

editio

n, 2

8 Ja

nuar

y 20

04)[2

]ar

e in

bol

dan

d ha

ve a

n as

terisk

*ne

xt t

o th

e pr

ice.

Alw

ays

chec

k w

ebsi

tefo

r m

ost

rece

ntly

upd

ated

lis

t. Inc

oter

ms

vary

acc

ordi

ng t

o m

anuf

actu

rers

.[10]

Tabl

e 1g

– P

aedi

atric

For

mul

atio

nsFo

r de

tails

on

elig

ibili

ty a

nd o

ffer re

stric

tions

for

cou

ntrie

s an

d in

stitu

tions

, pl

ease

ref

er to

tabl

e 2.

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

17

18 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Com

pany

Gla

xoSm

ithKl

ine

Gla

xoSm

ithKl

ine

Elig

ibili

ty (co

untrie

s)

Leas

t Dev

elop

ed C

ount

ries

(LDCs

) pl

ussu

b-Sa

hara

n Af

rica.

All pr

ojec

ts ful

ly fin

ance

d by

the

Glo

bal

Fund

to

fight

AID

S, T

B a

nd M

alar

ia.

(For

mid

dle

inco

me

deve

lopi

ng c

ount

ries

publ

ic s

ecto

r pr

ices

neg

otia

ted

on a

case

-by-

case

bas

is o

r bi

late

rally

thr

ough

the

AAI).

Leas

t Dev

elop

ed C

ount

ries

(LDCs

) pl

ussu

b-Sa

hara

n Af

rica.

All pr

ojec

ts ful

ly fin

ance

d by

the

Glo

bal

Fund

to

fight

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B a

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alar

ia.

(For

mid

dle

inco

me

deve

lopi

ng c

ount

ries

publ

ic s

ecto

r pr

ices

neg

otia

ted

on a

case

-by-

case

bas

is o

r bi

late

rally

thr

ough

the

AAI).

Tabl

e 2

Com

pany

ARV

offe

rs a

nd r

estric

tions

for

dev

elop

ing

coun

trie

s, a

dult

and

paed

iatric

for

mul

atio

ns

Tabl

e 2a

Nuc

leos

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NRT

Is)

Prod

uct

abac

avir

300m

g ta

blet

s(Z

iage

n®)

abac

avir

20m

g/m

l or

also

lutio

n 24

0ml

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gen®

)

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, ai

d or

gani

zation

s,ch

aritie

s, U

N a

genc

ies,

oth

er

not-fo

r-pr

ofit o

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izat

ions

and

inte

rnat

iona

l pu

rcha

se fun

ds s

uch

as t

he G

loba

l Fu

nd t

o fig

ht A

IDS,

TB a

nd M

alar

ia.

In s

ub-S

ahar

an A

fric

a em

ploy

ers

ther

e w

ho o

ffer

HIV

/AID

S ca

re a

ndtrea

tmen

t di

rect

ly t

o th

eir

staf

fth

roug

h w

orkp

lace

clin

ics

orsi

mila

r ar

rang

emen

ts a

re a

lso

elig

ible

.

All

orga

niza

tion

s m

ust

supp

ly t

hepr

efer

ential

ly p

rice

d pr

oduc

ts o

n a

not

for

prof

it b

asis

.

Gov

ernm

ents

, ai

d or

gani

zation

s,ch

aritie

s, U

N a

genc

ies,

oth

er

not-fo

r-pr

ofit o

rgan

izat

ions

and

inte

rnat

iona

l pu

rcha

se fun

ds s

uch

as t

he G

loba

l Fu

nd t

o fig

ht A

IDS,

TB a

nd M

alar

ia.

In s

ub-S

ahar

an A

fric

a em

ploy

ers

ther

e w

ho o

ffer

HIV

/AID

S ca

re a

ndtrea

tmen

t di

rect

ly t

o th

eir

staf

fth

roug

h w

orkp

lace

clin

ics

orsi

mila

r ar

rang

emen

ts a

re a

lso

elig

ible

.

All

orga

niza

tion

s m

ust

supp

ly t

hepr

efer

ential

ly p

rice

d pr

oduc

ts o

n a

not

for

prof

it b

asis

.

Price

in U

S$

US$

887

/yea

r(U

S$ 1

.215

/uni

t)

US$

31.32

per

bottle

Addi

tiona

l co

mm

ents

Supp

ly A

gree

men

tre

quire

d (F

or N

GOs

requ

iring

les

s th

an 1

0pa

tient

pac

ks p

erm

onth

, th

is req

uire

men

tm

ay b

e w

aive

d).

The

man

ufac

ture

rre

com

men

ds tha

t‘p

resc

riber

s m

ust en

sure

that

pat

ient

s ar

e fu

llyin

form

ed reg

ardi

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pers

ensitiv

ity rea

ctio

nto

aba

cavi

r. Pa

tient

sde

velo

ping

sig

ns o

rsy

mpt

oms

mus

t co

ntac

tth

eir do

ctor

imm

edia

tely

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’

Supp

ly A

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men

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quire

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or N

GOs

requ

iring

les

s th

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0pa

tient

pac

ks p

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, th

is req

uire

men

tm

ay b

e w

aive

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man

ufac

ture

rre

com

men

ds tha

t‘p

resc

riber

s m

ust en

sure

that

pat

ient

s ar

e fu

llyin

form

ed reg

ardi

nghy

pers

ensitiv

ity rea

ctio

nto

aba

cavi

r. Pa

tient

sde

velo

ping

sig

ns o

rsy

mpt

oms

mus

t co

ntac

tth

eir do

ctor

imm

edia

tely

for

adv

ice.

’

Del

iver

y of

good

s[10]

CIP

CIP

Com

pany

Bristo

l-Mye

rsSq

uibb

Co.

Bristo

l M

yers

Squi

bb C

o,

Gla

xoSm

ithKl

ine

Prod

uct

dida

nosi

ne10

0mg

(Vid

ex®

)

dida

nosi

nepo

wde

r fo

ror

al s

olut

ion

2g+an

ti-ac

id(V

idex

®)

lam

ivud

ine

150m

g ta

blet

(Epi

vir®

)

Elig

ibili

ty (co

untrie

s)

Sub-

Saha

ran

Afric

a.

(For

oth

er d

evel

opin

g c

ount

ries,

pric

esne

gotia

ted

on

a ca

se b

y ca

se b

asis

thro

ugh

the

AAI.)

Sub-

Saha

ran

Afric

a

(For

oth

er d

evel

opin

g c

ount

ries,

pric

esne

gotia

ted

on

a ca

se b

y ca

se b

asis

thro

ugh

the

AAI.)

Leas

t Dev

elop

ed C

ount

ries

(LDCs

) pl

ussu

b-Sa

hara

n Af

rica.

All pr

ojec

ts ful

ly fin

ance

d by

the

Glo

bal

Fund

to

fight

AID

S, T

B a

nd M

alar

ia.

(For

mid

dle

inco

me

deve

lopi

ng c

ount

ries

publ

ic s

ecto

r pr

ices

neg

otia

ted

on a

case

-by-

case

bas

is o

r bi

late

rally

thr

ough

the

AAI.)

Elig

ibili

ty (bo

dy)

Bot

h pr

ivat

e an

d pu

blic s

ecto

ror

gani

satio

ns tha

t ar

e ab

le to

prov

ide

effe

ctiv

e, s

usta

inab

le a

nd m

edical

lyso

und

care

and

tre

atm

ent of

HIV

/AID

Sar

e el

igib

le.

Bot

h pr

ivat

e an

d pu

blic s

ecto

ror

gani

satio

ns tha

t ar

e ab

le to

prov

ide

effe

ctiv

e, s

usta

inab

le a

nd m

edical

lyso

und

care

and

tre

atm

ent of

HIV

/AID

Sar

e el

igib

le.

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, UN a

genc

ies,

oth

er

not-fo

r-pro

fit o

rgan

isat

ions

and

inte

rnat

iona

l pu

rcha

se fun

ds s

uch

asth

e Glo

bal Fu

nd to

fight

AID

S, T

B a

ndM

alar

ia.

In s

ub-S

ahar

an A

frica

empl

oyer

s th

ere

who

offe

r HIV

/AID

S ca

re a

nd tre

atm

ent di

rect

lyto

the

ir st

aff th

roug

h w

orkp

lace

clin

ics

or s

imila

r ar

rang

emen

ts a

re a

lso

elig

ible

.

All or

gani

satio

ns m

ust su

pply

the

pref

eren

tially

pric

ed p

rodu

cts

on a

not

for pr

ofit

basis.

Price

in U

S$

US$

310

/yea

r(U

S$ 0

.212

/uni

t)

Low

er tab

let

dosa

ges

prices

in

line

with

thi

s of

fer

US$

14.

74 p

erbo

ttle

US$

69/

year

(US$

0.0

95/u

nit)

Addi

tiona

l co

mm

ents

Supp

ly A

gree

men

tre

quire

d (F

or N

GOs

requ

iring

les

s th

an10

pat

ient

pac

ks p

erm

onth

, th

is

requ

irem

ent m

ay b

ew

aive

d).

Del

iver

y of

good

s[10]

DDU to

gove

rnm

ent

purc

hasing

entit

ies.

DDU to

gove

rnm

ent

purc

hasing

entit

ies.

CIP

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

19

20 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Prod

uct

lam

ivud

ine

10m

g/m

l or

also

lutio

n24

0ml

(Epi

vir®

)

stav

udin

e20

mg,

30m

gan

d 40

mg

caps

(Ze

rit®

)

stav

udin

e1m

g/m

lpo

wde

r fo

rsy

rup

200m

l(Z

erit®

)

Com

pany

Gla

xoSm

ithKl

ine

Bristo

l-Mye

rsSq

uibb

Co.

Bristo

l-Mye

rsSq

uibb

Co.

Elig

ibili

ty (co

untrie

s)

LDCs

plu

s su

b-Sa

hara

n Af

rica.

All pr

ojec

ts ful

ly fin

ance

d by

the

Glo

bal

Fund

to

fight

AID

S, T

B a

nd M

alar

ia.

(For

mid

dle

inco

me

deve

lopi

ng c

ount

ries

publ

ic s

ecto

r pr

ices

neg

otia

ted

on a

case

-by-

case

bas

is o

r bi

late

rally

thr

ough

the

AAI.)

Sub-

Saha

ran

Afric

a.

(For

oth

er d

evel

opin

g co

untrie

s, p

rices

nego

tiate

d on

a c

ase

by c

ase

basis

thro

ugh

the

AAI.)

Sub-

Saha

ran

Afric

a.

(For

oth

er d

evel

opin

g co

untrie

s, p

rices

nego

tiate

d on

a c

ase

by c

ase

basis

thro

ugh

the

AAI.)

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, UN a

genc

ies,

oth

er

not-fo

r-pro

fit o

rgan

isat

ions

and

inte

rnat

iona

l pu

rcha

se fun

ds s

uch

asth

e Glo

bal Fu

nd to

fight

AID

S, T

B a

ndM

alar

ia.

In s

ub-S

ahar

an A

frica

empl

oyer

s th

ere

who

offe

r HIV

/AID

S ca

re a

nd tre

atm

ent di

rect

lyto

the

ir st

aff th

roug

h w

orkp

lace

clin

ics

or s

imila

r ar

rang

emen

ts a

real

so e

ligib

le.

All or

gani

satio

ns m

ust su

pply

the

pref

eren

tially

pric

ed p

rodu

cts

on a

not fo

r pr

ofit

basis.

Bot

h pr

ivat

e an

d pu

blic s

ecto

ror

gani

satio

ns tha

t ar

e ab

le to

prov

ide

effe

ctiv

e, s

usta

inab

le a

nd m

edical

lyso

und

care

and

tre

atm

ent of

HIV

/AID

Sar

e el

igib

le.

Bot

h pr

ivat

e an

d pu

blic s

ecto

ror

gani

satio

ns tha

t ar

e ab

le to

prov

ide

effe

ctiv

e, s

usta

inab

le a

nd m

edical

lyso

und

care

and

tre

atm

ent of

HIV

/AID

Sar

e el

igib

le.

Price

in U

S$

US$

6.7

3 pe

rbo

ttle

20m

g:

US$

5.2

5 pe

r 56

caps

(US$

0.0

94/u

nit)

30m

g:US$

48.

18/y

ear

(US$

0.0

66/u

nit)

40m

g:US

$ 54

.75/

year

(US$

0.0

75/u

nit)

US$

9.50

per

bottl

e

Addi

tiona

l co

mm

ents

Supp

ly A

gree

men

tre

quire

d (F

or N

GOs

requ

iring

les

s th

an10

pat

ient

pac

ks p

erm

onth

, th

is

requ

irem

ent m

ay b

ew

aive

d).

Del

iver

y of

good

s[10]

CIP

DDU to

gove

rnm

ent

purc

hasing

entit

ies

DDU to

gove

rnm

ent

purc

hasing

entit

ies

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

21

Prod

uct

zido

vudi

ne30

0mg

tabl

ets

(Ret

rovi

r®)

zido

vudi

ne10

mg/

ml

syru

p20

0ml

(Ret

rovi

r®)

Com

pany

Gla

xoSm

ithKl

ine

Gla

xoSm

ithKl

ine

Elig

ibili

ty (co

untrie

s)

LDCs

plu

s su

b-Sa

hara

n Af

rica.

All pr

ojec

ts ful

ly fin

ance

d by

the

Glo

bal

Fund

to

fight

AID

S, T

B a

nd M

alar

ia.

(For

mid

dle

inco

me

deve

lopi

ngco

untrie

s pu

blic s

ecto

r pr

ices

nego

tiate

d on

a c

ase-

by-c

ase

basis

orbi

late

rally

thr

ough

the

AAI

.)

LDCs

plu

s su

b-Sa

hara

n Af

rica.

All pr

ojec

ts ful

ly fin

ance

d by

the

Glo

bal

Fund

to

fight

AID

S, T

B a

nd M

alar

ia.

(For

mid

dle

inco

me

deve

lopi

ngco

untrie

s pu

blic s

ecto

r pr

ices

nego

tiate

d on

a c

ase-

by-c

ase

basis

orbi

late

rally

thr

ough

the

AAI

.)

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, UN a

genc

ies,

oth

er

not-fo

r-pro

fit o

rgan

isat

ions

and

inte

rnat

iona

l pu

rcha

se fun

ds s

uch

asth

e Glo

bal Fu

nd to

fight

AID

S, T

B a

ndM

alar

ia.

In s

ub-S

ahar

an A

frica,

em

ploy

ers

ther

ew

ho o

ffer HIV

/AID

S ca

re a

ndtrea

tmen

t di

rect

ly to

thei

r st

aff

thro

ugh

wor

kpla

ce c

linics

or s

imila

rar

rang

emen

ts a

re a

lso

elig

ible

.

All or

gani

satio

ns m

ust su

pply

the

pref

eren

tially

pric

ed p

rodu

cts

on a

not

for pr

ofit

basis.

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, UN a

genc

ies,

oth

er

not-fo

r-pro

fit o

rgan

isat

ions

and

inte

rnat

iona

l pu

rcha

se fun

ds s

uch

asth

e Glo

bal Fu

nd to

fight

AID

S, T

B a

ndM

alar

ia.

In s

ub-S

ahar

an A

frica,

em

ploy

ers

ther

ew

ho o

ffer HIV

/AID

S ca

re a

ndtrea

tmen

t di

rect

ly to

thei

r st

aff

thro

ugh

wor

kpla

ce c

linics

or s

imila

rar

rang

emen

ts a

re a

lso

elig

ible

.

All or

gani

satio

ns m

ust su

pply

the

pref

eren

tially

pric

ed p

rodu

cts

on a

not

for pr

ofit

basis.

Price

in U

S$

US$

212

/yea

r(U

S$ 0

.290

/uni

t)

US$

7.10

per

bottle

Addi

tiona

lco

mm

ents

Supp

ly A

gree

men

tre

quire

d.

(For

NGOs

requ

iring

les

s th

an10

pat

ient

pac

kspe

r m

onth

, th

isre

quire

men

t m

aybe

wai

ved.

)

Supp

ly A

gree

men

tre

quire

d.

(For

NGOs

requ

iring

les

s th

an10

pat

ient

pac

kspe

r m

onth

, th

isre

quire

men

t m

aybe

wai

ved.

)

Del

iver

y of

good

s[10]

CIP

CIP

Tabl

e 2b

Non

-Nuc

leos

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NNRT

Is)

Prod

uct

efav

irenz

(Sto

crin

®)

efav

irenz

(Sto

crin

®)

nevi

rapi

ne20

0mg

tabl

ets

(Vira

mun

e®)

nevi

rapi

ne10

mg/

ml

susp

ensi

on24

0ml

(Vira

mun

e®)

Com

pany

Mer

ck &

Co.

, In

c.

Mer

ck &

Co.

, In

c.

Boe

hrin

ger

Inge

lhei

m

Boe

hrin

ger

Inge

lhei

m

Del

iver

y of

good

s[10]

CIP

CIP

CIF

CIF

Elig

ibili

ty (co

untrie

s)

Low

Hum

an D

evel

opm

ent In

dex

(HDI)

coun

trie

s pl

us m

ediu

m H

DI

coun

trie

s w

ith a

dult

HIV

pre

vale

nce

of 1

% o

r gr

eate

r[11].

Med

ium

HDI co

untrie

s w

ith a

dult

HIV

pre

vale

nce

less

tha

n 1%

[11].

All W

orld

Ban

k lo

w-in

com

eco

untrie

s an

d su

b-Sa

hara

n Af

rica.

(Oth

er c

ount

ries

on a

cas

e-by

-cas

eba

sis.

)

All W

orld

Ban

k lo

w-in

com

eco

untrie

s an

d su

b-Sa

hara

n Af

rica.

(Oth

er c

ount

ries

on a

cas

e-by

-cas

eba

sis.

)

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, in

tern

atio

nal

orga

nisa

tions

, NGOs,

priv

ate

sect

oror

gani

satio

ns (e.

g. e

mpl

oyer

s,ho

spita

ls a

nd ins

urer

s).

Mer

ck &

Co.

, In

c. d

oes

not ru

leou

t su

pply

ing

ARVs

to

patie

nts

thro

ugh

reta

il ph

arm

acie

s.

Gov

ernm

ents

, in

tern

atio

nal

orga

nisa

tions

, NGOs,

priv

ate

sect

oror

gani

satio

ns (e.

g. e

mpl

oyer

s,ho

spita

ls a

nd ins

urer

s).

Mer

ck &

Co.

, In

c. d

oes

not ru

leou

t su

pply

ing

ARVs

to

patie

nts

thro

ugh

reta

il ph

arm

acie

s.

Gov

ernm

ents

, NGOs

and

othe

rpa

rtne

rs w

ho c

an g

uara

ntee

tha

tth

e pr

ogra

mm

e is run

in

are

spon

sibl

e m

anne

r.

Gov

ernm

ents

, NGOs

and

othe

rpa

rtne

rs w

ho c

an g

uara

ntee

tha

tth

e pr

ogra

mm

e is run

in

are

spon

sibl

e m

anne

r.

Price

in U

S$

600m

g ta

blet

: US$

346

.75/

year

(US$

0.9

50/u

nit)

200m

g ca

psul

e:

US$

500

/yea

r(U

S$ 0

.457

/uni

t)

50m

g ca

psul

e:

US$

0.116

/uni

tUS$

3.4

7 pe

r bo

ttle

of 3

0

600m

g ta

blet

: US$

767

/yea

r (U

S$ 2

.100

/uni

t)

200m

g ca

psul

e:

US$

920

/yea

r(U

S$ 0

.840

/uni

t)

50m

g ca

psul

e US$

0.2

13 p

er u

nit

US$

6.3

9 pe

r bo

ttle

of 3

0

US$

438

/yea

r(U

S$ 0

.600

/uni

t)

US$

17.

50 p

er u

nit

Addi

tiona

l co

mm

ents

Alth

ough

Rom

ania

does

not

fal

l un

der

thes

e ca

tego

ries

ital

so b

enef

its fro

mth

ese

prices

due

to

ago

vern

men

tco

mm

itmen

t to

apr

ogra

mm

e of

univ

ersa

l ac

cess

.

22 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Tabl

e 2c

Nuc

leot

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NtR

TIs)

Prod

uct

teno

fovi

r30

0mg

(Vire

ad®

)

Com

pany

Gile

ad

Del

iver

y of

good

s[10]

FOB

Elig

ibili

ty (co

untrie

s)

53 n

atio

ns in

Afric

a an

d 15

oth

erUN-d

esig

nate

d ‘le

ast de

velo

ped’

coun

trie

s.

Elig

ibili

ty (bo

dy)

Org

anisat

ions

tha

t pr

ovid

e HIV

trea

tmen

t in

the

68

coun

trie

sco

vere

d by

the

Vire

ad A

cces

spr

ogra

mm

e w

ill b

e ab

le to

rece

ive

Vire

ad a

t th

e ac

cess

price.

App

licat

ions

will

go

thro

ugh

a re

view

pro

cess

.

Price

in U

S$

US$

474

.50/

year

(U

S$ 1

.300

/uni

t)

Addi

tiona

lco

mm

ents

The

prog

ram

mes

will

be

man

aged

thro

ugh

Axio

s.

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

23

24 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Tabl

e 2d

Pro

teas

e In

hibi

tors

(PI

s)

Prod

uct

indi

navi

r(4

00m

g ca

ps)

(Crix

ivan

®)

indi

navi

r(4

00m

g ca

ps)

(Crix

ivan

®)

nelfi

navi

r25

0mg

tabl

ets

(Vira

cept

®)

Com

pany

Mer

ck &

Co.

,In

c.

Mer

ck &

Co.

,In

c.

Roch

e

Del

iver

y of

good

s[10]

CIP

CIP

Term

s an

dco

nditi

ons:

Effe

ctive

date

1st M

arch

2003

. FC

ABa

sel (

CH),

CAD

(Cas

h Ag

ains

tDoc

umen

ts)

30 d

ays

atsigh

t. M

inim

umor

der an

dde

liver

yam

ount

per

ship

men

t is

CHF

10,0

00

(US$

789

1)

Elig

ibili

ty (co

untrie

s)

Low

Hum

an D

evel

opm

ent

Inde

x (H

DI)

coun

trie

s pl

usm

ediu

m H

DI co

untrie

s w

ithad

ult HIV

pre

vale

nce

of 1

%or

gre

ater

[11].

Med

ium

HDI co

untrie

s w

ithad

ult HIV

pre

vale

nce

less

than

1%

[11].

Leas

t Dev

elop

ed C

ount

ries

(LDCs

) pl

us s

ub-S

ahar

an A

frica.

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, in

tern

atio

nal

orga

nisa

tions

, NGOs,

priv

ate

sect

oror

gani

satio

ns (e.

g. e

mpl

oyer

s,ho

spita

ls a

nd ins

urer

s).

Mer

ck &

Co.

, In

c. d

oes

not ru

le o

utsu

pply

ing

ARVs

to

patie

nts

thro

ugh

reta

il ph

arm

acie

s.

Gov

ernm

ents

, in

tern

atio

nal

orga

nisa

tions

, NGOs,

priv

ate

sect

oror

gani

satio

ns (e.

g. e

mpl

oyer

s,ho

spita

ls a

nd ins

urer

s).

Mer

ck &

Co.

, In

c. d

oes

not ru

le o

utsu

pply

ing

ARVs

to

patie

nts

thro

ugh

reta

il ph

arm

acie

s.

Gov

ernm

ents

, Non

Pro

fit Ins

titut

iona

lPr

ovid

ers

of H

IV c

are,

NGOs.

Price

in U

S$

800m

g* (pl

usrit

onav

ir 10

0mg)

twice

daily

US$

400

/yea

r(U

S$ 0

.274

/uni

t)

800m

g 3

times

daily

not

boo

sted

US$

600/

year

(US$

0.27

4/un

it)

800m

g* (pl

usrit

onav

ir 10

0mg)

twice

daily

US$

686

/yea

r(U

S$ 0

.470

/uni

t)

800m

g 3

times

daily

not

boo

sted

US$

1029

(US$

0.47

0/un

it)

Bot

tle o

f 27

0ta

blet

s CH

F 88

.40

(US$

69.

76)

US$

942

/yea

r(U

S$ 0

.258

/uni

t)

Addi

tiona

l co

mm

ents

Alth

ough

Rom

ania

doe

sno

t fa

ll un

der th

ese

cate

gorie

s it

also

bene

fits

from

the

sepr

ices

due

to

ago

vern

men

t co

mm

itmen

tto

a p

rogr

amm

e of

univ

ersa

l ac

cess

.

* Th

e ye

arly

and

uni

t pr

ice

is for

ind

inav

ir on

ly. Se

e pr

ice

of b

oost

er o

n pa

ge 2

6.

Prod

uct

nelfi

navi

r 25

0mg

tabl

ets

(Vira

cept

®)

nelfi

navi

rpo

wde

r fo

r or

also

lutio

n 14

4g

50m

g/g

(Vira

cept

®)

nelfi

navi

rpo

wde

r fo

r or

also

lutio

n 14

4g50

mg/

g(V

irace

pt®

)

Com

pany

Roch

e

Roch

e

Roch

e

Del

iver

y of

good

s[10]

Term

s an

dco

nditi

ons:

Effe

ctiv

e da

te 1

stM

arch

200

3. F

CABa

sel (C

H),

CAD

(Cas

h Ag

ains

tDoc

umen

ts) 30

days

at sigh

t.M

inim

um o

rder

and

deliv

ery

amou

nt p

ersh

ipm

ent is

CHF

10,0

00

(US$

789

1)

Term

s an

dco

nditi

ons:

Effe

ctiv

e da

te 1

stM

arch

200

3. F

CABa

sel (C

H),

CAD

(Cas

h Ag

ains

tDoc

umen

ts) 30

days

at sigh

t.M

inim

um o

rder

and

deliv

ery

amou

nt p

ersh

ipm

ent is

CHF

10,0

00

(US$

789

1)

Elig

ibili

ty (co

untrie

s)

Low

inc

ome

coun

trie

s an

dlo

wer

mid

dle

inco

me

coun

trie

s - as

cla

ssifi

ed b

yth

e W

orld

Ban

k.

Leas

t Dev

elop

ed C

ount

ries

(LDCs

) pl

us s

ub-S

ahar

an A

frica.

Low

inc

ome

coun

trie

s an

dLo

wer

mid

dle

inco

me

coun

trie

s - as

cla

ssifi

ed b

yth

e W

orld

Ban

k.

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, Non

Pro

fit Ins

titut

iona

lPr

ovid

ers

of H

IV c

are,

NGOs.

Gov

ernm

ents

, Non

Pro

fit Ins

titut

iona

lPr

ovid

ers

of H

IV c

are,

NGOs.

Gov

ernm

ents

, Non

Pro

fit Ins

titut

iona

lPr

ovid

ers

of H

IV c

are,

NGOs.

Price

in U

S$

Bot

tle o

f 27

0 ta

blet

s:

CHF

3o0.

00

US$

236

.74

US$

320

1/ye

ar(U

S$ 0

.877

/uni

t)

CHF

39.5

0 pe

r bo

ttle

(US$

31.17

)

CHF

55.0

0 pe

r bo

ttle

(US$

43.

40)

Addi

tiona

lco

mm

ents

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

25

Prod

uct

riton

avir

100m

g ca

ps(N

orvi

r®)

riton

avir

oral

solu

tion

450m

l(N

orvi

r®)

saqu

inav

ir20

0mg

hard

gel ca

psul

es(In

vira

se®

)

saqu

inav

ir20

0mg

hard

gel ca

psul

es(In

vira

se®

)

Com

pany

Abbo

tt

Abbo

tt

Roch

e

Roch

e

Del

iver

y of

goo

ds[1

0]

FOB

FOB

Term

s an

dco

nditi

ons:

Effe

ctiv

eda

te 1

st M

arch

2003

. FC

ABa

sel

(CH),

CAD (Ca

shAg

ains

t Doc

umen

ts)

30 d

ays

at s

ight

.M

inim

um o

rder

and

deliv

ery

amou

nt

per sh

ipm

ent is

CHF

10,0

00

(US$

789

1)

Term

s an

dco

nditi

ons:

Effe

ctiv

eda

te 1

st M

arch

2003

. FC

ABa

sel

(CH),

CAD (Ca

shAg

ains

t Doc

umen

ts)

30 d

ays

at s

ight

.M

inim

um o

rder

and

deliv

ery

amou

nt

per sh

ipm

ent is

CHF

10,0

00

(US$

789

1)

Elig

ibili

ty (co

untrie

s)

All A

frican

cou

ntrie

s an

d th

eLD

Cs o

utside

of A

frica.

All A

frican

cou

ntrie

s an

d th

eLD

Cs o

utside

of A

frica.

Low

inc

ome

coun

trie

s an

dLo

wer

mid

dle

inco

me

coun

ries

- as

cla

ssifi

ed b

yth

e W

orld

Ban

k.

Leas

t Dev

elop

ed C

ount

ries

(LDCs

) pl

us s

ub-S

ahar

an A

frica.

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, NGOs,

UN s

yste

mor

gani

satio

ns a

nd o

ther

nat

iona

l an

din

tern

atio

nal he

alth

ins

titut

ions

.

Gov

ernm

ents

, NGOs,

UN s

yste

mor

gani

satio

ns a

nd o

ther

nat

iona

l an

din

tern

atio

nal he

alth

ins

titut

ions

.

Gov

ernm

ents

, Non

Pro

fit Ins

titut

iona

lPr

ovid

ers

of H

IV c

are,

NGOs.

Gov

ernm

ents

, Non

Pro

fit Ins

titut

iona

lPr

ovid

ers

of H

IV c

are,

NGOs.

Price

in U

S$

“Boo

ster

dos

e”:

US$

83/

year

(U

S$ 0

.114

/uni

t)

US$

41.67

per

bottle

Bot

tle o

f 27

0ca

psul

es:

CHF

300.

00(U

S$ 2

36.7

4)

US$

320

1/ye

ar(U

S$ 0

.877

/uni

t)

Bot

tle o

f 27

0ca

psul

es:

CHF

89.6

0(U

S$ 7

0.71

)

US$

956

/yea

r(U

S$ 0

.262

/uni

t)

Addi

tiona

lco

mm

ents

26 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Tabl

e 2e

Fix

ed D

ose

Com

bina

tions

Prod

uct

lopi

navi

r/rit

onav

ir13

3.33

+ 3

3.3

mg

caps

ules

(Kal

etra

®)

lopi

navi

r/rit

onav

ir or

also

lutio

n30

0ml

(Kal

etra

®)

lam

ivud

ine

+zido

vudi

ne30

0mg

+15

0mg

tabl

ets

(Com

bivi

r®)

Com

pany

Abbo

tt

Abbo

tt

Gla

xoSm

ithKl

ine

Del

iver

y of

good

s[10]

FOB

FOB

CIP

Elig

ibili

ty (co

untrie

s)

All A

frican

cou

ntrie

s an

d th

eLe

ast Dev

elop

ed C

ount

ries

(LDCs

) ou

tsid

e of

Africa.

All A

frican

cou

ntrie

s an

d th

eLe

ast Dev

elop

ed C

ount

ries

(LDCs

) ou

tsid

e of

Africa.

LDCs

plu

s su

b-Sa

hara

n Af

rica.

All pr

ojec

ts ful

ly fin

ance

d by

the

Glo

bal Fu

nd to

fight

AID

S,TB

and

Mal

aria

.

(For

mid

dle

inco

me

deve

lopi

ng c

ount

ries

publ

icse

ctor

pric

es n

egot

iate

d on

aca

se-b

y-ca

se b

asis o

rbi

late

rally

thr

ough

the

AAI

.)

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, NGOs, U

N s

yste

mor

gani

satio

ns, an

d ot

her na

tiona

l and

inte

rnat

iona

l hea

lth in

stitu

tions

.

Gov

ernm

ents

, NGOs, U

N s

yste

mor

gani

satio

ns, an

d ot

her na

tiona

l and

inte

rnat

iona

l hea

lth in

stitu

tions

.

Gov

ernm

ents

, ai

d or

gani

satio

ns, ch

ariti

es,

UN a

genc

ies, o

ther

not

-for-p

rofit

orga

nisa

tions

and

inte

rnat

iona

l pur

chas

efu

nds

such

as

the

Glo

bal F

und

to fig

htAI

DS,

TB

& M

alar

ia.

In s

ub-S

ahar

an A

frica

, em

ploy

ers

ther

ewho

offe

r HIV

/AID

S ca

re a

nd tre

atm

ent

dire

ctly to

thei

r st

aff th

roug

h wor

kpla

ceclin

ics

or s

imila

r ar

rang

emen

ts a

re a

lso

elig

ible

.

All o

rgan

isat

ions

mus

t su

pply the

pref

eren

tially

pric

ed p

rodu

cts

on a

not

for pr

ofit

basis.

Price

in U

S$

US$

500

/yea

r(U

S$ 0

.228

/uni

t)

US$

41.67

per

bottle

US$

237

/yea

r(U

S$ 0

.325

/uni

t)

Addi

tiona

l co

mm

ents

Supp

ly A

gree

men

tre

quire

d.

(For

NGOs

requ

iring

less

tha

n 10

pat

ient

pack

s pe

r m

onth

,th

is req

uire

men

t m

aybe

wai

ved.

)

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

27

Prod

uct

abac

avir

+la

miv

udin

e +

zido

vudi

ne30

0 + 1

50 +

300m

g ta

blet

s(T

riziv

ir®)

Com

pany

Gla

xoSm

ithKl

ine

Del

iver

y of

good

s[10]

CIP

Elig

ibili

ty (co

untrie

s)

LDCs

plu

s su

b-Sa

hara

n Af

rica.

All pr

ojec

ts ful

ly fin

ance

d by

the

Glo

bal Fu

nd to

fight

AID

S,TB

and

Mal

aria

.

(For

mid

dle

inco

me

deve

lopi

ng c

ount

ries

publ

icse

ctor

pric

es n

egot

iate

d on

aca

se-b

y-ca

se b

asis o

rbi

late

rally

thr

ough

the

AAI

.

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, ai

d or

gani

satio

ns, ch

ariti

es,

UN a

genc

ies, o

ther

not

-for-p

rofit

orga

nisa

tions

and

inte

rnat

iona

l pur

chas

efu

nds

such

as

the

Glo

bal F

und

to fig

htAI

DS,

TB

& M

alar

ia.

In s

ub-S

ahar

an A

frica

, em

ploy

ers

ther

ewho

offe

r HIV

/AID

S ca

re a

nd tre

atm

ent

dire

ctly to

thei

r st

aff th

roug

h wor

kpla

ceclin

ics

or s

imila

r ar

rang

emen

ts a

re a

lso

elig

ible

.

All o

rgan

isat

ions

mus

t su

pply the

pref

eren

tially

pric

ed p

rodu

cts

on a

not

for pr

ofit

basis.

Price

in U

S$

US$

124

1/ye

ar(U

S$ 1

.700

/uni

t)

Addi

tiona

l co

mm

ents

Supp

ly A

gree

men

tre

quire

d.

(For

NGOs

requ

iring

less

tha

n 10

pat

ient

spa

ck p

er m

onth

, th

isre

quire

men

t m

ay b

ew

aive

d.)

28 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

29

Oth

er g

ener

ic m

anuf

actu

rers

pro

duci

ng A

RVs

exis

t bu

t ar

e no

t in

clud

ed in

this

sum

mar

y of

offe

rs

Com

pany

Auro

bind

o

Cipl

a

Com

bino

phar

m

GPO

Het

ero

Ranb

axy

Strid

es

Del

iver

y of

goo

ds[1

0]

FOB H

yder

abad

(Indi

a)

FOB M

umba

i(In

dia)

or CI

F.Fr

eigh

t ch

arge

sse

para

tely

on

actu

al.

FOB B

arce

lona

(Spa

in)

FOB B

angk

ok(T

haila

nd)

FOB M

umba

i(In

dia)

FOB D

elhi

/Mum

bai

(Indi

a)

FOB B

anga

lore

(Indi

a)

Elig

ibili

ty (co

untrie

s)

No

rest

rictio

n

No

rest

rictio

n

No

rest

rictio

n

No

rest

rictio

n

No

rest

rictio

n

No

rest

rictio

n

No

rest

rictio

n

Elig

ibili

ty (bo

dy)

NGOs

and

Gov

ernm

enta

lOrg

anizat

ions

.

No

rest

rictio

n

No

rest

rictio

n.

Not

-for-p

rofit

org

anizat

ions

and

gove

rnm

ents

.

Priv

ate

sect

or, Pu

blic

sect

or a

nd N

GO’s.

NGO’s a

nd G

over

nmen

tsor

Pro

gram

s su

ppor

ted

byth

em.

Gov

ernm

ents

, no

n pr

ofit

inst

itutio

nal pr

ovid

ers

ofHIV

tre

atm

ent,

NGO’s.

Price

in U

S$

See

Tabl

e 1.

See

Tabl

e 1.

For bu

lk p

urch

ases

prices

are

neg

otia

ble.

See

Tabl

e 1.

See

Tabl

e 1.

See

Tabl

e 1.

Prices

giv

en in

Tabl

e 1

appl

y to

ord

ers

for a

min

imum

of 1.5

mill

ion

units

. Diff

eren

t pr

ices

are

offe

red

for sm

alle

rqu

antit

ies

(50

0 00

0 or

1 m

illio

n un

its).

US$

per

pac

k un

it as

give

n in

pric

e lis

t.

Addi

tiona

l co

mm

ents

Prices

ava

ilabl

e fo

r at

lea

st 1

,000

,000

uni

ts for

each

pro

duct

per

sin

gle

ship

men

t.

Paym

ent by

let

ter of

cre

dit.

No

quan

tity

rela

ted

cond

ition

s. P

rices

are

as

per ta

ble

1 ho

wev

er for

lar

ger qu

antit

ies

the

prices

are

neg

otia

ble.

Del

iver

y te

rms

120

days

.No

min

imum

ord

er req

uire

d un

less

any

spe

cial

labe

lling

is

requ

ired

(sta

ndar

d la

belli

ng is

inSp

anish)

: or

der of

a c

ompl

ete

batc

h. P

ack

of60

or 30

0 ca

psul

es a

vaila

ble

for ZD

V.

Paym

ent by

sig

ned

letter

of cr

edit.

Prices

cou

ld b

e ne

gotia

ted

on ind

ivid

ual ba

sis

acco

rdin

g co

mm

ercial

ter

ms.

Sign

ed let

ter of

cre

dit.

Paym

ent by

sig

ned

letter

of cr

edit.

Tabl

e 2f

Sel

ecte

d ge

neric

com

pani

es’A

RV o

ffer

s an

d re

stric

tions

for

dev

elop

ing

coun

trie

s

Anne

x 2:

Hum

an D

evel

opm

ent In

dex

(HDI)

Sour

ce:

Hum

an D

evel

opm

ent

Repo

rt20

02, M

akin

g ne

w t

echn

olog

ies

wor

kfo

r hu

man

dev

elop

men

t UNDP.

For

full

list

of H

uman

Dev

elop

men

t In

dex

rank

ing

see

http

://w

ww.u

ndp.

org/

hdr2

003/

pdf/p

ress

kit/HDR03

_PKE_

HDI.p

df

Low

hum

an d

evel

opm

ent

Ang

ola;

Ben

in;

Bur

kina

Fas

o;Bur

undi

; Ca

mer

oon;

Cen

tral

Afric

anRe

publ

ic;

Chad

; Co

ngo

(Dem

. Re

p. o

fth

e);

Côte

d’Iv

oire

; Djib

outi;

Eritre

a;Et

hiop

ia;

Gam

bia;

Gui

nea;

Gui

nea-

Bis

sau;

Hai

ti;

Keny

a;

Mad

agas

car;

Mal

awi;

Mal

i; M

aurita

nia;

Moz

ambi

que;

Nep

al;

Nig

er;

Nig

eria

;Pa

kist

an;

Rw

anda

; Se

nega

l; Si

erra

Leon

e; T

anza

nia

(U. Re

p. o

f);

Uga

nda;

Yem

en;

Zam

bia;

Zim

babw

e.

Med

ium

hum

an d

evel

opm

ent

Alb

ania

; Alg

eria

; Ant

igua

and

Bar

buda

; Arm

enia

; Aze

rbai

jan;

Ban

glad

esh;

; Bel

ize;

Bhu

tan;

Bol

ivia

;Bos

nia

and

Her

zego

vina

; Bot

swan

a;Bra

zil;

Bul

garia;

Cam

bodi

a;;

Cape

Verd

e; C

hina

; Co

lom

bia;

Com

oros

;Co

ngo;

; Dom

inic

a; D

omin

ican

Repu

blic

; Ec

uado

r; E

gypt

; El

Salv

ador

; Eq

uato

rial

Gui

nea;

Fiji

;Gab

on;

Geo

rgia

; Gha

na;

Gre

nada

;Gua

tem

ala;

Guy

ana;

Hon

dura

s; Ind

ia;

Indo

nesi

a; Ira

n (Isl

amic

Rep

. of

);

Anne

x 1:

Leas

t Dev

elop

ed C

ount

ries

(LDCs

)

Sour

ce:

UNCT

AD

http

://w

ww.u

ncta

d.or

g/Te

mpl

ates

/Web

Flye

r.asp

?int

Item

ID=21

61&

lang

=1

Forty-

nine

cou

ntries

are

cur

rent

lyde

sign

ated

lea

st d

evel

oped

coun

trie

s (L

DCs

). T

he lis

t is

rev

iew

edev

ery

thre

e ye

ars.

Afg

hani

stan

; Ang

ola;

Ban

glad

esh;

Ben

in;

Bhu

tan;

Bur

kina

Fas

o;Bur

undi

; Ca

mbo

dia;

Cap

e Ve

rde;

Cent

ral A

fric

an R

epub

lic;

Chad

;Co

mor

os;

Dem

ocra

tic

Repu

blic

of

Cong

o; D

jibou

ti;

Equa

torial

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pay

the

cost

s an

d frei

ght

nece

ssar

yto

bring

the

goo

ds t

o th

e na

med

port o

f de

stin

atio

n BUT

the

risk

of

loss

or

dam

age

to t

he g

oods

, as

wel

l as

any

add

itio

nal co

sts

due

toev

ents

occ

urring

after

the

tim

e of

deliv

ery, a

re t

rans

ferred

fro

m t

hese

ller

to t

he b

uyer

.

CIP[1

0] ‘C

arriag

e an

d In

sura

nce

paid

to...

’m

eans

tha

t th

e se

ller

deliv

ers

the

good

s to

the

car

rier

nom

inat

edby

him

but

the

sel

ler

mus

t in

addi

tion

pay

the

cos

t of

car

riag

ene

cess

ary

to b

ring

the

goo

ds t

o th

ena

med

des

tina

tion

. Th

is m

eans

tha

tth

e bu

yer

bear

s al

l th

e risk

s an

d an

yad

dition

al c

osts

occ

urring

after

the

good

s ha

ve b

een

so d

eliv

ered

.How

ever

, in

CIP

the

selle

r al

so h

asto

pro

cure

ins

uran

ce a

gain

st t

hebu

yer’s

ris

k of

los

s of

or

dam

age

toth

e go

ods

during

the

car

riag

e.Co

nseq

uent

ly, th

e se

ller

cont

ract

s fo

rin

sura

nce

and

pays

the

ins

uran

cepr

emiu

m.

d4T

stav

udin

e; n

ucle

osid

e an

alog

uere

vers

e tran

script

ase

inhi

bito

r

ddIdi

dano

sine

; nu

cleo

side

ana

logu

ere

vers

e tran

script

ase

inhi

bito

r

Glo

ssar

y[12]

DDU

[10]

‘Del

iver

ed d

uty

unpa

id’

mea

ns t

hat

the

selle

r de

liver

s th

ego

ods

to t

he b

uyer

, no

t cl

eare

d fo

rim

port, an

d no

t un

load

ed fro

m a

nyar

rivi

ng m

eans

of tran

spor

t at

the

nam

ed p

lace

of de

stin

atio

n. T

hese

ller

has

to b

ear

the

cost

s an

drisk

s in

volv

ed in

brin

ging

the

goo

dsth

eret

o, o

ther

tha

n, w

here

appl

icab

le, an

y ‘d

uty’

(whi

ch t

erm

incl

udes

the

res

pons

ibili

ty for

the

risk

s of

the

car

ryin

g ou

t of

the

cust

oms

form

alitie

s, a

nd t

hepa

ymen

t of

for

mal

itie

s, c

usto

ms

duties

, ta

xes

and

othe

r ch

arge

s) for

impo

rt in

the

coun

try

of d

estina

tion

.Su

ch ‘du

ty’ha

s to

be

born

e by

the

buye

r as

wel

l as

any

cos

ts a

nd r

isks

caus

ed b

y hi

s fa

ilure

to

clea

r th

ego

ods

for

the

impo

rt t

ime.

EML

Esse

ntia

l M

edic

ines

Lis

t. F

irst

publ

ishe

d by

WHO in

1977

, it is

mea

nt t

o id

entify

a lis

t of

med

icin

es, w

hich

pro

vide

saf

e an

def

fect

ive

trea

tmen

t fo

r th

e in

fect

ious

and

chro

nic

dise

ases

, w

hich

affe

ctth

e va

st m

ajor

ity

of t

he w

orld

’spo

pula

tion

. Th

e 12

th U

pdat

ed L

ist

was

pub

lishe

d in

Apr

il 20

02 a

ndin

clud

es 1

2 an

tire

trov

iral

s.

EFV o

r EF

Zef

avire

nz;

non-

nucl

eosi

de a

nalo

gue

reve

rse

tran

script

ase

inhi

bito

r

EXW

[10]

‘Ex-

wor

ks’m

eans

tha

t th

e

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

33

SQV

sgc

saqu

inav

ir s

oft

gel

caps

ules

; pr

otea

se inh

ibitor

TDF

teno

fovi

r; n

ucle

otid

e re

vers

etran

script

ase

inhi

bito

r

UNAI

DS

Uni

ted

Nat

ions

Joi

nt C

o-sp

onso

red

Prog

ram

me

on H

IV/A

IDS,

crea

ted

in 1

996,

to

lead

, st

reng

then

and

supp

ort

an e

xpan

ded

resp

onse

to t

he H

IV/A

IDS

epid

emic

. Th

e si

xor

igin

al C

ospo

nsor

s ar

e UNIC

EF,

UNDP,

UNFP

A, UNES

CO, W

HO a

ndth

e W

orld

Ban

k. U

NDCP

join

ed in

April 19

99

UNDP

Uni

ted

Nat

ions

Dev

elop

men

tPr

ogra

mm

e

WHO

Wor

ld H

ealth

Org

aniz

atio

n

ZDV

zido

vudi

ne;

nucl

eosi

dean

alog

ue r

ever

se t

rans

crip

tase

inhi

bito

r

selle

r de

liver

s w

hen

he p

lace

s th

ego

ods

at t

he d

ispo

sal of

the

buy

erat

the

sel

ler’s

pre

mis

es o

r an

othe

rna

med

pla

ce (

i.e. w

orks

, fa

ctor

y,w

areh

ouse

etc

.) n

ot c

lear

ed for

expo

rt a

nd n

ot loa

ded

on a

nyco

llect

ing

vehi

cle.

FOB

[10]

‘Fre

e on

boa

rd’m

eans

tha

tth

e se

ller

deliv

ers

whe

n th

e go

ods

pass

the

shi

p’s

rail

at t

he n

amed

port o

f sh

ipm

ent. T

his

mea

ns t

hat

the

buye

r ha

s to

bea

r al

l co

sts

and

risk

s of

los

s or

dam

age

to t

hego

ods

from

tha

t po

int. T

he F

OB

term

req

uire

s th

e se

ller

to c

lear

the

good

s fo

r ex

port.

Gen

eric

dru

gAc

cord

ing

to W

HO, a

phar

mac

eutica

l pr

oduc

t us

ually

inte

nded

to

be int

erch

ange

able

with

the

inno

vato

r pr

oduc

t, w

hich

is

usua

lly m

anuf

actu

red

witho

ut a

licen

se fro

m t

he inn

ovat

or c

ompa

ny.

Gen

eric

pro

duct

s m

ay b

e m

arke

ted

eith

er u

nder

a n

on-p

ropr

ieta

ry o

rap

prov

ed n

ame

rath

er t

han

apr

opriet

ary

nam

e.

GPO

Gov

ernm

enta

l Ph

arm

aceu

tica

lOrg

aniz

atio

n (T

haila

nd)

GSK

Gla

xoSm

ithK

line

HIV

Hum

an Im

mun

odef

icie

ncy

Viru

s

IDV

indi

navi

r; p

rote

ase

inhi

bito

r

LDCs

Leas

t Dev

elop

ed C

ount

ries

,ac

cord

ing

to U

nite

d Nat

ions

clas

sific

atio

n

MSD

Mer

ck S

harp

& D

ome

(Mer

ck &

Co.,

Inc.

)

MSF

Méd

ecin

s Sa

ns F

ront

ière

s

NGO N

on G

over

nmen

tal Org

aniz

atio

n

NFV

nel

finav

ir;

prot

ease

inh

ibitor

NNRT

INon

-Nuc

leos

ide

Reve

rse

Tran

script

ase

Inhi

bito

r

NRT

I Nuc

leos

ide

Ana

logu

e Re

vers

eTr

ansc

ript

ase

Inhi

bito

r

NtR

TINuc

leot

ide

Reve

rse

Tran

script

ase

Inhi

bito

r

NVP

nevi

rapi

ne;

non-

nucl

eosi

dean

alog

ue r

ever

se t

rans

crip

tase

inhi

bito

r

PMTC

TPr

even

tion

of M

othe

r-To

-Chi

ldTr

ansm

issi

on

r rito

navi

r, lo

w d

ose

rito

navi

r us

edas

a b

oost

er;

prot

ease

inh

ibitor

SQV h

gc s

aqui

navi

r ha

rd g

elca

psul

es;

prot

ease

inh

ibitor

34 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

April

200

4 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Labo

rato

rios

, Pa

nala

b, F

ilaxi

s(A

rgen

tina

); P

harm

aqui

ck (

Ben

in);

Far

Man

guin

hos,

FURP,

Lap

efe,

Lao

b,Iq

uego

, IV

B (

Bra

zil); Ap

otex

,Nov

opha

rm (

Cana

da); S

hang

hai

Des

ano

Bio

phar

mac

eutica

l co

mpa

ny,

Nor

thea

st G

ener

al P

harm

aceu

tica

lFa

ctor

y (C

hina

); B

ioge

n (C

olom

bia)

;St

ein

(Cos

ta R

ica)

; Zy

dus

Cadi

laHea

lthc

are,

Em

cure

, Su

nPha

rma,

EAS-

SURG

, M

ac L

eods

, IP

CA(Ind

ia);

Cosm

os (

Keny

a);

LG C

hem

ical

s,Sa

mch

ully, Ko

rea

Uni

ted

Phar

m Inc

.(K

orea

); P

rote

in, Pi

sa (

Mex

ico)

;And

rom

aco

(Spa

in); A

spen

(So

uth

Afric

a); T.O. Ch

emec

al (

Thai

land

);La

bora

torio

Dos

a S.

A. (U

S), Va

rich

em(Z

imba

bwe)

.Th

is lis

t is

not

exh

aust

ive.

[6] Sc

alin

g up

ant

iretrov

iral th

erap

yin

res

ourc

e-lim

ited

settin

gs:

Trea

tmen

t gu

idel

ines

for

a p

ublic

heal

th a

ppro

ach

2003

Rev

ised

vers

ion.

http

://w

ww.w

ho.in

t/hi

v/pu

b/pr

ev_c

are/

en/A

RVGui

delin

esRe

vise

d200

3.pd

f

[7] Gui

delin

es for

the

Use

of

Antir

etro

vira

l Ag

ents

in

HIV

-1-

Infe

cted

Adu

lts a

nd A

dole

scen

ts, by

the

Pane

l on

Clin

ical

Pra

ctic

es for

the

Trea

tmen

t of

HIV

, M

arch

23,

2004

.ht

tp://

aids

info

.nih

.gov

/gui

delin

es/a

dult

/AA_0

3230

4.pd

f

Refe

renc

es[1] Ac

cess

ing

ARV

s: U

ntan

glin

g th

eW

eb o

f Pr

ice

Redu

ctio

ns for

Dev

elop

ing

Coun

trie

s , first

edi

tion

,Oct

ober

200

1 an

d se

cond

edi

tion

,Ju

ne 2

002,

thi

rd e

dition

, Dec

embe

r20

02, fo

urth

edi

tion

, Ju

ne 2

003

and

fifth

edi

tion

, Dec

embe

r 20

03.

[2] Pi

lot

Proc

urem

ent, Q

ualit

y an

dSo

urci

ng P

roje

ct: Ac

cess

to

HIV

/AID

Sdr

ugs

and

diag

nost

ics

of a

ccep

tabl

equ

ality

, 14

th e

dition

28

Janu

ary

2004

. ht

tp://w

ww.w

ho.in

t/m

edic

ines

/or

gani

zation

/qsm

/act

ivitie

s/pi

lotp

roc/

pilo

tpro

c.sh

tml

[3] So

urce

s an

d pr

ices

of se

lect

eddr

ugs

and

diag

nost

ics

for

peop

leliv

ing

with

HIV

/AID

S . A

join

t UNIC

EF,

UNAID

S Se

cret

aria

t, W

HO, M

SFpr

ojec

t. M

ay 2

004

(WHO/E

DM

/PAR/2

003.

2).

http

://w

ww.w

ho.in

t/m

edic

ines

/org

aniz

atio

n/pa

r/ip

c/so

urce

s-pr

ices

.pdf

[4] Tw

o Pi

lls a

Day

Sav

ing

Live

s:Fi

xed-

dose

com

bina

tions

(FD

Cs)

ofan

tiret

rovi

ral dr

ugs .

MSF

Brief

ing

Not

e, F

ebru

ary

2004

.ht

tp://w

ww.a

cces

smed

-msf

.org

/do

cum

ents

/fact

shee

tfdc

.pdf

[5] Oth

er g

ener

ic m

anuf

actu

rers

know

n to

be

prod

ucin

g on

e or

mor

eARV

s bu

t no

t in

clud

ed in

this

docu

men

t ar

e: R

ichm

ond

[8] Pa

tent

Situ

atio

n of

HIV

/AID

Sre

late

d dr

ugs

in 8

0 co

untrie

s ,W

HO/U

NAID

S, 2

000.

http

://w

ho.in

t/m

edic

ines

/libr

ary/

par/hi

vrel

ated

docs

/pat

ents

hivd

rugs

.pdf

[9] ht

tp://w

ww.a

cces

smed

-m

sf.o

rg/d

ocum

ents

/pat

ents

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3.pd

f

[10]

Inc

oter

ms

2000

.ht

tp://w

ww.ic

cwbo

.org

/inde

x_in

cote

rms.

asp

[11] T

o fin

d th

e HIV

pre

vale

nce

stat

usof

cou

ntries

see

http

://w

ww.w

ho.in

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idem

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pubf

acts

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[12]

Abb

revi

atio

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ARV

s ar

eta

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from

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WHO d

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Scal

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up A

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Publ

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RVGui

delin

esRe

vise

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f

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•Ap

ril 2

004

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

35

Cam

paig

n fo

r Ac

cess

to

Esse

ntia

l M

edic

ines

Méd

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ns F

ront

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Documents

Sources and prices of selected drugs and diagnostics for people living with HIV/AIDS