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Can voluntary pooled procurement reduce the price of antiretroviral drugs? a case study of Efavirenz.

Kim, SW; Skordis-Worrall, J; (2017) Can voluntary pooled procurement reduce the price of antiretroviral drugs? a case study of Efavirenz. Health Policy and Planning , 32 (4) pp. 516-526. 10.1093/heapol/czw165. Green open access

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Abstract

PURPOSE: A number of strategies have aimed to assist countries in procuring antiretroviral therapy (ARV) at lower prices. In 2009, as the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) commenced a voluntary pooled procurement scheme, however, the impact of the scheme on ARV prices remains uncertain. This study aims to estimate the effect of VPP on drug prices using Efavirenz as a case study. METHODS: This analysis uses WHO Global price report mechanism (GPRM) data from 2004 to 2013. Due to the highly skewed distribution of drug Prices, a generalized linear model (GLM) was used to conduct a difference-in-difference estimation of drug price changes over time. RESULTS: These analyses found that voluntary pooled procurement reduced both the ex-works price of generic Efavirenz and the incoterms price by 16.2 and 19.1%, respectively (P < 0.001) in both cases). The year dummies were also statistically significant from 2006 to 2013 (P < 0.001), indicating a strong decreasing trend in the price of Efavirenz over that period. CONCLUSION: Voluntary pooled procurement significantly reduced the price of 600 mg generic Efavirenz between 2009 and 2013. Voluntary pooled procurement therefore offers a potentially effective strategy for the reduction in HIV drug prices and the improvement of technical efficiency in HIV programming. Further work is required to establish if these findings hold also for other drugs.

Type: Article
Title: Can voluntary pooled procurement reduce the price of antiretroviral drugs? a case study of Efavirenz.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/heapol/czw165
Publisher version: https://doi.org/10.1093/heapol/czw165
Language: English
Additional information: This is a pre-copyedited, author-produced PDF of an article accepted for publication in [insert journal title] following peer review. The version of record Sung Wook Kim, Jolene Skordis-Worrall; Can voluntary pooled procurement reduce the price of antiretroviral drugs? a case study of Efavirenz. Health Policy Plan 2017 czw165. doi: 10.1093/heapol/czw165 is available online at: http://dx.doi.org/10.1093/heapol/czw165.
Keywords: Difference-in-difference, procurement price, the global fund to fight AIDS, tuberculosis and malaria (GFATM), voluntary pooled procurement
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/1536513
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