sources & prices of selected medicines 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

WHO

JUNE 2003

WHO/EDM/PAR/2003.7

This report is also available

On the following web pages:

UNICEF: www.unicef.org

UNICEF Supply Division: www.supply.unicef.dk

UNAIDS: www.unaids.org

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

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

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

Or by contacting:

Pharmaceuticals & Micronutrients GroupUNICEF Supply DivisionFax: +45 35 269421

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

Department of Policy Strategy and ResearchUNAIDSFax: +41 22 7914741

Campaign for Access to Essential DrugsMédecins 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 Blood Safety and Clinical Technology website: www.who.int/bct

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

© World Health Organization, UNICEF Supply Division, Joint United Nations Programme on HIV/AIDS (UNAIDS), MédecinsSans Frontières, 2003. 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 graphicsPrinted in France

Contents

ANNEX 4.FURTHER READING, REFERENCES, AND CONTACTS

iii

Glossary v

1. Introduction 1

2. Pricing 3

3. Access to quality HIV/AIDS medicines and diagnostics 5

4. Sources and prices of medicines 7

5. Variation in price between surveys 14

Annex 1 A. Registration status of products included in the sources and prices survey 15

B. Index of manufacturers 33

C. Geographical distribution of participating manufacturers 40

Annex 2 WHO Bulk Procurement Scheme 2003 41

Annex 3 A. Summary of main characteristics of methods for CD4/CD8 lymphocyte determination 44

B. Summary of main characteristics of Viral Load Technologies 45

Annex 4 Further reading, references and contacts 48

Annex 5 Feedback and enquiry form 51

Annex 6 Untangling the web of price reductions: a pricing guide for the purchase of ARVs fordeveloping countries 53

Tables

Table 1. Anti-infective medicines 7

Antibacterials 7

Antifilarials 8

Antifungal medicines 8

Anthelminthics 9

Antiprotozoal medicines 9

Antiviral medicines 9

Antiretroviral medicines 9

Table 2. Antineoplastic medicines 11

Cytotoxic medicines 11

Table 3. Psychotherapeutic medicines 12

Medicines used in depressive disorders 12

Medicines used in generalized anxiety and sleep disorders 12

iv


Table 4. Analgesics 12

Opioid analgesics 12

Medicines used in the treatment of opioid dependence 12

Table 5. Gastrointestinal medicines 13

Antacids and other antiulcer medicines 13

Antiemetic medicines 13

Laxatives 13

Table 6. Variation in the price of ciprofloxacin and fluconazole between surveys 14

Glossary

AIDS1 Acquired Immune Deficiency Syndrome – the latestage of HIV disease. AIDS involves the loss of func-tion of the immune system as CD4 cells are infectedand destroyed, allowing the body to succumb toopportunistic infections (e.g., Pneumocystis cariniipneumonia, toxoplasmosis) that are generally not patho-genic in people with intact immune systems.

COF Consejo General de Colegios Oficiales de Farmacéu-ticos – Spanish organization of PharmaceuticalColleges, which represents all colleges in the nationaland international forum, develops norms, rules, andprofessional policy, and acts as the interlocutor withSpanish Ministries.

Diagnostics Laboratory tests used in the diagnosis ofHIV infection.

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 a geo-graphic location, community or population.

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

EXW2 Ex-works – (... named place) the seller’s only re-sponsibility is to make the goods available at the sell-er’s premises, i.e., the works or factory. The seller isnot 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)This term has been designed to meet the requirementsof multimodal 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 sales agree-ment. The risk of loss of or damage to the goods istransferred to the buyer when the goods pass the ship’srail (i.e., off the dock and placed on the ship). Theseller 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 a pharmaceu-tical product usually intended to be interchangeablewith the innovator product, which is usually manufac-tured without a license from the innovator companyand marketed after expiry of patent or other exclusiv-ity rights where these have previously existed. Genericproducts may be marketed either under the non-pro-prietary approved name or under a new brand (propri-etary) name. They may sometimes be marketed indosage forms and/or strengths different from thoseof the innovator products.

Generic pharmaceutical manufacturers Manufactu-rers who produce generic medicines

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 transmitted sexu-ally, through blood or vertically (from mother to child).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.

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

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

International Price Indicator Guide 2002 A joint pub-lication by the World Health Organization and Manage-ment Sciences for Health (MSH). Provides a spectrumof prices from non-profit drug suppliers, procurementagencies, and ministries of health, based on their cur-rent catalogs or price lists.

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

MSF Médecins Sans Frontières – setting up medical hu-manitarian aid missions around the world since 1971.

MSH Management Sciences for Health – private, non-profit educational and scientific organization workingto close the gap between knowledge and action inpublic health.

MTCT Mother-to-child transmission (of HIV)

Opportunistic infections1 (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 is sup-pressed. Common OI in HIV positive people includePneumocystis carinii pneumonia (PCP), Mycobacteriumavium complex (MAC) and cytomegalovirus (CMV) in-fection.

Palliative care4 Pain and symptom management, andpsycho-social support for persons living with a termi-nal illness, 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 authorities confer-ring a temporary monopoly for the exploitation of aninvention upon the person who reveals it, furnishes asufficiently 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.

Research based pharmaceutical manufacturersManufacturers that produce mainly innovative medi-cines

Reverse transcriptase inhibitor Type of ARV medicine.Can be divided into two classes: Nucleoside ReverseTranscriptase Inhibitor (NRTI) and Non Nucleoside Re-verse 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 or

no equipment, making them particularly suitable foruse in Voluntary Counselling and Testing (VCT) centres.

The World Bank Group Established in July 1, 1944 it isone of the world’s largest sources of development as-sistance. In Fiscal Year 2002, the institution providedmore than US$19.5 billion in loans to its client coun-tries.

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 to coordi-nate this effort.

UNFPA United Nations Population Fund, began operationsin 1969. It is the largest international source of popu-lation assistance. About a quarter of all population as-sistance from donor nations to developing countries ischannelled through UNFPA.

UNICEF United Nations Children’s Fund – Created by theUnited Nations General Assembly in 1946 to help chil-dren 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.

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 WTO

1

1. Introduction

Even where affordable alternatives exist, many decision-makers do not have the information they need to identifythose manufacturers that can supply these medicines.They require easier access to comparative prices.

1.2 Aim

This report sets out to provide market information thatcan be used to help procurement agencies make informeddecisions on the source of medicines and serve as thebasis for negotiating affordable prices. The aim is to helpincrease access to medicines for people living with HIV/AIDS in developing countries.

The data provided by the manufacturers serves to high-light the multiplicity of suppliers and the variation in priceof some essential HIV/AIDS-related medicines on the in-ternational market. Without this information, there is arisk that low-income countries may be paying more thanneeded to obtain essential medicines. Price variations arehighlighted through the tables and graphs included.

Provision of price information addresses only one barrierto access to medicines in countries with limited resourcesand, it is appreciated that many other factors will affectthe availability of medicines. Some of the other issuesthat must be considered in relation to the purchase ofmedicines for HIV/AIDS and related conditions are healthinfrastructure, human resources, and supply and distribu-tion systems.9

1.1 Background

Improving access to medicines for people living with HIV/AIDS presents a challenge for all countries, and an evengreater challenge for the developing nations. By the endof 2002, UNAIDS estimated that the total number of peo-ple living with HIV/AIDS stood at 42 million, including 5million new infections. In the same year, an estimated 3.1million people died of the disease. Over 95% of the peo-ple infected live in developing countries.

The national ownership, initiative, and responsibility takenby National AIDS programme managers, health directorsand Health Ministers in these countries is commendable,but the issue of inadequate funding still remains.

To reduce the disparity between needs and funding, suc-cessful proposals from low income countries are receiv-ing much needed grants from the Global Fund to FightAIDS, TB, and Malaria as well as other International Devel-opment Assistance, for strategies to prevent new infec-tions, including prevention of mother to child transmission,and treatment and care of infected people. With this newfunding, the number of people being treated withantiretrovirals is expected to increase six-fold. This scale-up will require the careful identification, selection, andprocurement of medicines.

The high price of many of the HIV-related medicines of-fered by common suppliers—especially antiretroviralmedicines—is one of the main barriers to their availabil-ity in developing countries.7 These medicine prices maybe governed by the following factors:

— Patents8

— Limited volume

— Limited price competition

— High import duties, tariffs, and local taxes

— High mark-ups for wholesaling, distribution, and dis-pensing

— Individual country pricing strategies—for example,price fixing by the government, policies of pricefreedom for new products or even agreements withindustry on profit control.


7 UN agencies and partners are working together to help ex-pand access to the full range of HIV-related medicines, withinthe context of local health care systems and national HIV/AIDS plans and priorities. A four-part strategy has been adoptedto guide and coordinate action on access to HIV-related medi-cines: (1) rational selection and use of HIV-related medicines(2) affordable prices (3) sustainable financing and (4) reliablehealth supply systems.

8 For further information on Patents and the TRIPS agreement,refer to Annex 4, Further Reading: Intellectual Property Rightsand pharmaceuticals.

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.


2

1.3 Generating the Report

This report is the fourth in a series of annual reports ofsources and prices surveys commenced in 1999. Thesesurveys will be continued and the report will be regularlyupdated and made available when appropriate.

A survey, carried out from Dec 2002 through to Feb 2003,of 388 manufacturers in 50 different countries was thebasis of this report. The number of manufacturers reachedhas greatly increased since the first survey in 1999 asmore resources are made available via industry websitesand cooperation with other international organizations;allowing this publication to include 61 manufacturers.Manufacturers that participated in previous surveys, thoseheld in various databases, and those belonging toNational Pharmaceutical Associations were contacted andasked to fill in a comprehensive questionnaire. The re-sponse to the questionnaire was accompanied by a Na-tional GMP certificate and associated documents relatingto the company and the products.

The UNAIDS Secretariat, UNICEF, MSF, and WHO haveworked jointly to conduct the survey, and put togetherthe responses into an easy to use, comprehensive publi-cation, whilst respecting the manufacturers’ requests forconfidentiality with respect to their individual pricing infor-mation.

It must be pointed out however that the companies in-cluded in this report have been screened only through thecompleteness of the documents they have provided. In-clusion in the report does not necessarily constituteprequalification or approval of any sort by UNICEF, WHO,UNAIDS or MSF. Only those products identified in Annex1A in bold and with an asterisk (*) have (at the time ofpublication of this document) been approved through theongoing Pilot Procurement Quality and SourcingProject (see section 3.)

1.4 Selection of medicines

The 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.

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 required for the compre-hensive treatment of HIV/AIDS.

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

— Greater cost offset by greater safety, e.g. fluco-nazole instead of ketoconazole.

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

For this survey, paediatric forms have been included wher-ever possible.

Antiretroviral therapySince October 2000, the report has included informationon the availability and price range of antiretroviral medi-cines for use in Highly Active Antiretroviral Therapy(HAART). More specific information on treatment sched-ules should be obtained from the WHO department of HIV/AIDS at the following webpage http://www.who.int/HIV_AIDS.

Antituberculosis medicinesThis report does not include data on sources and pricesof medicines for the treatment of tuberculosis as this in-formation is available on the website of the InternationalPrice Indicator Guide 200210 or of the Global DrugFacility at http://www.stoptb.org/GDF/drugsupply/drugs.available.html.

10 The International Price Indicator Guide 2002 is a joint publica-tion of MSH and WHO. For more information refer to Annex 4,Websites: Drug Prices.

3

2. Pricing

for developing countries” included in this publication asAnnex VI.

2.3 Additional methods ofcost reduction

In addition to generic competition and advocacy for thereduced pricing of HIV medicines in line with the purchas-ing power of countries, important parallel avenues to bepursued by governments include, for example, the activeuse of compulsory licensing, government use of patentsand parallel importation. As agreed by the Member Statesof the World Trade Organization in 2001, least developedcountries (LDCs) are not obliged to enforce pharmaceuti-cal patents until at least 2016.12 LDCs should make useor avail themselves of this provision to purchase lowestcost medicines on the world market. The Global Fund “en-courages recipients to comply with national laws and ap-plicable international obligations in the field of intellectualproperty including the flexibilities provided in the TRIPSagreement and referred to in the Doha Declaration in amanner that achieves the lowest possible price for prod-ucts of assured quality.”13 Other measures may includereducing or eliminating import duties and taxes, and in-creasing demand through pooled procurement.

2.4 Information accompanyingeach medicine

The prices indicated in this report are based on the pricedata of 1st quarter 2003, unless indicated otherwise.

The following information is provided for each medicine:

• The number of manufacturers that gave an in-dicative price


2.1 Context

The prices listed generally apply in the context of bulkprocurement i.e. the working unit is one batch. Althoughbatch sizes vary greatly among formulations and manu-facturers, the following sizes are typical: capsules andtablets in batches of 100,000 to 500,000 (these are notminimum purchases, batches of over 1 million are notuncommon); vials and bottles in batches of 5,000 to20,000.

Prices are ex-works (EXW) or free-on-board (FOB). Theydo not include the added cost of items such as freight,insurance, import duties or taxes. For this reason theprices quoted in this report cannot be compared withconsumer prices. Many countries continue to imposeconsiderable import duties and taxes on the price of es-sential medicines.11 In addition, wholesale and retail mark-ups vary from one country to the other. As a result, theex-works price is often less than half of the end-price tothe consumer.

Price information and exchange rates are subject to vari-ation, and relate to the date at which the offer was made.

2.2 Offers of donation andprice reductions

Public pressure, advocacy, competition from genericmanufacturers and initiatives from pharmaceutical com-panies have led to reduced prices of some drugs for de-veloping countries. There is no systematic approach tothe differential pricing. Each company determines its owneligibility criteria for countries, sectors and institutionsthat may benefit from its reduced price. Some compa-nies 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 Section 4 of this publicationdo not necessarily reflect all agreements that may havebeen negotiated with individual countries. Information onprice offers for antiretroviral medicines publicly announcedby pharmaceutical manufacturers, including informationon countries eligible for the offers and other conditions,can be found in the MSF report “Untangling the web ofprice reductions: a pricing guide for the purchase of ARVs

11 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

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

13 The Global Fund to Fight AIDS, Tuberculosis and Malaria, Re-port of the Third Board Meeting, GF/B4/2, page 25, para 10(a).


4

• The indicative price

UnitThe price quoted relates to the unit described, for exam-ple, if the unit is “tab” the price quoted is for a singletablet.

Maximum priceThe maximum price listed represents the highest priceamong products, with no differentiation among originalor generic products.

Minimum priceThe minimum price listed represents the lowest priceamong products, with no differentiation among originalor generic products.

Median priceThe 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 are belowit.

25th percentileThe value point representing the first quartile of quotedprices in ascending order. It is used to give some indica-tion of the dispersion of prices for a given product.

No. < than 25th percentileThis is used to indicate how many manufacturers can pro-duce the medicine below the 25th percentile price range.

• The Brazilian list priceThe Brazilian list price included in this report representsthe minimum price payable by Brazilian health institutionsfor the product and is taken from the Brazilian databankof health purchases. Where the entry reads “none”, thisindicates no purchase has been made for that product,therefore no minimum price payable is available.

• The Spanish list priceThis price is ex-works and has been calculated by apply-ing the new margins (as stated in the Royal Decree 286/2001) to the consumer price as published by ConsejoGeneral de Colegios Oficiales de Farmacéuticos in Spain(www.cof.es). It should be noted that Spanish list pricesare generally considered the lowest in Europe. In mostcases, the indicative prices listed in the report are a frac-tion of the comparative prices in the Spanish list.

5

3. Access to quality HIV/AIDSmedicines and diagnostics

3.1 Pilot Procurement Quality andSourcing Project

The Pilot Procurement, Quality and Sourcing Project wasstarted 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 pilot project evaluates pharmaceutical products ac-cording to WHO recommended standards of quality andcompliance with Good Manufacturing Practices. It is thebeginning of an ongoing process that will expand as par-ticipation of suppliers increases. A list of suppliers whoseHIV-related medicines have been found acceptable, in prin-ciple, for procurement by UN agencies is now availableon the web sites of collaborating UN agencies.

As of March 2003, 160 product dossiers for various prod-ucts and dosage forms from 21 manufacturers were re-ceived and 74 of these products, from 11 manufacturers,have been fully reviewed and listed as pre-qualified prod-ucts. The remaining products are currently under review.The products evaluated include antiretroviral medicines,and medicines for the treatment of opportunistic infec-tions and cancers. A list of products evaluated under thispilot project is regularly updated through the websites ofcollaborating UN agencies. Interested readers are advisedto consult these sites for the latest versions, or to ac-cess the list via the WHO website: (http://www.who.int/medicines/organization/qsm/activities/pilotproc/suppliers.doc)

The survey on Sources and Prices of Selected Medicinesand Diagnostics for People Living with HIV/AIDS is a pric-ing service, not a prequalification service. Every efforthas been made to ensure the accuracy of the price infor-mation presented here and screening of the products in-cluded in this survey has been carried out as indicated onpage 2. This screening, however, in no way constitutesan in depth review of product quality. Products that havebeen pre-qualified by the Pilot Procurement, Qualityand Sourcing Project are marked in Annex Ia of thisdocument in bold and with an asterisk (*). Other productslisted in this document should, in relation to purchase, besubject to pre-qualification review as indicated in the WHO


General Procedure for Prequalification of Suppliersof Pharmaceutical Products.

(Please refer to http://www.who.int/medicines for moreinformation.)

3.2 Product registration

Annex 1A provides information on countries in which themajority of products listed are currently registered. Thisinformation is given as supplied by manufacturing com-panies, and is subject to change.

3.3 Diagnostics

In 1989, WHO established a HIV test kit bulk-procurementscheme, which now is operated in collaboration with otherUnited Nations organizations (UNAIDS Secretariat, UNICEF,UNFPA, and World Bank). The aim is to provide nationalAIDS programmes, blood transfusion services, large hos-pitals, non-governmental organizations, reference labora-tories, UN agencies, donor-supported AIDS projects, andregulatory authorities in developing countries with highquality tests at the lowest possible cost.

Since 1988, WHO has provided objective assessmentsof commercially available test kits. This ongoing evalua-tion programme is coordinated by the Department of BloodSafety and Clinical Technology. All HIV tests availablethrough the scheme have been evaluated by the WHOevaluation programme and meet specific, rigorous crite-ria (see Annex 2 for further details). Bulk purchase pricesfor all assays in the scheme are directly negotiated withthe manufacturers, a process that enables the scheme tooffer a per test cost approximately half that of tests pur-chased on the open market, which has resulted in sub-stantial cost savings.

The test kits on the list are reviewed annually and coverthe three broad categories, including simple/rapid test,ELISA tests and supplemental tests. Annex 3A providesan overview of the assays included in the HIV test kit bulkprocurement scheme 2003.

Over recent years there has been an increase in the avail-ability and demand for simple/rapid tests. These are easy-


6

to-use tests that require little or no equipment and limitedtraining to perform and can provide accurate same–dayresults. This makes them particularly suitable for use involuntary counselling and testing (VCT) centres and inantenatal clinics for prevention of mother to child trans-mission of HIV. When initial tests are reactive for HIV, con-firmation of the test results is needed to rule out any falsepositive results. In formation on recommended WHO test-ing strategies is available in Weekly EpidemiologicalRecord, 1997, 72, 81–88.

Increased access to antiretroviral (ARV) medicines hasalso highlighted the need for appropriate and cost effec-tive diagnostic support. Diagnostic support is essential

to monitor the progression of the disease, the effective-ness of the 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 available types ofCD4 T-cell enumeration technologies are given in Annex3A, whilst information on HIV Viral Load technologies andHIV resistance tests is given in Annex 3B. Please notethat this information is regularly updated and available onthe WHO website at www.WHO.int/bct (follow the links toKey Initiatives, HIV Diagnostics, HIV Test Kit Bulk Procure-ment Scheme).

7

4. Sources & prices of medicines

Table 1. Anti-infective medicines

Manufacturer Indicative prices, US$ List prices, US$

NoNo No < than

Antibacterials of of 25th 25thbeta-lactam medicines manuf countries unit max min median perc perc Brazil Spain

cefixime

paediatric oral suspension, 4 3 ml 0.201 0.016 0.028 0.023 1 none 1.422100 mg/ 5 ml

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

tablet, 200 mg 4 3 tab 1.213 0.210 0.438 0.334 1 none 0.790

tablet, 400 mg 6 6 tab 0.460 0.064 0.103 0.075 2 none n/a

ceftriaxone

powder for injection, 250 mg 11 7 vial 2.250 0.600 1.000 0.790 3 1.113 2.274(as sodium salt) in vial

powder for injection, 1 g 3 3 vial 1.820 0.679 1.000 0.839 1 none n/a(as sodium salt) in vial

Other antibacterials

azithromycin

capsule, 250 mg (dihydrate) 5 3 caps 0.532 0.120 0.200 0.146 2 none 1.251

capsule, 500 mg (dihydrate) 3 2 caps 2.812 0.180 0.300 0.240 1 1.106 3.861

capreomycin

powder for injection, 1 g in vial 2 2 vial 5.000 5.000 5.000 5.000 1 none 2.361

ciprofloxacin

tablet, 250 mg (as hydrochloride) 25 12 tab 0.792 0.011 0.047 0.017 3 0.026 0.303

tablet, 500 mg (as hydrochloride) 3 3 tab 0.170 0.024 0.054 0.039 1 none n/a

clarithromycin

tablet, 250 mg 12 8 tab 0.700 0.105 0.150 0.137 3 0.504 0.568(as 500 mg)

clindamycin

capsule, 150 mg 3 3 caps 0.311 0.036 0.113 0.074 1 0.118 n/a

injection, 150 mg (as phosphate)/ml 2 2 2 ml vial 1.592 0.191 0.891 0.541 1 0.4715 n/a (600 mg/

4 ml)

cycloserine

capsule, 250 mg 2 1 caps 1.500 0.500 1.000 0.750 1 none n/a



8


NoNo No < thanof of 25th 25th

Other antibacterials manuf countries unit max min median perc perc Brazil Spain

erythromycin

powder for oral suspension, 125 mg 7 6 ml 0.018 0.002 0.009 0.006 2 0.006 n/aequivalent

tablet, 250 mg (as stearate) 17 8 tab 0.096 0.015 0.032 0.028 6 0.049 0.104

ofloxacin

IV infusion, 2 mg/ml (hydrochloride) 1 1 ml 0.032 0.032 0.032 0.032 1 none 3.150


spectinomycin

powder for injection, 2 g (as 1 1 vial 4.000 4.000 4.000 4.000 1 none 2.275hydrochloride) in vial

sulfadiazine

tablet, 500 mg 5 4 tab 0.257 0.022 0.036 0.028 2 0.037 0.054

sulfamethoxazole+

trimethoprim

oral suspension, 200+40 mg/5 ml 11 9 ml 0.009 0.001 0.006 0.005 4 none n/a

tablet, 100+20 mg 10 5 tab 0.024 0.003 0.008 0.005 4 0.010 n/a

tablet, 400+80 mg 20 10 tab 0.035 0.006 0.009 0.008 7 0.010 n/a

tablet, 800+160 mg 2 2 tab 0.100 0.030 0.065 0.048 1 0.010 n/a

Antifilarials

crotamiton

cream/lotion 10% 1 1 ml 0.010 0.010 0.010 0.010 1 none 0.573

ivermectin*

lindane*

Antifungal medicines

amphotericine B

powder for injection, 50 mg in vial 2 2 vial 9.000 4.464 6.732 5.031 1 none 2.339

fluconazole


capsule, 200 mg 7 4 caps 0.600 0.038 0.200 0.126 2 none 6.346

solution for injection, 2mg/ml 3 2 bottle 1.650 0.546 0.820 0.683 1 1.610 n/ain 100 ml bottle

itraconazole

capsule, 100 mg 3 2 caps 0.960 0.111 0.140 0.126 1 0.256 1.100

ketoconazole

tablet, 200 mg 12 9 tab 0.150 0.024 0.042 0.037 5 0.041 0.304

* No price information

9



Antifungal medicines manuf countries unit max min median perc perc Brazil Spain

miconazole

cream, 2% in 15 g tube 4 4 tube 0.400 0.120 0.360 0.240 1 0.428 n/a

cream, 2% in 30 g tube 7 5 tube 1.245 0.333 0.560 0.435 2 none n/a

Anthelminthics

albendazole

chewable tablet, 400 mg 9 6 tab 0.200 0.017 0.050 0.041 3 0.033 n/a

Antiprotozoal medicines

pentamidine

powder for injection, 300 mg 3 3 vial 48.400 8.599 24.700 16.650 1 none 8.618(isetionate) in vial

pyrimethamine


tinidazole


Antiviral medicines

aciclovir


tablet, 200 mg 14 10 tab 0.435 0.034 0.065 0.042 4 0.034 0.616

tablet, 400 mg 8 6 tab 0.500 0.008 0.069 0.060 4 0.093 n/a


cidofovir*

famciclovir*

foscarnet sodium*

ganciclovir

powder for injection, 500 mg in vial 1 1 vial 42.52 42.52 42.52 42.52 1 9.263 21.478

imiquimod*

podofilox*

valacyclovir*

valganciclovir*

Antiretroviral medicines

abacavir (ABC)

oral solution, 20 mg/ml 1 1 ml 0.145 0.145 0.145 0.145 1 0.156 n/a

tablet, 300 mg 1 1 tab 1.350 1.350 1.350 1.350 1 2.044 n/a

4. SOURCES & PRICES OF MEDICINES



10



Antiretroviral medicines manuf countries unit max min median perc perc Brazil Spain

amprenavir (APV)*

didanosine (ddl)

powder for syrup, 2 g 1 1 bottle — — — — — none 23.160


tablet, 100 mg 6 5 tab 1.875 0.175 0.315 0.212 2 0.385 1.289

efavirenz (EFZ)

capsule, 200 mg 6 3 caps 2.001 0.430 0.493 0.452 1 0.846 3.299


indinavir (IDV)


lamivudine (3TC)

oral solution, 50 mg/5 ml 1 1 bottle 5.070 5.070 5.070 5.070 1 10.181 n/a

tablet, 150 mg 8 5 tab 1.531 0.119 0.184 0.161 3 0.288 2.701

nelfinavir (NFV)

capsule, 250 mg 4 4 caps 0.921 0.252 0.436 0.376 1 0.723 1.255

nevirapine (NVP)


suspension, 50 mg/5 ml 2 2 ml 0.025 0.014 0.019 0.017 1 none 0.194

ritonavir (RTV)*

saquinavir (SQV)


stavudine (d4T)

powder for syrup, 1 mg/ml 2 2 ml 0.013 0.011 0.012 0.011 1 none 0.144


zalcitabine (ddC)

tablet, 0.75 mg 2 2 tab 0.865 0.046 0.456 0.251 1 none 1.517

zidovudine (AZT or ZDV)

capsule, 100 mg 13 8 caps 1.000 0.078 0.132 0.098 4 0.132 0.787



injection, 10 mg/ml in 20 ml vial 2 2 vial 9.330 2.140 5.735 3.938 1 none n/a

oral solution, 50 mg/5 ml 5 4 ml 0.062 0.016 0.023 0.019 1 none 0.073


11




Antiretroviral – combinations manuf countries unit max min median perc perc Brazil Spain

3TC/AZT

tablet, 150/300 mg 7 5 tab 2.951 0.063 0.433 0.362 1 0.564 5.558

lopinavir (LPV)/RTV*

3TC/ABC/ZDV

3TC/D4T/NVP

tablet, 150/40/200 mg 3 2 tab 0.496 0.400 0.417 0.408 1 none n/a

Table 2. Antineoplastic medicines



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

bleomycin

powder for injection, 15 mg 3 3 vial 25.000 18.000 21.000 19.500 1 17.433 13.617(as sulphate) in vial

calcium folinate (leucovorin)


doxorubicine HCl



liposomal, conc for IV infusion, — — vial — — — — — none 424.6892mg/ml in vial1*

etoposide


injection, 20 mg/ ml in 5 ml ampoule 5 4 amp 25.000 5.000 8.000 5.000 2 2.659 7.772

methotrexate


tablet, 2.5 mg 2 2 tab 0.188 0.080 0.134 0.107 1 0.109 0.048

vinblastine

powder for injection, 10 mg 3 3 vial 14.260 1.400 8.000 4.700 1 6.772 n/a(sulphate) in vial

vincristine

powder for injection, 1 mg 4 3 vial 6.000 1.500 2.440 1.725 1 1.946 n/a(sulphate) in vial

vinorelbine

inj conc 10mg/ml in 1 ml vial 2 2 vial 38.000 16.480 27.240 21.860 1 none 18.434



12

Table 3. Psychotherapeutic medicines


NoNo No < than

Medicines used in of of 25th 25thdepressive disorders manuf countries unit max min median perc perc Brazil Spain

amitriptyline

tablet, 25 mg 4 3 tab 0.012 0.004 0.006 0.004 1 0.007 0.021

fluoxetine

capsule, 20 mg 9 6 caps 0.150 0.019 0.056 0.021 3 0.039 0.298

Medicines used in generalized anxiety and sleep disorders

lorazepam

tablet, 1 mg 3 2 tab 0.325 0.012 0.019 0.015 1 0.100 0.016

methotrimprazine/

levomepromazine*

Table 4. Analgesics



Opioid analgesics manuf countries unit max min median perc perc Brazil Spain

codeine

tablet, 30 mg 5 4 tab 0.060 0.020 0.030 0.030 2 0.237 0.102

morphine

injection, 10 mg (hydrochloride) 1 1 amp 0.2861 0.2861 0.2861 0.2861 1 none n/ain 1 ml ampoule

oral solution (sulphate), 10 mg/5 ml 1 1 bottle 2.7416 2.7416 2.7416 2.7416 1 none n/ain 100 ml bottle

pethidine

inj, 50 mg (hydrochloride)/ml 4 4 amp 0.390 0.332 0.352 0.346 1 0.279 n/ain 2-ml ampoule


Medicines used in the treatment of opioid dependence

buprenorphine*

sublingual tablet, 0.2 mg 1 1 tab 0.070 0.070 0.070 0.070 1 0.150 0.319(hydrochloride)

naltrexone HCl



13


Table 5. Gastrointestinal medicines


NoNo No < than

Antacids and other of of 25th 25thantiulcer medicines manuf countries unit max min median perc perc Brazil Spain

omeprazole


capsule, 20 mg 10 6 caps 0.216 0.013 0.099 0.030 4 0.026 0.152


powder for injection, 40 mg in vial 1 1 vial 3.000 3.000 3.000 3.000 1 0.945 n/a(as sodium salt)

powder for IV infusion, 40 mg vial 2 2 vial 3.000 1.950 2.475 2.213 1 none n/a(sodium salt)

Antiemetic medicines

dimenhydrinate


metoclopramide

injection 5 mg/ml in 2 ml ampoule 3 3 amp 0.133 0.055 0.084 0.070 1 0.045 n/a

tablet, 10 mg (as hydrochloride) 9 7 tab 0.033 0.002 0.008 0.008 5 0.003 0.016

prochlorperazine

injection, 12.5 mg/ml 1 1 vial 1.763 1.763 1.763 1.763 1 none n/a


Laxatives

docusate sodium


5. Variation in pricebetween surveys


14

Figure 1. Variation in the maximum price quoted for ciprofloxacin and fluconazole between the1st (2000) 2nd (2001) 3rd (2002) and 4th (2003) surveys

There is a considerable decrease in the price of fluconazole between surveys, as shown in Figure 1 above, whereasciprofloxacin has only shown a very slight decrease in price.

Table 6. Variation in the price of ciprofloxacin and fluconazole

ciprofloxacin, tab, 250 mg max min med 25th perc no <25th perc

1st Survey 1.20 0.02 0.13 0.05 3

2nd Survey 0.95 0.02 0.10 0.04 5

3rd Survey 0.64 0.01 0.10 0.03 6

4th Survey 0.79 0.01 0.05 0.02 3

fluconazole, caps, 200 mg max min med 25th perc no <25th perc

1st Survey 15.24 8.42 14.10 11.26 1

2nd Survey 7.25 0.20 0.36 0.24 2

3rd Survey 1.25 0.20 0.39 0.27 2

4th Survey 0.60 0.04 0.20 0.13 2

0

5

10

15

20

Cos

t un

US$

per

tabl

et

Survey

1st survey 2nd survey 3rd survey 4th survey

ciprofloxacin, tab, 250 mg

fluconazole, caps, 200 mg

15


ANNEX 1A

Registration status ofproducts included in thesources and prices survey(Listed in alphabetical order of International Non-proprietary Name (INN). n/a indicates data not available at the time ofpublication. Products marked in bold and with an asterisk (*) are on the list of pre-qualified products, see section 3.)

InternationalNon-Proprietary Dosage form National Registration inName (INN) & strength Manufacturer Country Registration other countries

aciclovir powder for injection, Combino Pharm, S.L. Spain Yes n/a250 mg (as sodium salt)

aciclovir powder for injection, Lab. Filaxis International Argentina Yes Mexico, Brazil, Costa Rica250 mg (as sodium salt) S.A.

aciclovir powder for injection, Neon Antibiotics PVT. Ltd. India Yes Ukraine, Sri Lanka in process250 mg (as sodium salt)

aciclovir powder for injection, Samchully Pharm. Co., Korea, Yes Singapore, Vietnam250 mg (as sodium salt) Ltd. Republic of

aciclovir tablet, 200 mg Alpharma Indonesia Yes Denmark, UK, Netherlands, Norway,Spain, Saudi Arabia, United ArabEmirates

aciclovir tablet, 200 mg Apotex Protein, S.A. Mexico Yes Panamade C.V.

aciclovir tablet, 200 mg Cipla Ltd. India Yes Latvia

aciclovir tablet, 200 mg Genepharm SA Greece Yes Cyprus

aciclovir tablet, 200 mg Sdn Bhd Malaysia Yes Singapore, Hong Kong, Sri Lanka,Myanmar, Cambodia

aciclovir tablet, 200 mg IPCA Laboratories Limited India Yes n/a

aciclovir tablet, 200 mg Korea United Pharm. Inc. Korea, Yes n/aRepublic of

aciclovir tablet, 200 mg Lab. Filaxis International Argentina Yes n/aS.A.

aciclovir tablet, 200 mg Lomapharm Germany Yes n/a

*aciclovir tablet, 200 mg Ranbaxy Laboratories India Yes Algeria, Australia, Belarus, Brazil,Ltd Cameroon, China, Costa Rica, Czech

Republic, Denmark, Dominican Republic,El Salvador, Finland, Ghana, Hong Kong,Iraq, Ireland, Ivory Coast, Jamaica,Kazakhstan, Kenya, Malawi, Malaysia,Mali, Moldova, Nepal, Netherlands, NewZealand, Nigeria, Norway, Panama,Poland, Romania, Russia, Singapore,South Africa, Sweden, Tanzania,Thailand, Uganda, UK, Ukraine, USA,Vietnam, Zimbabwe

aciclovir tablet, 200 mg Remedica Ltd. Cyprus Yes Hong Kong, Kenya, Malawi, Myanmar,Singapore, Jordan

aciclovir tablet, 200 mg Samchully Pharm. Co., Korea, Yes TanzaniaLtd. Republic of

aciclovir tablet, 200 mg Sanofi-Synthelabo Vietnam Viet Nam Yes n/a

aciclovir tablet, 200 mg Sdn Bhd Malaysia Yes Myanmar, Cambodia, Mauritius

aciclovir tablet, 400 mg Cipla Ltd. India Yes Latvia

aciclovir tablet, 400 mg Ecobi Farmaceutici S.a.s. Italy Yes Albania


16


aciclovir tablet, 400 mg Far Manguinhos Brazil Yes n/a

aciclovir tablet, 400 mg Sdn Bhd Malaysia Yes Singapore, Hong Kong, Sri Lanka,Myanmar, Cambodia, Yemen



*aciclovir tablet, 400 mg Ranbaxy Laboratories Ltd India Yes Australia, Belarus, Brazil, Cameroon,Costa Rica, Czech Republic, Denmark,Dominican Republic, Egypt, Finland,Ivory Coast, Jamaica, Kazakhstan,Kenya, Malawi, Malaysia, Moldova,Myanmar, Netherlands, New Zealand,Norway, Panama, Poland, Romania,Russia, Singapore, South Africa,Sweden, Tanzania, Thailand, Uganda,UK, USA, Uzbekistan, Vietnam,Peru, Hong Kong

aciclovir tablet, 400 mg Remedica Ltd. Cyprus Yes Zimbabwe, Hong Kong

aciclovir tablet, 800 mg Cipla Ltd. India Yes n/a

aciclovir tablet, 800 mg Combino Pharm, S.L. Spain Yes n/a

aciclovir tablet, 800 mg Ecobi Farmaceutici S.a.s. Italy Yes Albania



aciclovir tablet, 800 mg Lab. Filaxis International Argentina Yes n/aS.A.

aciclovir tablet, 800 mg Laboratorios Cinfa S.A. Spain Yes n/a

*aciclovir tablet, 800 mg Ranbaxy Laboratories Ltd India Yes Australia, Belarus, Brazil, Cameroon,Costa Rica, Czech Republic, Denmark,Finland, Ivory Coast, Kazakhstan,Malaysia, Moldova, Netherlands, NewZealand, Norway, Poland, Romania,Russia, Singapore, South Africa,Sweden, Thailand, UK, Ukraine, USA,Uzbekistan, Vietnam, El Salvador,Peru, Hong Kong

aciclovir tablet, 800 mg Remedica Ltd. Cyprus Yes Guyana, Jordan

albendazole chewable tablet, 400 mg Artesan Pharma GmbH Germany No n/a& Co.

albendazole chewable tablet, 400 mg Beltapharm SpA Italy Tanzania, Panama, Honduras,Guatemala

albendazole chewable tablet, 400 mg Gracure Pharmaceuticals India Yes n/aLtd.

albendazole chewable tablet, 400 mg Korea United Pharm. Inc. Korea, Yes n/aRepublic of

albendazole chewable tablet, 400 mg Lyka Labs Limited India Yes n/a

albendazole chewable tablet, 400 mg Pharmadrug Germany No n/a

albendazole chewable tablet, 400 mg Remedica Ltd. Cyprus No Netherlands

albendazole chewable tablet, 400 mg Shiba Pharmaceuticals Yemen, Yes In process for: United Arab Emirates,& Chemicals Ltd. Republic of Eritrea, Ethiopia, Iraq, Sudan, Tanzania

albendazole chewable tablet, 400 mg Strides Arcolab Limited India No Vietnam

amitriptyline tablet, 25 mg Gracure Pharmaceuticals India Yes n/aLtd.

amitriptyline tablet, 25 mg Intas Pharmaceuticals Ltd India Tanzania, Mauritius, Sri Lanka, Peru,Malaysia, Uganda, Jamaica

amitriptyline tablet, 25 mg Pharmadrug Germany No n/a

amitriptyline tablet, 25 mg Remedica Ltd. Cyprus Yes Malawi

17


amphotericin B powder for injection, Combino Pharm, S.L. Spain Yes n/a50 mg in vial

amphotericin B powder for injection, Neon Antibiotics PVT. Ltd. India Yes Sri Lanka in process50 mg in vial

azithromycin capsule, 250 mg (dihydrate) Aleppo Pharmaceutical Syria Yes Lebanon, Yemen, Sudan,Industries (Alpha) Iraq, Algeria

azithromycin capsule, 250 mg (dihydrate) Aurobindo Pharma Ltd. India Yes n/a

azithromycin capsule, 250 mg (dihydrate) Lyka Labs Limited India Yes Vietnam, Cambodia, DR Congo

azithromycin capsule, 250 mg (dihydrate) Shiba Pharmaceuticals & Yemen, Yes In process for: United Arab Emirates,Chemicals Ltd. Republic of Eritrea, Ethiopia, Iraq, Sudan, Tanzania

azithromycin capsule, 250 mg (dihydrate) Strides Arcolab Limited India No n/a

azithromycin capsule, 500 mg (dihydrate) Aurobindo Pharma Ltd. India Yes n/a

azithromycin capsule, 500 mg (dihydrate) Lyka Labs Limited India Yes n/a

azithromycin tablet, 500 mg (dihydrate) Tecnimede Sociedade Portugal Yes n/aTecnico Medicinal, S.A.

bleomycin powder for injection, 15 mg Aventis Pharma France Yes Algeria, Belgium, France, Ivory Coast,(as sulfate) in vial Madagascar, Morocco, Romania, Tunisia

bleomycin powder for injection, 15 mg Korea United Pharm. Inc. Korea, Yes n/a(as sulfate) in vial Republic of

bleomycin powder for injection, 15 mg Neon Antibiotics PVT. Ltd. India Yes n/a(as sulfate) in vial

buprenorphine sublingual tablet, 0.2 mg ICN Hungary Co. Ltd. Hungary Yes n/a(hydrochloride)

calcium folinate tablet, 15 mg Ecobi Farmaceutici S.a.s. Italy Yes Albania(leucovorin)

calcium folinate tablet, 15 mg Korea United Pharm. Inc. Korea, Yes n/a(leucovorin) Republic of

calcium folinate tablet, 15 mg Lab. Filaxis International Argentina Yes Uruguay, Mexico, Brazil(leucovorin) S.A.

calcium folinate tablet, 15 mg Medac GmbH, Germany Yes China(leucovorin) International Operations

capreomycin powder for injection, Cheil Jedang Corp. Korea, Yes Russia1 g in vial Republic of

capreomycin powder for injection, Neon Antibiotics PVT. Ltd. India Yes n/a1 g in vial

cefixime paediatric oral suspension, Aurobindo Pharma Ltd. India Yes n/a100 mg/5 ml

cefixime paediatric oral suspension, Aventis Pharma France Yes Algeria, Burkina Faso, Benin, Cameroon,100 mg/5 ml Central African Republic, DR Congo,

France, Gabon, Guinea, Haiti, Ireland,Ivory Coast, Morocco, Madagascar,Mali, Mauritania, Mauritius, Niger,Senegal, Togo, Tunisia, UK

cefixime paediatric oral suspension, Bilim Pharmaceutical Ind. Turkey Yes n/a100 mg/5 ml

cefixime paediatric oral suspension, Lyka Labs Limited India Yes n/a100 mg/5 ml

cefixime paediatric oral suspension, Aventis Pharma France Yes Algeria, Cameroon, Congo, France,40 mg/ 5 ml Gabon, Guinea, Ivory Coast, Morocco,

Madagascar, Mali, Mauritania, Mauritius,Niger, Senegal, Chad, Tunisia

cefixime tablet, 200 mg Aurobindo Pharma Ltd. India Yes n/a

cefixime tablet, 200 mg Aventis Pharma France Yes Algeria, Burkina Faso, Benin, Cameroon,Central African Republic, Congo, France,Gabon, Guinea, Haiti, Ireland, IvoryCoast, Morocco, Madagascar, Mali,Mauritania, Mauritius, Niger, Senegal,Togo, Tunisia, UK

ANNEX 1A. REGISTRATION STATUS OF PRODUCTS INCLUDED IN THE SOURCES AND PRICES SURVEY


18


cefixime tablet, 200 mg Korea United Pharm. Inc. Korea, Yes n/aRepublic of

cefixime tablet, 200 mg Lyka Labs Ltd India Yes Vietnam in process

cefixime tablet, 400 mg Alpharma Indonesia Yes Denmark, UK, Netherlands, Norway,Spain, Saudi Arabia, United ArabEmirates

cefixime tablet, 400 mg Bilim Pharmaceutical Ind. Turkey Yes n/a

cefixime tablet, 400 mg Genepharm SA Greece Yes Cyprus

cefixime tablet, 400 mg Lomapharm Germany n/a

cefixime tablet, 400 mg Samchully Pharm. Co., Korea, Yes VietnamLtd. Republic of

cefixime tablet, 400 mg Sdn Bhd Malaysia Yes Myanmar, Cambodia

ceftriaxone powder for injection, 1 g Neon Laboratories Ltd India Yes n/a(as sodium salt) in vial

ceftriaxone powder for injection, 1 g Panpharma France Yes n/a(as sodium salt) in vial

ceftriaxone powder for injection, 1 g Rekah Pharmaceutical Israel Yes n/a(as sodium salt) in vial Group

ceftriaxone powder for injection, 250 mg Aleppo Pharmaceutical Syria Yes Lebanon, Yemen, Sudan,(as sodium salt) in vial Industries (Alpha) Iraq, Algeria

ceftriaxone powder for injection, 250 mg Aventis Limited Bangladesh Yes Sri Lanka(as sodium salt) in vial

ceftriaxone powder for injection, 250 mg Cheil Jedang Corp. Korea, Yes Japan, Singapore, United Arab Emirates,(as sodium salt) in vial Republic of Vietnam, Cambodia, Nicaragua,

Honduras, Venezuela

ceftriaxone powder for injection, 250 mg Combino Pharm, S.L. Spain Yes n/a(as sodium salt) in vial

ceftriaxone powder for injection, 250 mg Demo S.A. Greece Yes Yemen, Yugoslavia, Jordan(as sodium salt) in vial

ceftriaxone powder for injection, 250 mg Korea United Pharm. Inc. Korea, Yes n/a(as sodium salt) in vial Republic of

ceftriaxone powder for injection, 250 mg Lupin Laboratories Ltd. India Yes Bulgaria, China, Czech Republic,(as sodium salt) in vial Ethiopia, Kenya, Romania, Russia,

Slovakia

ceftriaxone powder for injection, 250 mg Lyka Labs Limited India Yes Philippines, Vietnam, Cambodia, DR(as sodium salt) in vial Congo, Russia, Sudan, Sri Lanka

ceftriaxone powder for injection, 250 mg Mepha Ltd Switzerland No Benin, Brazil, Burkina Faso, Congo, El(as sodium salt) in vial Salvador, Gabon, Guatemala, China,

Ivory Coast, Kenya, Kuwait, Lithuania,Malaysia, Mali, Niger, Portugal, Senegal,Sudan, Tanzania, Togo, Turkmenistan

ceftriaxone powder for injection, 250 mg Ranbaxy Laboratories Ltd India Yes Bahrain, Belarus, Botswana, Cameroon,(as sodium salt) in vial Chad, China, Congo, Gabon, Georgia,

Guinea, Iraq, Ivory Coast, Kazakhstan,Kenya, Lithuania, Madagascar, Malawi,Mauritania, Mauritius, Myanmar, Nigeria,Oman, Russia, Singapore, Sri Lanka,Tanzania, Thailand, Trinidad & Tobago,Ukraine, Uzbekistan, Zimbabwe

ceftriaxone powder for injection, 250 mg Strides Arcolab Limited India No n/a(as sodium salt) in vial

ciprofloxacin tablet, 250 mg Alpharma Indonesia Yes UK, Netherlands, Germany, Austria,(as hydrochloride) Norway, Finland, Denmark, Portugal,

Sweden, Malaysia, Philippines

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

ciprofloxacin tablet, 250 mg Aurobindo Pharma Ltd. India Yes Zambia, Malawi, Myanmar(as hydrochloride)

19


ciprofloxacin tablet, 250 mg Aventis Limited Bangladesh Yes n/a(as hydrochloride)

ciprofloxacin tablet, 250 mg Bayer AG Germany Yes n/a(as hydrochloride)

*ciprofloxacin tablet, 250 mg Cipla Ltd. India Yes Myanmar, Russia, Yemen, Ghana,(as hydrochloride) Sudan, Zambia, Belarus, Iraq, Sri Lanka,

Armenia, Hong Kong, Kenya

ciprofloxacin tablet, 250 mg Demo S.A. Greece Yes n/a(as hydrochloride)

ciprofloxacin tablet, 250 mg Fourrts Laboratories India Yes Sri Lanka(as hydrochloride) Pvt. Ltd.

ciprofloxacin tablet, 250 mg Genepharm SA Greece Yes Romania(as hydrochloride)

ciprofloxacin tablet, 250 mg Glenmark India Yes n/a(as hydrochloride) Pharmaceuticals Ltd

ciprofloxacin tablet, 250 mg Gracure Pharmaceuticals India Yes Kenya, Mali, Burma, Nepal(as hydrochloride) Ltd.

ciprofloxacin tablet, 250 mg Intas Pharmaceuticals Ltd India Yes Armenia, Belarus, Cambodia, Ethiopia,(as hydrochloride) Georgia, Ghana, Hong Kong, Singapore,

Sri Lanka, Uganda, Vietnam, Zimbabwe,Malaysia, Peru, Zambia

ciprofloxacin tablet, 250 mg IPCA Laboratories India Yes Ethiopia, Kenya, Tanzania, UK, South(as hydrochloride) Limited Africa

ciprofloxacin tablet, 250 mg IVAX Pharmaceuticals Mexico Yes Costa Rica, El Salvador, Honduras,(as hydrochloride) Mexico, S.A. de C.V. Nicaragua, Haiti, Dominican Republic,

Guatemala, Chile

ciprofloxacin tablet, 250 mg Korea United Pharm. Inc. Korea, Yes n/a(as hydrochloride) Republic of

ciprofloxacin tablet, 250 mg Laboratorios Cinfa S.A. Spain Yes Venezuela, Dominican Republic(as hydrochloride)

ciprofloxacin tablet, 250 mg Lupin Laboratories Ltd. India Yes Bulgaria, China, Czech Republic,(as hydrochloride) Ethiopia, Kenya, Romania, Russia,

Slovakia

ciprofloxacin tablet, 250 mg Lyka Labs Limited India Yes Cambodia, Myanmar, Russia, DR Congo,(as hydrochloride) Sri Lanka, Chile, Peru

ciprofloxacin tablet, 250 mg Mepha Ltd Switzerland No Benin, Brazil, Burkina Faso, Congo, El(as hydrochloride) Salvador, Gabon, Guatemala, China,

Ivory Coast, Kenya, Kuwait, Lithuania,Malaysia, Mali, Niger, Portugal, Senegal,Sudan, Tanzania, Togo, Turkmenistan

*ciprofloxacin tablet, 250 mg Ranbaxy Laboratories Ltd India Yes Austria, Bahrain, Belarus, Belgium,(as hydrochloride) Brazil, Cambodia, Cameroon, China,

Congo, Costa Rica, Czech Republic,Denmark, Egypt, Finland, Georgia,Germany, Guatemala, Hungary, Iraq,Jamaica, Kazakhstan, Kenya, Kyrgyzstan,PDR Lao, Latvia, Lithuania, Luxembourg,Madagascar, Malawi, Mali, Mauritius,Mexico, Moldova, Myanmar, Nigeria,Oman, Peru, Poland, Portugal, Romania,Russia, South Africa, Spain, Sri Lanka,Sweden, Tanzania, Thailand, Trinidad &Tobago, Uganda, UK, Ukraine, USA,Uzbekistan, Vietnam, Yemen,Zimbabwe

ciprofloxacin tablet, 250 mg Remedica Ltd. Cyprus Yes Myanmar, Pakistan(as hydrochloride)

ciprofloxacin tablet, 250 mg Samchully Pharm. Co., Korea, yes Vietnam, Tanzania(as hydrochloride) Ltd. Republic of

ciprofloxacin tablet, 250 mg Shiba Pharmaceuticals Yemen, Yes United Arab Emirates, Eritrea, Ethiopia,(as hydrochloride) & Chemicals Ltd. Republic of Iraq, Sudan, Tanzania in process



20


ciprofloxacin tablet, 250 mg Strides Arcolab Limited India No Brazil(as hydrochloride)

ciprofloxacin tablet, 250 mg Tecnimede Sociedade Portugal Yes n/a(as hydrochloride) Tecnico Medicinal, S.A.

ciprofloxacin tablet, 500 mg Aleppo Pharmaceutical Syria Yes Lebanon, Yemen, Sudan, Iraq, Algeria(as hydrochloride) Industries (Alpha)

ciprofloxacin tablet, 500 mg Apotex Protein, S.A. Mexico Yes Panama, Nicaragua(as hydrochloride) de C.V.

ciprofloxacin tablet, 500 mg Glenmark India Yes n/a(as hydrochloride) Pharmaceuticals Ltd

clarithromycin tablet, 250 mg Alpharma Indonesia Yes UK, Netherlands, Germany, Austria,Norway, Finland, Denmark, Portugal,Sweden, Malaysia, Philippines

clarithromycin tablet, 250 mg Aurobindo Pharma Ltd. India Yes Cambodia, Vietnam

clarithromycin tablet, 250 mg Bilim Pharmaceutical Ind. Turkey Yes Azerbaijan, Cambodia, Ethiopia, HongKong, Macedonia, Malta, Mongolia,Moldova, Venezuela, Yemen, DominicanRepublic, Kenya, Lithuania, Morocco,Romania

clarithromycin tablet, 250 mg Genepharm SA Greece Yes n/a

clarithromycin tablet, 250 mg Intas Pharmaceuticals Ltd India Yes Cambodia, Georgia, Hong Kong,Singapore, Kenya, Malaysia, Peru,Thailand, Paraguay, Kenya, Sri Lanka,Myanmar, Sudan, Vietnam, Mauritius

clarithromycin tablet, 250 mg IVAX Pharmaceuticals Mexico Yes Costa Rica, El Salvador, Honduras,Mexico, S.A. de C.V. Nicaragua, Haiti, Dominican Republic,

Guatemala, Chile

clarithromycin tablet, 250 mg Korea United Pharm. Inc. Korea, Yes n/aRepublic of

clarithromycin tablet, 250 mg Lyka Labs Limited India Yes Vietnam, Cambodia, Myanmar,Sri Lanka, Romania

clarithromycin tablet, 250 mg Ranbaxy Laboratories Ltd India Yes Brazil, Chile, Costa Rica, DominicanRepublic, Jamaica, Myanmar, Russia,Tanzania, Trinidad & Tobago, Ukraine,Vietnam

clarithromycin tablet, 250 mg Remedica Ltd. Cyprus Yes n/a

clarithromycin tablet, 250 mg Strides Arcolab Limited India No Brazil

clarithromycin tablet, 250 mg The Government Pharma- Thailand Exempt n/aceutical Organization

clindamycin capsule, 150 mg Bilim Pharmaceutical Ind. Turkey Yes Mongolia, Ethiopia

clindamycin capsule, 150 mg Chephasaar, Chem.- Germany Yes n/apharm.Fabrick GmbH

clindamycin capsule, 150 mg Shiba Pharmaceuticals Yemen, Yes United Arab Emirates, Eritrea, Ethiopia,& Chemicals Ltd. Republic of Iraq, Sudan, Tanzania in process

clindamycin injection, 150 mg Combino Pharm, S.L. Spain Yes n/a(as phosphate)/ml

clindamycin injection, 150 mg Strides Arcolab Limited India No Brazil(as phosphate)/ml

codeine tablet, 30 mg ICN Hungary Co. Ltd. Hungary Yes n/a

codeine tablet, 30 mg Lomapharm Germany Yes n/a

codeine tablet, 30 mg Pharmadrug Germany No n/a

codeine tablet, 30 mg Rekah Pharmaceutical Israel Yes n/aGroup

codeine tablet, 30 mg Remedica Ltd. Cyprus Yes n/a

crotamiton cream/lotion 10% Sdn Bhd Malaysia Yes n/a

21


cycloserine capsule 250 mg Cheil Jedang Corp. Korea, Yes n/aRepublic of

cycloserine capsule 250 mg Korea United Pharm. Inc. Korea, Yes India, PhilippinesRepublic of

didanosine syrup, 2 g Aurobindo Pharma Ltd. India Yes n/a

didanosine tablet, 100 mg Apotex Protein, S.A. de C.V. Mexico Yes Panama, Nicaragua, Dominican Republic

didanosine tablet, 100 mg Aurobindo Pharma Ltd. India Yes n/a

didanosine tablet, 100 mg Far Manguinhos Brazil Yes n/a

didanosine tablet, 100 mg Lab. Filaxis International S.A. Argentina Yes Brazil

didanosine tablet, 100 mg Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,Bolivia

didanosine tablet, 100 mg Strides Arcolab Limited India No n/a

didanosine tablet, 25 mg Apotex Protein, S.A. de C.V. Mexico Yes Panama, Nicaragua, Dominican Republic

didanosine tablet, 25 mg Aurobindo Pharma Ltd. India Yes n/a

didanosine tablet, 25 mg Far Manguinhos Brazil Yes n/a

didanosine tablet, 25 mg Strides Arcolab Limited India No n/a

dimenhydrinate tablet, 50 mg Apotex Protein, S.A. de C.V. Mexico Yes Panama, Nicaragua, Dominican Republic

dimenhydrinate tablet, 50 mg Confab Laboratories Inc Canada No n/a

dimenhydrinate tablet, 50 mg Laboratorios Cinfa S.A. Spain Yes Bolivia, Guatemala, El Salvador

dimenhydrinate tablet, 50 mg Pharmadrug Germany Yes n/a

dimenhydrinate tablet, 50 mg The Government Thailand Exempt n/aPharmaceutical Organization

docusate sodium capsule, 100 mg Banner Pharmacaps Ltd. Canada No n/a

doxorubicine HCl powder for injection, Korea United Pharm. Inc. Korea, Yes n/a10 mg in vial Republic of

doxorubicine HCl powder for injection, Lab. Filaxis Argentina Yes Chile, Uruguay, Mexico, Brazil, Colombia,10 mg in vial International S.A. Dominican Republic, Costa Rica

doxorubicine HCl powder for injection, Medac GmbH, International Germany Yes UK10 mg in vial Operations

doxorubicine HCl powder for injection, Neon Antibiotics PVT. Ltd. India Yes Sri Lanka in process10 mg in vial

doxorubicine HCl powder for injection, Korea United Pharm. Inc. Korea, Yes n/a50 mg in vial Republic of

doxorubicine HCl powder for injection, Lab. Filaxis International Argentina Yes Chile, Uruguay, Mexico, Brazil, Colombia,50 mg in vial S.A. Dominican Republic, Costa Rica

doxorubicine HCl powder for injection, Medac GmbH, International Germany Yes UK50 mg in vial Operations

doxorubicine HCl powder for injection, Neon Antibiotics PVT. Ltd. India Yes n/a50 mg in vial

efavirenz caps, 200 mg Aurobindo Pharma Ltd. India Yes n/a

efavirenz caps, 200 mg Cipla Ltd. India Yes TBC

efavirenz caps, 200 mg Lab. Filaxis International S.A. Argentina Yes n/a

efavirenz caps, 200 mg Merck & Co., Inc. US USA, UK, Germany, France, Italy, Spain,+70 developing countries

efavirenz caps, 200 mg Ranbaxy Laboratories Ltd India Yes n/a

efavirenz caps, 200 mg Strides Arcolab Limited India No n/a

efavirenz caps, 600 mg Merck & Co., Inc. US USA, UK, Germany, France, Italy, Spain,+70 developing countries

erythromycin powder for oral suspension, Aventis Limited Bangladesh Yes n/a125 mg



22


erythromycin powder for oral suspension, Beltapharm SpA Italy Yes Cameroon, Panama, Costa Rica,125 mg Honduras

erythromycin powder for oral suspension, Gracure Pharmaceuticals India Yes n/a125 mg Ltd.

erythromycin powder for oral suspension, Lachifarma, SRL Italy No Yemen, Cameroon125 mg

erythromycin powder for oral suspension, Purna Pharmaceuticals NV Belgium No Macau125 mg

erythromycin powder for oral suspension, Remedica Ltd. Cyprus Yes Tanzania, Singapore, Sudan125 mg

erythromycin powder for oral suspension, Shiba Pharmaceuticals Yemen, No United Arab Emirates, Eritrea, Ethiopia,125 mg & Chemicals Ltd. Republic of Iraq, Sudan, Tanzania in process

erythromycin tab, 250 mg (as stearate) Artesan Pharma GmbH & Co. Germany No n/a

erythromycin tab, 250 mg (as stearate) Aurobindo Pharma Ltd. India Yes n/a

erythromycin tab, 250 mg (as stearate) Aventis Limited Bangladesh Yes n/a

erythromycin tab, 250 mg (as stearate) Beltapharm SpA Italy Yes Tanzania, Cameroon, Panama, Costa Rica

erythromycin tab, 250 mg (as stearate) Fourrts Laboratories Pvt. India Yes Sri LankaLtd.

erythromycin tab, 250 mg (as stearate) Glenmark Pharmaceuticals India Yes n/aLtd

erythromycin tab, 250 mg (as stearate) Gracure Pharmaceuticals India Yes n/aLtd.

erythromycin tab, 250 mg (as stearate) Sdn Bhd Malaysia Yes Singapore, Hong Kong, Sri Lanka,Myanmar, Yemen, Peru, Ghana,Botswana, Nigeria, Sudan, Zambia,Jordan, Haiti

erythromycin tab, 250 mg (as stearate) Lachifarma, SRL Italy No Yemen, Cameroon

erythromycin tab, 250 mg (as stearate) Lyka Labs Limited India Yes Cambodia, Myanmar, DR Congo

erythromycin tab, 250 mg (as stearate) Pharmadrug Germany Yes n/a

erythromycin tab, 250 mg (as stearate) Phyto-Riker Ghana Yes Benin, Cameroon, Togo, Mali,Pharmaceuticals Ltd. Senegal, Gambia, Ivory Coast, Niger

erythromycin tab, 250 mg (as stearate) Remedica Ltd. Cyprus Yes Kenya, Myanmar, Oman, Sri Lanka,Sudan, Tanzania, Malawi, Botswana,Singapore

erythromycin tab, 250 mg (as stearate) Sanavita Aktiengesell- Germany No Uzbekistanschaft & Co.

erythromycin tab, 250 mg (as stearate) Shiba Pharmaceuticals Yemen, Yes United Arab Emirates, Eritrea, Ethiopia,& Chemicals Ltd. Republic of Iraq, Sudan, Tanzania in process

erythromycin tab, 250 mg (as stearate) Sdn Bhd Malaysia Yes Vietnam, Cambodia, Myanmar, SriLanka, South Africa, Mauritius, HongKong, Singapore

erythromycin tab, 250 mg (as stearate) Strides Arcolab Limited India No n/a

etoposide capsule, 100 mg Korea United Pharm. Inc. Korea, Yes n/aRepublic of

etoposide capsule, 100 mg Medac GmbH, Germany Yes n/aInternational Operations

etoposide injection, 20 mg/ ml in Cipla Ltd. India Yes Russia, Sri Lanka, Kenya, Malaysia,5 ml ampoule Ukraine, Ivory Coast

etoposide injection, 20 mg/ ml in Korea United Pharm. Inc. Korea, Yes n/a5 ml ampoule Republic of

etoposide injection, 20 mg/ ml in Lab. Filaxis International Argentina Yes Uruguay, Mexico, Brazil, Colombia,5 ml ampoule S.A. Dominican Republic, Guatemala, Costa

Rica

etoposide injection, 20 mg/ ml in Neon Antibiotics PVT. India Yes n/a5 ml ampoule Ltd.

23


fluconazole capsule, 150 mg Bilim Pharmaceutical Ind. Turkey Yes Dominican Republic, Malta, Mongolia,Moldova, Russia, Azerbaijan

fluconazole capsule, 150 mg Gracure Pharmaceuticals India Yes Vietnam, CambodiaLtd.

fluconazole capsule, 200 mg Cipla Ltd. India Yes Russia, Vietnam, Belarus, Myanmar,Cambodia, Macau, Sri Lanka,Cameroon, Ukraine

fluconazole capsule, 200 mg Fourrts Laboratories Pvt. India Yes n/a Ltd.

fluconazole capsule, 200 mg IPCA Laboratories Limited India Yes Uganda, Zimbabwe, Tanzania, Ethiopia,Sudan, Kenya, Ukraine, Singapore,Malaysia, Ghana, Philippines, Thailand,Sri Lanka, Myanmar, South Africa, UK

*fluconazole capsule, 200 mg Ranbaxy Laboratories Ltd India Yes Russia, Bulgaria, Cambodia, Croatia,Czech Republic, El Salvador, Hong Kong,Hungary, Jamaica, Peru, Poland,Romania, Slovak Republic, South Africa,Trinidad & Tobago, UK, USA, Venezuela

fluconazole capsule, 200 mg Remedica Ltd. Cyprus Malawi, Tanzania, Cambodia, Botswana

fluconazole capsule, 200 mg Shiba Pharmaceuticals & Yemen, Yes United Arab Emirates, Eritrea, Ethiopia,Chemicals Ltd. Republic of Iraq, Sudan, Tanzania in process

fluconazole capsule, 200 mg The Government Pharma- Thailand Exempt n/aceutical Organization

fluconazole solution for injection, CLARIS Life sciences Ltd. India Yes Brazil, Chile, Mexico2mg/ml in ampoule

fluconazole solution for injection, Genepharm SA Greece Yes n/a2mg/ml in ampoule

fluconazole solution for injection, Strides Arcolab Limited India No Brazil2mg/ml in ampoule

fluoxetine caps, 20 mg IPCA Laboratories Limited India Yes Sri Lanka, Myanmar

fluoxetine caps, 20 mg Korea United Pharm. Inc. Korea, Yes Vietnam, PhilippinesRepublic of

fluoxetine caps, 20 mg Remedica Ltd. Cyprus Yes Hong Kong, Malawi, Venezuela, Sudan

fluoxetine tablet, 20 mg Apotex Protein, S.A. de C.V. Mexico Yes Panama, Costa Rica, Cameroon

fluoxetine tablet, 20 mg Combino Pharm, S.L. Spain Yes n/a

fluoxetine tablet, 20 mg Genepharm SA Greece Yes Cyprus

fluoxetine tablet, 20 mg IVAX Pharmaceuticals Mexico Yes Costa Rica, El Salvador, Honduras,Mexico, S.A. de C.V. Nicaragua, Haiti, Dominican Republic,

Guatemala, Chile

fluoxetine tablet, 20 mg Laboratorios Cinfa S.A. Spain Yes Venezuela, Dominican Republic in process

fluoxetine tablet, 20 mg Ranbaxy Laboratories Ltd India Yes Denmark, Finland, Germany, Ireland,Myanmar, Peru, Russia, UK, USA

ganciclovir powder for injection, Lab. Filaxis International Argentina Yes n/a500 mg in vial S.A.

indinavir caps, 400 mg Aurobindo Pharma Ltd. India Yes n/a

indinavir caps, 400 mg Far Manguinhos Brazil Yes n/a

indinavir caps, 400 mg Lab. Filaxis International S.A. Argentina Yes n/a

indinavir caps, 400 mg Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,Bolivia

indinavir caps, 400 mg Merck & Co., Inc. US USA, UK, Germany, France, Italy,Spain, +70 developing countries

indinavir caps, 400 mg Ranbaxy Laboratories Ltd India Yes Brazil, Cambodia, Chad, Ethiopia,Guatemala, Mauritius, Nigeria, Peru

indinavir caps, 400 mg Strides Arcolab Limited India No n/a



24


itraconazole capsule, 100 mg Glenmark Pharmaceuticals India Yes UkraineLtd

itraconazole capsule, 100 mg Intas Pharmaceuticals Ltd India Hong Kong, Macau, Trinidad & Tobago

itraconazole capsule, 100 mg IVAX Pharmaceuticals Mexico Yes Costa Rica, El Salvador, Honduras,Mexico, S.A. de C.V. Nicaragua, Haiti, Dominican Republic,

Guatemala, Chile

ketoconazole tablet, 200 mg Artesan Pharma GmbH Germany No n/a& Co.

ketoconazole tablet, 200 mg Beltapharm SpA Italy Yes Panama, Costa Rica, Cameroon

ketoconazole tablet, 200 mg Bilim Pharmaceutical Ind. Turkey Yes Yemen, Trinidad & Tobago

ketoconazole tablet, 200 mg Gracure Pharmaceuticals India Yes n/aLtd.

ketoconazole tablet, 200 mg Sdn Bhd Malaysia Yes Singapore, Hong Kong, Cambodia,Myanmar, Zambia, Sudan, Sri Lanka

ketoconazole tablet, 200 mg Intas Pharmaceuticals Ltd India Yes Kenya, Mauritius, Peru, Tanzania,Uganda, Vietnam, West Indies, Armenia,Bolivia, Cambodia, Georgia, Hong Kong,Chile, Algeria, Zambia

ketoconazole tablet, 200 mg IVAX Pharmaceuticals Mexico Yes Costa Rica, El Salvador, Honduras,Mexico, S.A. de C.V. Nicaragua, Haiti, Dominican Republic,

Guatemala, Chile

ketoconazole tablet, 200 mg Korea United Pharm. Inc. Korea, Yes n/aRepublic of

ketoconazole tablet, 200 mg Remedica Ltd. Cyprus Yes Albania, Cambodia, Ghana, Sudan,Tanzania, Uganda, Vietnam

ketoconazole tablet, 200 mg Sdn Bhd Malaysia Cambodia, Myanmar, Vietnam, HongKong, South Africa

ketoconazole tablet, 200 mg Strides Arcolab Limited India No Brazil, Mexico, Venezuela

ketoconazole tablet, 200 mg The Government Pharma- Thailand Exempt n/aceutical Organization

lamivudine syrup, 50 mg/5 ml Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,Bolivia

*lamivudine tablet, 150 mg Cipla Ltd. India Yes Ghana, Tanzania, Malawi, Iran,Cambodia, Macau, Burundi, Congo,Uganda, Myanmar, Syria, Cameroon,Central African Republic

lamivudine tablet, 150 mg Far Manguinhos Brazil Yes n/a

lamivudine tablet, 150 mg IPCA Laboratories Limited India Yes Ghana, Kenya, Tanzania, Uganda, Zaire,Zimbabwe

lamivudine tablet, 150 mg Lab. Filaxis International S.A. Argentina Yes Peru, Colombia

lamivudine tablet, 150 mg Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,Bolivia

*lamivudine tablet, 150 mg Ranbaxy Laboratories Ltd India Yes Benin, Brazil, Cambodia, Central AfricanRepublic, Chad, Congo, Guatemala,Guinea, Mali, Mauritius, Nigeria, Peru,Senegal, Togo

lamivudine tablet, 150 mg Strides Arcolab Limited India No n/a

lamivudine tablet, 150 mg The Government Pharma- Thailand Exempt n/aceutical Organization

3TC/d4T/NVP tablet, 150/40/200 mg Cipla Ltd. India Yes Congo, Guinea, Central AfricanRepublic, Malawi

3TC/d4T/NVP tablet, 150/40/200 mg Ranbaxy Laboratories Ltd India Yes n/a

3TC/d4T/NVP tablet, 150/40/200 mg The Government Pharma- Thailand Exempt n/aceutical Organization

lorazepam tablet, 1 mg Intas Pharmaceuticals Ltd India Yes n/a

lorazepam tablet, 1 mg Lomapharm Germany n/a

25


lorazepam tablet, 1 mg Pharmadrug Germany No n/a

methotrexate powder for injection, 50 mg Aventis Pharma France Yes Algeria, Argentina, Brazil, Colombia,(as sodium salt) in vial Ecuador

methotrexate powder for injection, 50 mg Korea United Pharm. Inc. Korea, Yes n/a(as sodium salt) in vial Republic of

methotrexate powder for injection, 50 mg Lab. Filaxis International Argentina Yes Uruguay, Mexico, Brazil, Dominican(as sodium salt) in vial S.A. Republic, Costa Rica

methotrexate powder for injection, 50 mg Neon Antibiotics PVT. Ltd. India Yes n/a(as sodium salt) in vial

methotrexate tablet, 2.5 mg Aventis Pharma France Yes Algeria, Argentina, Bangladesh, Brazil,Cambodia, Colombia, Ecuador, Egypt,France, Croatia, Kazakhstan, Israel,Lithuania, Latvia, Madagascar, Malaysia,Mauritius, Peru, Romania, Russia,Slovakia, Serbia, Tunisia, Turkey,Ukraine, Uruguay, Uzbekistan

methotrexate tablet, 2.5 mg Korea United Pharm. Inc. Korea, Yes n/aRepublic of

metoclopramide injection 5 mg/ml Aventis Limited Bangladesh Yes Myanmar

metoclopramide injection 5 mg/ml CLARIS Life sciences Ltd. India Yes Brazil, Haiti, Chile

metoclopramide injection 5 mg/ml The Government Pharma- Thailand Exempt n/aceutical Organization

metoclopramide tablet, 10 mg (as hydrochloride) Alpharma Indonesia Yes n/a

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

metoclopramide tablet, 10 mg (as hydrochloride) Aventis Limited Bangladesh Yes Myanmar

metoclopramide tablet, 10 mg (as hydrochloride) Fourrts Laboratories India Yes n/aPvt. Ltd.

metoclopramide tablet, 10 mg (as hydrochloride) Genepharm SA Greece Yes Peru, Macau

metoclopramide tablet, 10 mg (as hydrochloride) IPCA Laboratories Limited India Yes n/a

metoclopramide tablet, 10 mg (as hydrochloride) Lomapharm Germany n/a

metoclopramide tablet, 10 mg (as hydrochloride) Pharmadrug Germany No n/a

metoclopramide tablet, 10 mg (as hydrochloride) Remedica Ltd. Cyprus Yes Kenya, Malawi, Myanmar, Singapore

miconazole Cream 2% 15 g tube Fourrts Laboratories India Yes n/aPvt. Ltd.

miconazole Cream 2% 15 g tube Sdn Bhd Malaysia Yes Singapore, Hong Kong, Sri Lanka,Vietnam, Zambia, Myanmar

miconazole Cream 2% 15 g tube Lachifarma, SRL Italy No Yemen, Cameroon

miconazole Cream 2% 15 g tube Pharmadrug Germany No n/a

miconazole Cream 2% 30 g tube Apotex Protein, S.A. de C.V. Mexico Yes Peru, Nicaragua, Dominican Republic

miconazole Cream 2% 30 g tube Beltapharm SpA Italy Yes Cameroon, Honduras, Costa Rica,Panama

miconazole Cream 2% 30 g tube Confab Laboratories Inc Canada Yes n/a

miconazole Cream 2% 30 g tube Ecobi Farmaceutici S.a.s. Italy Yes Albania, Algeria, Senegal, Ivory Coast,Guinea, Togo, Burkina Faso, Gabon,Cameroon

miconazole Cream 2% 30 g tube IVAX Pharmaceuticals Mexico Yes Costa Rica, El Salvador, Honduras,Mexico, S.A. de C.V. Nicaragua, Haiti, Dominican Republic,

Guatemala, Chile

miconazole Cream 2% 30 g tube Lomapharm Germany n/a

miconazole Cream 2% 30 g tube Purna Pharmaceuticals NV Belgium No Albania

morphine injection, 10 mg Lab. Renaudin France Yes n/a(hydrochloride) in 1-ml ampoule

morphine oral solution, Martindale Pharma- UK Yes n/a10 mg(sulfate)/5ml ceuticals Ltd.



26


naltrexone HCl tablet, 50 mg Intas Pharmaceuticals Ltd India Yes Mauritius, Malaysia, Jordan, Ukraine,Russia

naltrexone HCl tablet, 50 mg Lachifarma, SRL Italy No Yemen, Cameroon

naltrexone HCl tablet, 50 mg Tecnimede Sociedade Portugal Yes n/aTecnico Medicinal, S.A.

nelfinavir 250mg, caps Aurobindo Pharma Ltd. India Yes n/a

*nelfinavir 250mg, caps F. Hoffmann-La Roche Ltd. Switzerland Yes Argentina, Aruba, Australia, Austria,Bahrain, Belgium, Belarus, Bolivia,Brazil, Bulgaria, Cambodia, Canada,Chile, Colombia, Costa Rica, Croatia,Curacao, Cyprus, Czech Republic,Denmark, Dominican Republic, Ecuador,Ireland, El Salvador, Estonia, Finland,France, Germany, Ghana, Greece,Guatemala, Honduras, Hong Kong,Hungary, Israel, Italy, Jamaica, Japan,Kenya, Kuwait, Latvia, Lithuania, Luxem-bourg, Malaysia, Malta, Mexico, Morocco,Netherlands, New Zealand, Nicaragua,Norway, Oman, Panama, Paraguay,Peru, Philippines, Poland, Portugal,Qatar, Romania, Russia, Singapore,Slovakia, Slovenia, South Africa, Spain,Sweden, Switzerland, Taiwan, Tanzania,Thailand, Trinidad & Tobago, Tunisia,USA, United Arab Emirates, UK,Uruguay, Venezuela, Yugoslavia

nelfinavir 250mg, caps Lab. Filaxis International S.A. Argentina Yes n/a

nelfinavir 250mg, caps Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile

nevirapine 200mg, tab Aurobindo Pharma Ltd. India Yes n/a

*nevirapine 200 mg, tab Cipla Ltd. India Yes Cambodia, Burundi, Congo, Uganda,Myanmar, Malawi, Guinea, CentralAfrican Republic

nevirapine 200mg, tab Far Manguinhos Brazil Yes n/a

nevirapine 200mg, tab Lab. Filaxis International S.A. Argentina Yes n/a

nevirapine 200mg, tab Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,Bolivia

*nevirapine 200 mg, tab Ranbaxy Laboratories Ltd India Yes Benin, Brazil, Cambodia, Central AfricanRepublic, Chad, Congo, Ethiopia,Guatemala, Guinea, Mali, Mauritius,Myanmar, Nigeria, Senegal, Togo

nevirapine 200mg, tab Strides Arcolab Limited India No n/a

nevirapine 200mg, tab The Government Pharma- Thailand Exempt n/aceutical Organization

nevirapine 50mg/5ml, syrup Cipla Ltd. India Yes Malawi

nevirapine 50mg/5ml, syrup The Government Pharma- Thailand Exempt n/aceutical Organization

ofloxacin IV infusion, 2 mg/ml Genepharm SA Greece Yes n/a(hydrochloride)

ofloxacin tablet, 200 mg Aventis Pharma France yes Algeria, Azerbaidjan, Benin, BurkinaFaso, Cambodia, Cameroon, Congo,France, Gabon, Georgia, Guinea,Hungary, Israel, Ivory Coast, Kuwait,Jordan, Lebanon, Madagascar, Mali,Mauritania, Morocco, Niger, Romania,Russia, Senegal, Slovakia, South Africa,Sri Lanka, Togo, Tunisia, Turkey,Turkmenistan, Ukraine, United ArabEmirates, Uzbekistan, Zimbabwe

ofloxacin tablet, 200 mg Genepharm SA Greece Yes Romania, Cyprus

ofloxacin tablet, 200 mg Glenmark Pharmaceuticals India Yes n/aLtd

27


ofloxacin tablet, 200 mg Gracure Pharmaceuticals Ltd. India Yes n/a

ofloxacin tablet, 200 mg Sdn Bhd Malaysia Yes Hong Kong, Myanmar, Yemen, Ethiopia

ofloxacin tablet, 200 mg Intas Pharmaceuticals Ltd India Yes Malaysia, Armenia, Hong Kong, Singa-pore, Cambodia, Jamaica, Trinidad &Tobago

ofloxacin tablet, 200 mg IPCA Laboratories Limited India Yes n/a

ofloxacin tablet, 200 mg Korea United Pharm. Inc. Korea, Yes Brazil, VietnamRepublic of

ofloxacin tablet, 200 mg Lyka Labs Limited India Yes n/a

ofloxacin tablet, 200 mg Ranbaxy Laboratories Ltd India Yes Algeria, Belarus, Cambodia, China,Costa Rica, Czech Republic, DominicanRepublic, Georgia, Germany, Guatemala,Guinea, Hungary, Indonesia, Iraq,Kazakhstan, Khyrgystan, Laos, Latvia,Lithuania, Mauritius, Moldova, Myanmar,Nigeria, Peru, Poland, Romania, Russia,Sri Lanka, UK, Ukraine, Uzbekistan,Vietnam

ofloxacin tablet, 200 mg Remedica Ltd. Cyprus Yes Cambodia, Panama, Vietnam, Zimbabwe

ofloxacin tablet, 200 mg Shiba Pharmaceuticals Yemen, Yes In process for: United Arab Emirates,& Chemicals Ltd. Republic of Eritrea, Ethiopia, Iraq, Sudan, Tanzania

ofloxacin tablet, 200 mg Tecnimede Sociedade Portugal Yes n/aTecnico Medicinal, S.A.

omeprazole caps, 10 mg Fourrts Laboratories Pvt. Ltd. India Yes n/a

omeprazole caps, 10 mg Lyka Labs Limited India Yes Rumania

omeprazole caps, 10 mg Sdn Bhd Malaysia Yes Myanmar, Cambodia, Sri Lanka

omeprazole caps, 10 mg Strides Arcolab Limited India No Brazil

omeprazole caps, 20 mg Apotex Protein, S.A. de C.V. Mexico Yes Panama, Chile

omeprazole caps, 20 mg Aurobindo Pharma Ltd. India Yes Malawi, Cambodia, Vietnam, Myanmar,Lao PDR

omeprazole caps, 20 mg Fourrts Laboratories Pvt. India Yes PolandLtd.

omeprazole caps, 20 mg Genepharm SA Greece Yes Romania, Sudan, Iraq

omeprazole caps, 20 mg Intas Pharmaceuticals Ltd India Yes Armenia, Georgia, Belarus, Hong Kong,Peru, Malaysia, Cambodia, Russia,Yugoslavia, Ukraine, Guyana, DominicanRepublic, Vietnam

omeprazole caps, 20 mg IVAX Pharmaceuticals Mexico Yes Costa Rica, El Salvador, Honduras,Mexico, S.A. de C.V. Nicaragua, Haiti, Dominican Republic,

Guatemala, Chile

omeprazole caps, 20 mg Laboratorios Cinfa S.A. Spain Yes Dominican Republic Pending inVenezuela and Macau

omeprazole caps, 20 mg Mepha Ltd Switzerland No n/a


omeprazole caps, 20 mg Tecnimede Sociedade Portugal Yes n/aTecnico Medicinal, S.A.

omeprazole caps, 40 mg Aurobindo Pharma Ltd. India Yes n/a


omeprazole caps, 40 mg Tecnimede Sociedade Portugal Yes n/aTecnico Medicinal, S.A.

omeprazole powder for injection, 40 mg Neon Antibiotics PVT. Ltd. India Yes n/ain vial (as sodium salt)

omeprazole powder for IV infusion, 40 mg Genepharm SA Greece Yes n/avial (sodium salt)

omeprazole powder for IV infusion, 40 mg Neon Antibiotics PVT. Ltd. India Yes n/avial (sodium salt)



28


pentamidine powder for injection, Aventis Pharma France yes Argentina, Australia, Azerbaidjan,300 mg (isetionate) in vial Belgium Brazil, Canada, Colombia,

Chile, Croatia, Denmark, Finland, France,Germany, Greece, Israel, Hong Kong,Ireland, Italy, Japan, Luxembourg,Madagascar, Malaysia, Mexico, Nether-lands, New Zealand, Peru, Portugal,Romania, Russia, Singapore, Slovakia,Slovenia, South Africa, Spain, Sweden,Switzerland, Thailand, UK, USAUruguay

pentamidine powder for injection, 300 mg Combino Pharm, S.L. Spain Yes n/a(isetionate) in vial

pentamidine powder for injection, 300 mg Lab. Filaxis International Argentina Yes Uruguay, Mexico, Brazil, Colombia(isetionate) in vial S.A.

pethidine inj, 50 mg (hydrochloride)/ml Martindale Pharma- UK Yes Ireland, Cyprus, El Salvador,in 1 ml ampoule ceuticals Ltd. Oman, Jordan

pethidine inj, 50 mg (hydrochloride)/ml Neon Laboratories Ltd India Yes n/ain 1-ml ampoule

pethidine inj, 50 mg (hydrochloride)/ml Pharmadrug Germany No n/ain 1-ml ampoule

pethidine inj, 50 mg (hydrochloride)/ml Lab. Renaudin France Yes Lebanon, Madagascar, Romaniain 2-ml ampoule

pethidine tablet, 50 mg Martindale Pharma- UK Yes Ireland, Nepalceuticals Ltd.

prochlorperazine injection, 12.5 mg/ml Aventis Limited Bangladesh Yes Myanmar, Sri Lanka

prochlorperazine tablet, 5 mg Aventis Limited Bangladesh Yes Myanmar, Sri Lanka

prochlorperazine tablet, 5 mg Pharmadrug Germany No n/a

prochlorperazine tablet, 5 mg Remedica Ltd. Cyprus Yes Yemen, Netherlands

pyrimethamine tablet, 25 mg Artesan Pharma GmbH & Co. Germany No n/a

pyrimethamine tablet, 25 mg Far Manguinhos Brazil Yes n/a

pyrimethamine tablet, 25 mg Pharmadrug Germany No n/a

pyrimethamine tablet, 25 mg Shiba Pharmaceuticals Yemen, Yes In process for: United Arab Emirates,& Chemicals Ltd. Republic of Eritrea, Ethiopia, Iraq, Sudan, Tanzania

rifabutin capsule, 150 mg Lupin Laboratories Ltd. India Yes Bulgaria, China, Czech Rep, Ethiopia,Kenya, Romania, Russia, Slovakia

saquinavir 200mg,caps Aurobindo Pharma Ltd. India Yes n/a

*saquinavir 200 mg,caps F. Hoffmann-La Roche Ltd. Switzerland Yes Argentina, Australia, Austria, Bahrain,Bangladesh, Belgium, Brazil, Bulgaria,Cambodia, Canada, Chile, Colombia,Costa Rica, Curacao, Cyprus, CzechRepublic, Denmark, Ecuador, Ireland, ElSalvador, Estonia, Ethiopia, Finland,France, Germany, Greece, Guatemala,Hong Kong, Hungary, Iceland, India,Israel, Italy, Japan, Kazakhstan, Kenya,Kuwait, Latvia, Lithuania, Luxembourg,Malaysia, Mexico, Morocco, Nepal,Netherlands, New Zealand, Norway,Oman, Panama, Peru, Philippines,Poland, Portugal, Qatar, Romania,Russia, Slovakia, South Africa, Korea,Spain, Sweden, Switzerland, Taiwan,Thailand, USA, United Arab Emirates,UK, Uruguay, Venezuela, Vietnam,Yugoslavia

spectinomycin powder for injection, 2 g Neon Antibiotics PVT. Ltd. India Yes n/a(as hydrochloride) in vial

stavudine 1mg/ml, syrup Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Bolivia,Chile

29


stavudine 1mg/ml, syrup The Government Pharma- Thailand Exempt n/aceutical Organization

stavudine 40 mg caps Apotex Protein, S.A. de C.V. Mexico Yes Panama, Nicaragua, Dominican Republic

stavudine 40 mg caps Aurobindo Pharma Ltd. India Yes Ethiopia

stavudine 40 mg caps Cipla Ltd. India Yes Ghana, Ivory Coast, Cameroon,Myanmar, Tanzania, Cambodia, Burundi,Congo, Uganda, Malawi, Guinea,Central African Republic

stavudine 40 mg caps Far Manguinhos Brazil Yes n/a

stavudine 40 mg caps Lab. Filaxis International S.A. Argentina Yes n/a

stavudine 40 mg caps Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,Bolivia

stavudine 40 mg caps Ranbaxy Laboratories Ltd India Yes Brazil, Cambodia, Chad, Ethiopia,Guatemala, Guinea, Mali, Mauritius,Myanmar, Nigeria, Senegal, Togo

stavudine 40 mg caps Samchully Pharm. Co., Ltd. Korea, In process n/aRepublic of

stavudine 40 mg caps Strides Arcolab Limited India No n/a

stavudine 40 mg caps The Government Pharma- Thailand Exempt n/aceutical Organization

sulfadiazine tablet, 500 mg Ecobi Farmaceutici S.a.s. Italy Yes n/a

sulfadiazine tablet, 500 mg Far Manguinhos Brazil Yes n/a

sulfadiazine tablet, 500 mg Heyl Chem.-pharm. Fabrik Germany Yes n/aGmbH KG

sulfadiazine tablet, 500 mg Laboratorio Reig Jofre S.A. Spain Yes n/a

sulfadiazine tablet, 500 mg Pharmadrug Germany No n/a

sulfamethoxazole+ oral suspension, Apotex Protein, S.A. de C.V. Mexico Yes Peru, Dominican Republictrimethoprim 200+40 mg/5 ml

sulfamethoxazole+ oral suspension, Aventis Limited Bangladesh Yes Myanmartrimethoprim 200+40 mg/5 ml

sulfamethoxazole+ oral suspension, Ecobi Farmaceutici S.a.s. Italy Yes Albania, Algeria, Senegaltrimethoprim 200+40 mg/5 ml

sulfamethoxazole+ oral suspension, Fourrts Laboratories Pvt. India Yes Uganda, Sri Lankatrimethoprim 200+40 mg/5 ml Ltd.

sulfamethoxazole+ oral suspension, Sdn Bhd Malaysia Yes Singapore, Hong Kong, Sri Lanka,trimethoprim 200+40 mg/5 ml Myanmar, Yemen, Cambodia, Ghana,

Kenya, Mali, Haiti, Papua New Guinea

sulfamethoxazole+ oral suspension, Lachifarma, SRL Italy No Yemen, Cameroontrimethoprim 200+40 mg/5 ml

sulfamethoxazole+ oral suspension, Purna Pharmaceuticals NV Belgium No El Salvadortrimethoprim 200+40 mg/5 ml

sulfamethoxazole+ oral suspension, Rekah Pharmaceutical Israel Yes n/atrimethoprim 200+40 mg/5 ml Group

sulfamethoxazole+ oral suspension, Remedica Ltd. Cyprus Yes Oman, Yemen, Albaniatrimethoprim 200+40 mg/5 ml

sulfamethoxazole+ oral suspension, Shiba Pharmaceuticals Yemen, Yes In process for: United Arab Emirates,trimethoprim 200+40 mg/5 ml & Chemicals Ltd. Republic of Eritrea, Ethiopia, Iraq, Sudan, Tanzania

sulfamethoxazole+ oral suspension, Sdn Bhd Malaysia Yes Cambodia, Myanmar, Papua New Guineatrimethoprim 200+40 mg/5 ml

sulfamethoxazole+ tab, 120 mg Lomapharm Germany n/atrimethoprim

sulfamethoxazole+ tablet, 100+20 mg Artesan Pharma GmbH Germany No n/atrimethoprim & Co.

sulfamethoxazole+ tablet, 100+20 mg Aurobindo Pharma Ltd. India Yes Zambia, Malawi, Tanzania, Cambodia,trimethoprim Lao PDR, Costa Rica, Honduras



30


sulfamethoxazole+ tablet, 100+20 mg Ecobi Farmaceutici S.a.s. Italy Yes Albaniatrimethoprim

sulfamethoxazole+ tablet, 100+20 mg Fourrts Laboratories Pvt. India Yes n/atrimethoprim Ltd.

sulfamethoxazole+ tablet, 100+20 mg Gracure Pharmaceuticals India Yes n/atrimethoprim Ltd.

sulfamethoxazole+ tablet, 100+20 mg Lachifarma, SRL Italy No Yemen, Cameroontrimethoprim

sulfamethoxazole+ tablet, 100+20 mg Lyka Labs Limited India Yes DR Congo, Cambodia, Chile, Perutrimethoprim

sulfamethoxazole+ tablet, 100+20 mg Rekah Pharmaceutical Israel Yes Kazakhstantrimethoprim Group

sulfamethoxazole+ tablet, 100+20 mg The Government Pharma- Thailand Exempt n/atrimethoprim ceutical Organization

sulfamethoxazole+ tablet, 400+80 mg Alpharma Indonesia Yes Netherlands, Germany, UKtrimethoprim

sulfamethoxazole+ tablet, 400+80 mg Apotex Protein, S.A. de C.V. Mexico Yes Panama, Nicaragua, Dominican Republictrimethoprim

sulfamethoxazole+ tablet, 400+80 mg Artesan Pharma GmbH Germany No n/atrimethoprim & Co.

sulfamethoxazole+ tablet, 400+80 mg Aurobindo Pharma Ltd. India Yes Zambia, Malawi, Tanzania, Cambodia,trimethoprim Lao PDR, Costa Rica, Honduras

sulfamethoxazole+ tablet, 400+80 mg Ecobi Farmaceutici S.a.s. Italy Yes Albania, Algeriatrimethoprim

sulfamethoxazole+ tablet, 400+80 mg Far Manguinhos Brazil Yes n/atrimethoprim

sulfamethoxazole+ tablet, 400+80 mg Fourrts Laboratories Pvt. India Yes Myanmar, Uganda, Sri Lankatrimethoprim Ltd.

sulfamethoxazole+ tablet, 400+80 mg Gracure Pharmaceuticals India Yes n/atrimethoprim Ltd.

sulfamethoxazole+ tablet, 400+80 mg Sdn Bhd Malaysia Yes Singapore, Hong Kong, Sri Lanka,trimethoprim Myanmar, Yemen, El Salvador, Mali,

sulfamethoxazole+ tablet, 400+80 mg Intas Pharmaceuticals Ltd India Yes Haiti, Singapore, Zimbabwe, Armenia,trimethoprim Zambia, Belarus, Costa Rica, Nicaragua

sulfamethoxazole+ tablet, 400+80 mg Intas Pharmaceuticals Ltd India Yes Myanmartrimethoprim

sulfamethoxazole+ tablet, 400+80 mg IPCA Laboratories Limited India Yes Ethiopia, Kazakhstan, Malawi, Myanmar,trimethoprim Nigeria, Russia, Sri Lanka, Tanzania,

Trinidad & Tobago, Uganda, Ukraine,Yemen, Zimbabwe, Afghanistan, Mali,Sudan

sulfamethoxazole+ tablet, 400+80 mg IVAX Pharmaceuticals Mexico Yes Costa Rica, El Salvador, Honduras,trimethoprim Mexico, S.A. de C.V. Nicaragua, Haiti, Dominican Republic,

Guatemala, Chile

sulfamethoxazole+ tablet, 400+80 mg Pharmadrug Germany Yes n/atrimethoprim

sulfamethoxazole+ tablet, 400+80 mg Ranbaxy Laboratories Ltd India Yes Belarus, Burkina Faso, Cameroon,trimethoprim Kazakhstan, Lithuania, Malawi, Malaysia,

Moldova, Myanmar, Russia, Senegal, SriLanka, Thailand, Trinidad & Tobago,Uganda, Ukraine, Yemen

sulfamethoxazole+ tablet, 400+80 mg Remedica Ltd. Cyprus Yes Ethiopia, Hong Kong, Malawi, Myanmar,trimethoprim Oman, Sudan

sulfamethoxazole+ tablet, 400+80 mg Sanavita Aktiengesell- Germany Yes Russia, Madagascar, Armenia,trimethoprim schaft & Co. Kazakhstan, Uzbekistan

sulfamethoxazole+ tablet, 400+80 mg Sanofi-Synthelabo Vietnam Viet Nam Yes Myanmartrimethoprim

31


sulfamethoxazole+ tablet, 400+80 mg Shiba Pharmaceuticals Yemen, Yes In process for: United Arab Emirates,trimethoprim & Chemicals Ltd. Republic of Eritrea, Ethiopia, Iraq, Sudan, Tanzania

sulfamethoxazole+ tablet, 400+80 mg Strides Arcolab Limited India No Sri Lankatrimethoprim

sulfamethoxazole+ tablet, 400+80 mg Lomapharm Germany Yes n/atrimethoprim

sulfamethoxazole+ tablet, 800+160 mg Apotex Protein, S.A. de C.V. Mexico Yes Panama, Nicaragua, Dominican Republictrimethoprim

sulfamethoxazole+ tablet, 800+160 mg Rekah Pharmaceutical Israel Yes n/atrimethoprim Group

tinidazole tablet, 500 mg Fourrts Laboratories Pvt. Ltd. India Yes n/a

tinidazole tablet, 500 mg Gracure Pharmaceuticals Ltd. India Yes n/a

tinidazole tablet, 500 mg Pharmadrug Germany No n/a

tinidazole tablet, 500 mg Remedica Ltd. Cyprus Yes Ethiopia, Kenya, Malaysia, Sudan

vinblastine powder for injection, Korea United Pharm. Inc. Korea, Yes n/a10 mg (sulfate) in vial Republic of

vinblastine powder for injection, Lab. Filaxis International S.A. Argentina Yes Uruguay, Mexico, Brazil10 mg (sulfate) in vial

vinblastine powder for injection, Neon Antibiotics PVT. Ltd. India Yes n/a10 mg (sulfate) in vial

vincristine injection, 1 mg (sulfate)/ Neon Antibiotics PVT. Ltd. India Yes n/aml in vial

vincristine powder for injection, Korea United Pharm. Inc. Korea, Yes n/a1 mg (sulfate) in vial Republic of

vincristine powder for injection, Lab. Filaxis International S.A. Argentina Yes Chile, Uruguay, Mexico, Brazil, Colombia1 mg (sulfate) in vial

vincristine powder for injection, Korea United Pharm. Inc. Korea, Yes n/a5 mg (sulfate) in vial Republic of

vinorelbine injection concentrate Lab. Filaxis International S.A. Argentina Yes Uruguay, Brazil10mg/ml in vial

vinorelbine injection concentrate Pierre Fabre Laboratory France Yes Iraq, Algeria10mg/ml in vial

zalcitabine 0.75mg, tab Far Manguinhos Brazil Yes n/a

zalcitabine 0.75mg, tab Lab. Filaxis International S.A. Argentina Yes Colombia

*ZDV/3TC 300mg/150mg, tab Cipla Ltd. India Yes Tanzania, Cambodia, Burundi, Congo,Uganda, Myanmar, Syria, Ghana,Guinea, Central African Republic

ZDV/3TC 300mg/150mg, tab Far Manguinhos Brazil Yes n/a

ZDV/3TC 300mg/150mg, tab Lab. Filaxis International S.A. Argentina Yes n/a

ZDV/3TC 300mg/150mg, tab Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile, Bolivia

*ZDV/3TC 300mg/150mg, tab Ranbaxy Laboratories Ltd India Yes Benin, Brazil, Cambodia, Central AfricanRepublic, Chad, Ethiopia, Guatemala,Guinea, Mali, Mauritius, Myanmar,Nigeria, Senegal, Togo

ZDV/3TC 300mg/150mg, tab Strides Arcolab Limited India No n/a

ZDV/3TC 300mg/150mg, tab The Government Pharma- Thailand Exempt n/aceutical Organization

zidovudine (AZT) capsule, 100 mg Apotex Protein, S.A. de C.V. Mexico Yes Panama, Nicaragua, Dominican Republic

zidovudine (AZT) capsule, 100 mg Aurobindo Pharma Ltd. India Yes Cambodia

*zidovudine (AZT) capsule, 100 mg Cipla Ltd. India Yes Uganda, Iran, Zambia, Ghana, Malawi,Cambodia, Congo, Myanmar, Guinea,Tanzania

*zidovudine (AZT) capsule, 100 mg Combino Pharm, S.L. Spain Yes Ivory Coast, Gabon

zidovudine (AZT) capsule, 100 mg Far Manguinhos Brazil Yes n/a



32


zidovudine (AZT) capsule, 100 mg IPCA Laboratories Limited India Yes Ghana, Kenya, Tanzania, Uganda, Zaire,Zimbabwe

zidovudine (AZT) capsule, 100 mg Korea United Pharm. Inc. Korea, Yes List to be provided. Vietnam, CambodiaRepublic of

zidovudine (AZT) capsule, 100 mg Lab. Filaxis International S.A. Argentina Yes Chile, Uruguay, Mexico, Brazil,Venezuela, Rep. Dominican

zidovudine (AZT) capsule, 100 mg Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,Bolivia

*zidovudine (AZT) capsule, 100 mg Ranbaxy Laboratories Ltd India Yes Nigeria

zidovudine (AZT) capsule, 100 mg Samchully Pharm. Co., Ltd. Korea, Yes Vietnam, GuineaRepublic of

zidovudine (AZT) capsule, 100 mg Strides Arcolab Limited India No n/a

zidovudine (AZT) capsule, 100 mg The Government Pharma- Thailand Exempt Cambodiaceutical Organization

zidovudine (AZT) capsule, 250 mg Apotex Protein, S.A. de C.V.Mexico Yes Panama, Nicaragua, Dominican Republic

*zidovudine (AZT) capsule, 250 mg Combino Pharm, S.L. Spain Yes Ivory Coast, Gabon

zidovudine (AZT) capsule, 250 mg Lab. Filaxis International S.A. Argentina Yes Mexico, Brazil, Colombia

zidovudine (AZT) capsule, 250 mg Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,Bolivia

zidovudine (AZT) capsule, 250 mg Samchully Pharm. Co., Ltd. Korea, Yes NigeriaRepublic of

zidovudine (AZT) capsule, 250 mg Strides Arcolab Limited India No n/a

zidovudine (AZT) capsule, 300 mg Aurobindo Pharma Ltd. India Yes Cambodia, Haiti

*zidovudine (AZT) capsule, 300 mg Cipla Ltd. India Yes Malawi, Cameroon, Iran, Burundi,Congo, Uganda, Myanmar, Guinea,Tanzania

zidovudine (AZT) capsule, 300 mg Combino Pharm, S.L. Spain Yes Ivory Coast

*zidovudine (AZT) capsule, 300 mg Ranbaxy Laboratories Ltd India Yes Benin, Cambodia, Central AfricanRepublic, Chad, Congo, Guatemala,Guinea, Mali, Mauritius, Myanmar,Nigeria, Peru, Senegal, Togo

zidovudine (AZT) capsule, 300 mg Samchully Pharm. Co., Ltd. Korea, No n/aRepublic of

zidovudine (AZT) capsule, 300 mg The Government Pharma- Thailand Exempt Cambodiaceutical Organization

zidovudine (AZT) injection, 10 mg/ml Lab. Filaxis International S.A. Argentina Yes Mexico, Brazilin 20-ml vial

zidovudine (AZT) injection, 10 mg/ml Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,in 20-ml vial Bolivia

zidovudine (AZT) oral solution, 50 mg/5 ml Aurobindo Pharma Ltd. India Yes n/a

*zidovudine (AZT) oral solution, 50 mg/5 ml Cipla Ltd. India Yes Burundi, Congo, Uganda

zidovudine (AZT) oral solution, 50 mg/5 ml Combino Pharm, S.L. Spain Yes n/a

zidovudine (AZT) oral solution, 50 mg/5 ml Lab. Filaxis International S.A. Argentina Yes Uruguay, Mexico, Brazil, Colombia

zidovudine (AZT) oral solution, 50 mg/5 ml Laboratorio Dosa S.A. US Yes Argentina, Uruguay, Paraguay, Chile,Bolivia

33


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2Th

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an d

iscr

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betw

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HIV-

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d HI

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Equi

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sam

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dai

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ANNEX 2. WHO BULK PROCUREMENT SCHEME 2003

ANN

EX 3

A

Su

mm

ary

of

mai

n c

har

acte

rist

ics

of

met

hod

s fo

rC

D4/C

D8 l

ym

ph

ocy

te d

eter

min

atio

nFl

ow c

ytom

etry

FAC

SCou

nttm

Cou

lter

man

ual

Zym

mun

eC

apce

llia

Dyn

abea

dsR

Imm

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lkal

ine

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4+ c

ount

kit

Phos

phat

ase

Man

ufac

ture

rBe

cton

Dic

kins

onBe

cton

Dic

kins

onCo

ulte

r Co

rp.

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Inc.

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fi D

iagn

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ents

ava

ilabl

eCo

ulte

r Co

rp.

Past

eur

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mer

cial

lyO

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gnos

tic S

yst.

Inst

rum

ent

Flow

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omet

er a

ndAu

tom

ated

spe

cial

Auto

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ed o

r lig

htM

icro

titer

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Mic

rotit

er E

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agne

t and

cou

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icro

scop

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mpu

ter

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sted

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ent

mic

rosc

ope

and

equi

pmen

t* a

lt. li

ght

anal

y sis

.he

mat

ocy t

omet

er.

or fl

oure

scen

cePr

epar

atio

n ca

n be

mic

rosc

ope

auto

mat

ed. M

ay n

eed

use

of c

ell c

ount

er.

Det

ectio

n sy

stem

Fluo

resc

ence

labe

lled

Fluo

resc

ence

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CD4

MAB

Anti-

CD4

and

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Stai

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ears

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Spec

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Who

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with

Who

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Who

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le b

lood

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(sta

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for

EIA)

for

EIA)


44

ANNEX 3A. SUMMARY OF MAIN CHARACTERISTICS OF METHODS FOR CD4/CD8 LYMPHOCYTE DETERMINATION

Flow

cyt

omet

ryFA

CSC

ount

tmC

oulte

r m

anua

lZy

mm

une

Cap

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46

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requ

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t es,

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(& re

frig

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l but

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ANNEX 3B. SUMMARY OF MAIN CHARACTERISTICS OF VIRAL LOAD TECHNOLOGIES

Com

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plip

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gene

tics

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Type

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me

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ber

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red15

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bato

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tor,

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ader

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bato

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7deg

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ter

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iger

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pmen

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up

pack

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udes

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r ne

cess

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pmen

t and

3 k

its)

15Al

l tes

t s re

quire

pip

ett e

s an

d vo

rtex

mix

ers

47

ANNEX 4

Further reading, references,and contacts

Treatment guidelines

• Web version only: The Selection and Use of EssentialMedicines. Report of the WHO Expert Committee, 2003(including the 13th Model List of Essential Medicines).WHO, Geneva, 2003.

http://www.who.int/medicines/organization/par/edl/expertcomm.shtml

• The Selection and Use of Essential Medicines. Reportof the WHO Expert Committee, 2002 (including the12th Model List of Essential Medicines). WHO, Geneva,2003 (WHO Technical Report Series, No. 914).

http://www.who.int/medicines/organization/par/edl/expertcomm.shtml

• WHO Model Formulary 2002. World Health Organiza-tion, Geneva, 2002.

http://mednet3.who.int/mf/intro.asp

• Scaling up antiretroviral therapy in resource-limitedsettings: Guidelines for a public health approach. WHO,Geneva, 2002.

http://www.who.int/hiv/pub/prev_care/ScalingUp_E.pdf

• Guidelines for the management of sexually transmit-ted infections. WHO, Geneva, 2001 (WHO HIV_AIDS/2001.01).

http://www.who.int/hiv/pub/sti/pub6/en/

• AIDS: Palliative Care. UNAIDS Technical Update.UNAIDS, Geneva, 2000.

http://www.unaids.org/publications/documents/care/general/JC-PalliCare-TU-E.pdf

• Safe and effective use of antiretroviral treatments inadults, with particular reference to resource limitedsettings. WHO/UNAIDS/International AIDS Society,Geneva, 2000 (WHO/HSI/2000.04).

http://www.paho.org/english/hcp/hca/useARVadults.pdf

• WHO Model Prescribing Information: Drugs Used in HIV-related Illnesses. WHO, Geneva, 1999 (WHO/DMP/DSI/99.2).

http://www.who.int/medicines/library/qsm/who-dmp-dsi-99-2/who-dmp-dsi-99-2.htm


48

• 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/

• Policy and programming options for reducing the pro-curement costs of essential medication in developingcountries. Levison, L., Boston University School ofPublic Health, 2003.

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

• Report on the Global HIV/AIDS Epidemic 2002.UNAIDS/WHO, Geneva, 2002 (UNAIDS/02.46E).

http://www.unaids.org/worldaidsday/2002/press/update/epiupdate2002_en.doc

• 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

• Ethical & Social Issues Relating to Antiretroviral Treat-ments, Module 9. WHO/UNAIDS, Geneva, 1998 (WHO/ASD/ 98.1–UNAIDS/98.7).

• Managing Drug Supply. MSH/WHO, Second Edition,1997.

http://www.msh.org/what_MSH_does/cpm/resources.html#top

Intellectual Property rights andpharmaceuticals

• Drug patents under the spotlight: sharing practicalknowledge about pharmaceutical patents. MSF,Geneva, 2003.

http://www.accessmed-msf.org/prod/publications.asp?scntid=2252003114784&contenttype=PARA&

• Globalization, patents and drugs. An annotated bibli-ography. Health Economics and Drugs EDM Series No.9. 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 andTRIPS on Access to Medicines. Meeting report. 2001.Health Economics and Drugs EDM Series No. 11 (WHO/EDM/PAR/2002.1)

• Globalization, TRIPS and Access to Pharmaceuticals.WHO Policy Perspectives on Medicines, No.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 EDM Series No. 7 Revised (WHO/DAP/98.9)

Pricing strategies

• Cost-containment mechanisms for Essential Medicines,including antiretrovirals, in China. WHO, Geneva, 2003(WHO/EDM/PAR/2003.6).

http://www.who.int/medicines/

• Medicine Prices: a new approach to measurement,2003 edition. Joint WHO and HAI publication, Geneva,2003 (WHO/EDM/PAR/2003.2).

http://www.who.int/medicines/library/prices.shtml

• Public-Private Roles in the pharmaceutical sector. Im-plications for equitable access and rational drug use.

Drug Action Programme on Essential Drugs, WHO,Geneva, 1997 (WHO/DAP/97.2).

http://www.who.int/medicines/library/dap/who-dap-97-12/who-dap-97-12.htm

• Overview of pharmaceutical pricing and reimbursementregulation in Europe. Panos Kanavos, LSE Health andSocial Care, 2001

• Annex: Comparative Review of Drug Prices. Policieson Pricing and Reimbursement of Medicines in Europe,Networking for Information Exchange among policyMakers. WHO Regional Office for Europe, Copenhagen,2000.

Websites

Partner sitesUNAIDS: www.unaids.org

UNICEF: www.unicef.org

WHO: www.who.int

MSF: www.msf.org

Public drug pricesSpain:

http://www.cof.es

http://www.canaldefarmacia.com

UK:

http://www.drugtariff.com

http://www.doh.gov.uk/generics

Brazil:

http://bpreco.saude.gov.br/pls/BPREFD/consulta.inicio

Latin America & Caribbean:

http://www.paho.org/English/HCP/HCA/antiretrovirals_HP.htm

Canada:

http://www.pmprb-cepmb.gc.ca

WHO:

http://www.who.int/medicines/organization/par/ipc/drugpriceinfo.shtml

Other:

http://cptech.org/ip/health/econ/pricingstudies.html


49


50

Treatment & testing guidelines

Taken fromhttp://www.who.int/HIV_AIDS/first.html#HIV/

AIDS%20Care%20and%20Antiretrovirals

• Safe and effective use of antiretroviral therapy in adultswith reference to resource poor settings 2000

• Key elements in HIV/AIDS care and support 2000

• Fact Sheets on HIV/AIDS for nurses and midwives

• Nine Guidance Modules on Antiretroviral Treatments,1998

• WHO-UNAIDS HIV Vaccine Initiative

• Voluntary Counselling and Testing for HIV Infection inAntenatal Care Practical considerations for implemen-tation

• Guidelines for the Management of Sexually Transmit-ted Infections

• Report of the WHO consultative meeting on ARV use inresource limitted settings, May 2001

Other websites for generalinformation on HIV/AIDSrelated issues

http://www.globalfundatm.org

http://www.genericsnow.org

http://www.avert.org

http://www.aegis.com

http://www.msh.org/

http://www.haiweb.org

http://www.phrma.org

http://www.ims-global.com/insight/report/global/report.htm

Contacts

For further information about suppliers or products, pleasecontact:

• Pharmaceutical and Micronutrient Group, Sources ofMedicines for HIV/AIDS Survey, UNICEF [email protected] +45 35 269421

For further information on HIV test kit evaluations or thebulk procurement scheme, contact

• Blood Safety and Clinical Technology (BCT)World Health OrganizationFax +41 22 791 4836

For any comments on this document, or additionalinformation that could be useful to this project,please contact:

• Sources of medicines for HIV/AIDS SurveyPharmaceutical and Micronutrient Group, UNICEF,Supply DivisionFax: +45 35 269421

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

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

• Campaign for Access to Essential Drugs, MSFFax: +41 22 8498404

Alternatively, please complete the feedback form,Annex VI, and return it to:

• Sources of medicines for HIV/AIDS SurveyPharmaceutical and Micronutrient GroupUNICEF Supply DivisionUnicef pladsFreeport DK-2100Copenagen ØDenmark

Fax: +45 35 269421Email: [email protected]

51


Please fill out this form and fax it to UNICEF Supply Division +45 35 26 94 21 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:

✁

ANNEX 5

Feedback and enquiry form


ANNEX 6

Untangling the web ofprice reductions

15th

May

200

3Fo

urth

edi

tion

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:

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

5Li

mita

tions

of th

e cu

rren

t sy

stem

5Th

e ch

alle

nge

of p

aedi

atric

for

mul

atio

ns6

Rese

arch

and

deve

lopm

ent

for HIV

/AID

S7

The

effe

cts

of g

ener

ic c

ompe

titio

n8

Gui

de t

o re

adin

g an

d us

ing

tabl

es9

Tabl

es9

Tabl

e 1:

Sum

mar

y of

sel

ecte

d ph

arm

aceu

tical

com

pani

es’ b

est AR

V p

rice

offe

rs for

elig

ible

dev

elop

ing

coun

trie

s9

Tab

le 1

a –

Nuc

leos

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NRT

Is)

10 T

able

1b

– Non

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ide

Reve

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scrip

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11Ta

ble

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tase

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12 T

able

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– Pr

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se Inh

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s)13

Tab

le 1

e –

Fixe

d Dos

e Co

mbi

natio

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Cs)

14 T

able

1f –

Paed

iatric F

orm

ulat

ions

15 T

able

2: Co

mpa

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RV o

ffer

s an

d re

stric

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for

dev

elop

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trie

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dult

and

paed

iatric for

mul

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ns15

Tab

le 2

a –

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leos

ide

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Tran

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tase

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Is)

18 T

able

2b

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Reve

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scrip

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19 T

able

2c

– Nuc

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20Ta

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(PI

s)23

Tabl

e 2e

– F

ixed

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e Co

mbi

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25Ta

ble

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Sel

ecte

d Gen

eric c

ompa

nies

’ ARV

offe

rs a

nd res

trictio

ns for

dev

elop

ing

coun

trie

s26

An

nexe

s26

Ann

ex 1

: Le

ast

Dev

elop

ed C

ount

ries

(LDCs

)26

Ann

ex 2

: Hum

an D

evel

opm

ent

Inde

x (H

DI)

27 A

nnex

3: Su

b-Sa

hara

n co

untrie

s27

Ann

ex 4

: W

orld

Ban

k lo

w-in

com

e co

untrie

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Ann

ex 5

: Co

mpa

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onta

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29Glo

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31Re

fere

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Tabl

e of

con

tent

s

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

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-msf

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ay 2

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tang

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Web

of Pr

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Redu

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ns •

3

Gen

eral

bac

kgro

und

and

obje

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es

Lack

of clea

r in

form

atio

n on

phar

mac

eutic

al p

rices

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

edicin

es in

deve

lopi

ngco

untrie

s. T

he s

ituat

ion

is p

artic

ular

lyco

mpl

ex in

the

case

of an

tiret

rovi

rals

(ARV

s).

The

data

in

this g

uide

on

ARV

prices

offe

red

by o

rigin

ator

com

pani

es a

ndso

me

gene

ric c

ompa

nies

in

low

- an

dm

iddl

e-in

com

e co

untrie

s ar

e m

eant

to

prov

ide

pote

ntia

l bu

yers

with

cle

arve

rifie

d da

ta. Th

is inf

orm

atio

n is

inte

nded

for

use

by

gove

rnm

ent an

dno

n-pr

ofit

proc

urem

ent ag

encies

, as

wel

l as

oth

er b

ulk

purc

hase

rs o

fAR

Vs, in

clud

ing

heal

th fac

ilitie

s an

dno

n go

vern

men

tal or

gani

satio

ns(N

GOs)

.

This d

ocum

ent in

clud

es b

oth

adul

tan

d pa

edia

tric for

mul

atio

ns, an

d is

mea

nt to

be u

sed

in tan

dem

with

the

repo

rt o

f “ P

ilot Pr

ocur

emen

t, Qua

lity

and

Sour

cing

Pro

ject

: Ac

cess

to

HIV

/AID

S Dru

gs a

nd D

iagn

ostic

s of

Acce

ptab

le Q

ualit

y”,

a p

roje

ctin

itiat

ed b

y W

HO a

nd d

evel

oped

in

colla

bora

tion

with

oth

er U

nite

dNat

ions

Org

anisat

ions

(UNAI

DS,

UNIC

EF, UNFP

A). Th

is p

roje

ct e

valu

ates

cont

acte

d an

d as

ked

to v

erify

the

irof

fers

. Th

e lis

t of

gen

eric p

rodu

cers

includ

ed in

this rep

ort is b

y no

mea

nsex

haus

tive4 .

All ge

neric

dru

gs inc

lude

din

thi

s pr

icin

g gu

ide

have

mad

e pr

ice

offe

rs for

dev

elop

ing

coun

trie

s an

dha

ve a

t le

ast be

en c

lear

ed for

mar

ketin

g in

the

ir co

untrie

s of

orig

in.

Man

ufac

ture

rs w

ere

aske

d to

pro

vide

the

follo

win

g in

form

atio

n:

•dr

ug, do

sage

and

pha

rmac

eutic

al

form

•pr

ice

per un

it (o

r da

ily d

ose)

of

diffe

rent

pric

e of

fers

•re

stric

tions

tha

t ap

ply

to t

he

offe

rs, in

clud

ing:

i. co

untry

elig

ibili

tyii.

pot

entia

l be

nefic

iarie

s of

the

of

fer

iii. ad

ditio

nal co

mm

ents

on

cond

ition

s or

pro

cedu

res,

suc

h as

qu

antit

y re

stric

tions

, ho

w t

o ac

cess

di

scou

nts,

bur

eauc

ratic

pro

cedu

res

phar

mac

eutic

al m

anuf

actu

rers

and

prod

ucts

acc

ordi

ng to

WHO

reco

mm

ende

d st

anda

rds

of q

ualit

yan

d co

mpl

ianc

e w

ith G

ood

Man

ufac

turin

g Pr

actic

es. It

is p

art of

an o

ngoi

ng p

roce

ss tha

t w

ill e

xpan

das

the

par

ticip

atio

n of

sup

plie

rsin

crea

ses.

An

upda

ted

list of

pro

duct

sis reg

ular

ly p

oste

d on

the

web

site

s of

WHO a

nd o

ther

UN-c

olla

bora

ting

agen

cies

1 ; pr

oduc

ts o

n th

is list ar

eco

mm

only

ref

erre

d to

as

“WHO p

re-

qual

ified

.” T

his

list of

“pr

e-qu

alifi

ed”

drug

s is n

ot e

xhau

stiv

e.

Pricin

g in

form

atio

n on

oth

er e

ssen

tial

drug

s an

d di

agno

stics

used

for

HIV

/AID

S ca

n be

fou

nd in

the

4th

editi

on o

f th

e re

port “

Sour

ces

and

Prices

of Se

lect

ed D

rugs

and

Dia

gnos

tics

for Pe

ople

Liv

ing

with

HIV

/AID

S”

May

200

32 .

This is

the

fou

rth

editi

on o

f “ A

cces

sing

Antir

etro

vira

ls: Unt

angl

ing

the

Web

of

Price

Redu

ctio

ns for

Dev

elop

ing

Coun

trie

s ”, th

e fir

st e

ditio

n w

aspu

blishe

d in

Oct

ober

200

13 .

Met

hodo

logy

In o

rder

to

obta

in a

ccur

ate

info

rmat

ion

on d

isco

unte

d pr

ice

offe

rsby

bot

h or

igin

ator

and

gen

eric

com

pani

es, co

mpa

nies

wer

e

such

as

mem

oran

da o

f un

ders

tand

ing

or s

pecial

agr

eem

ent

iv. de

liver

y of

goo

ds in

rela

tion

to

paym

ent

(FOB, CI

F et

c.)5

Info

rmat

ion

is p

rese

nted

in

a ta

ble

form

at t

o fa

cilit

ate

com

pariso

n.How

ever

, co

mpa

riso

n is

diff

icul

tbe

caus

e of

the

lac

k of

stan

dard

isat

ion

amon

g di

ffere

ntco

mpa

nies

on

elig

ibili

ty, te

rms

and

cond

itio

ns, an

d pr

icin

g. F

or p

rodu

cts

for

whi

ch c

ompl

ete

info

rmat

ion

was

avai

labl

e, t

he a

nnua

l co

st o

f th

erap

yw

as c

alcu

late

d ac

cord

ing

to t

hedo

sing

sch

edul

es r

epor

ted

in W

HO

“Sca

ling-

up A

ntire

trov

iral Th

erap

y in

Reso

urce

Lim

ited

Settin

gs:

Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch”6 ,

2002

, or

the

Cen

tres

for

Dis

ease

Con

trol

and

Pre

vent

ion

(CDC)

, “ G

uide

lines

for

the

Use

of

Antir

etro

vira

l Ag

ents

in

HIV

-Infe

cted

Adul

ts a

nd A

dole

scen

ts”,

by

the

Pane

l on

Clin

ical

Pra

ctic

es for

the

Trea

tmen

t of

HIV

, 20

027 .

This

fou

rth

editi

on p

rovi

des:

•up

date

d in

form

atio

non

price

s fo

r el

igib

le c

ount

ries

, in

clud

ing

both

price

pe

r un

it 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

ap

plyi

ng t

o th

ese

offe

rs

4 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

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

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

5

All pr

ices

are

quo

ted

in U

S do

llars

and

conv

ersion

s w

ere

mad

e on

the

day

the

price

was

rec

eive

d.

All pr

ices

wer

e ch

ecke

d an

d ve

rifie

dby

com

pani

es.

It is

im

portan

t to

not

e th

at the

sepr

ices

may

not

cor

resp

ond

to e

nd-

user

pric

es (pr

ices

to

patie

nts)

, w

hich

may

be

furthe

r in

fluen

ced

by o

ther

fact

ors

such

as

natio

nal di

strib

utio

nan

d ha

ndlin

g ch

arge

s, m

ark-

up r

ates

,an

d na

tiona

l an

d/or

im

port a

nd s

ales

taxe

s. Inf

orm

atio

n co

ncer

ning

the

pate

nt s

tatu

s of

ARV

s w

as n

otin

clud

ed in

the

pres

ent an

alys

is, an

dw

ill d

iffe

r be

twee

n co

untrie

s. S

ome

info

rmat

ion

abou

t pa

tent

sta

tus

ofAR

Vs in

som

e co

untrie

s ca

n be

fou

ndin

“Pa

tent

Situ

atio

n of

HIV

/AID

Sre

late

d dr

ugs

in 8

0 co

untrie

s”,

WHO/U

NAI

DS,

200

08 .

Prac

tical

inf

orm

atio

n on

pat

ents

can

also

be

foun

d in

the

new

MSF

rep

ort

“ Dru

g pa

tent

s un

der

the

spot

light

:sh

arin

g pr

actic

al k

now

ledg

e ab

out

phar

mac

eutic

al p

aten

ts”,

May

200

39 .

Incl

usio

n in

the

rep

ort do

es n

otco

nstit

ute

pre-

qual

ifica

tion

or a

ppro

val

by M

SF. Nat

iona

l re

gula

tory

auth

oriti

es a

re u

ltim

atel

y re

spon

sibl

e

for

appr

ovin

g us

e of

a g

iven

dru

gfrom

a g

iven

man

ufac

ture

r. Pr

oduc

tsth

at w

ere

“WHO p

re-q

ualif

ied”

at th

etim

e of

writ

ing

are

indi

cate

d w

ith a

nas

teris

k (*

)1 .

Lim

itatio

ns o

f th

e cu

rren

t sy

stem

The

lack

of a

unifo

rm p

refe

rent

ial

pricin

g sy

stem

has

res

ulte

d in

eac

hco

mpa

ny d

efin

ing

a un

ique

ser

ies

ofte

rms

and

crite

ria. Fo

r in

stan

ce,

whe

reas

Mer

ck &

Co.

, In

c. tak

es int

oac

coun

t cr

iteria

rel

ated

to

reso

urce

s(H

uman

Dev

elop

men

t In

dex)

and

epid

emio

logy

(HIV

/AID

S pr

eval

ence

10)

to d

eter

min

e na

tiona

l el

igib

ility

(the

oret

ical

ly, ne

arly

120

cou

ntrie

sbe

nefit

fro

m the

se o

ffers

),Gla

xoSm

ithKl

ine

(GSK

) us

es the

clas

sific

atio

n of

Lea

st D

evel

oped

Coun

trie

s an

d th

e ge

ogra

phical

clas

sific

atio

n of

sub

-Sah

aran

coun

trie

s (a

tot

al o

f 63

cou

ntrie

s).

Mos

t of

the

orig

inat

or c

ompa

nies

,ap

art fro

m M

erck

& C

o., In

c. a

ndRo

che,

do

not ha

ve a

pol

icy

for

coun

trie

s ou

tsid

e su

b-Sa

hara

n Af

rica,

or a

re n

ot c

lass

ified

by

UNCT

AD a

sLe

ast Dev

elop

ed C

ount

ries.

For

exam

ple,

Bris

tol-M

yers

Squ

ibb

(BM

S)ap

plie

s di

scou

nts

to w

hole

sale

and

reta

il pu

rcha

sers

in

sub-

Saha

ran

Afric

a (the

oret

ical

ly, 48

cou

ntrie

s

bene

fit fro

m thi

s of

fer) b

ut n

ot in

Cent

ral A

mer

ica

whe

re p

rices

are

nego

tiate

d on

a c

ase-

by-c

ase

basis

thro

ugh

the

Acce

lera

ted

Acce

ssIn

itiat

ive.

Even

whe

n a

give

n co

untry

is e

ligib

le,

all in

stitu

tions

with

in the

cou

ntry

may

not be

elig

ible

for

red

uced

pric

es.

Agai

n, e

ligib

ility

is

curren

tly a

t th

eco

mpa

nies

’ discr

etio

n. It do

es n

otm

ean

that

the

dru

gs a

re reg

iste

red

and

a di

strib

utio

n sy

stem

exist

s in

thes

e co

untrie

s.

In a

ctua

l pr

actic

e, M

SF h

as o

bser

ved

that

the

mos

t po

wer

ful do

wnw

ard

pres

sure

on

pric

es h

as b

een

asy

stem

of eq

uity

pric

ing.

Equ

itypr

icin

g is

com

pose

d of

a s

erie

s of

sim

ulta

neou

s st

rate

gies

: a)

stim

ulat

ing

gene

ric c

ompe

titio

n; b

)di

ffere

ntia

l pr

icin

g w

hich

add

ress

esal

l de

velo

ping

cou

ntrie

s, a

ccor

ding

to

clea

rly d

efin

ed p

olic

ies,

or

volu

ntar

ylic

ensi

ng o

f pr

oprie

tary

pro

duct

s; a

ndc)

rea

dine

ss o

n th

e pa

rt o

f na

tiona

lgo

vern

men

ts t

o ov

errid

e pa

tent

s by

issu

ing

com

puls

ory

licen

ses

orm

akin

g go

vern

men

t us

e of

a p

aten

tw

hen

affo

rdab

le p

rices

are

not

offe

red

for

pate

nted

pro

duct

s. S

ince

the

adop

tion

of t

he D

oha

decl

arat

ion

on T

RIPS

and

Pub

lic H

ealth

lea

st

deve

lope

d co

untrie

s(L

DC’

s) a

re n

otob

ligat

ed t

o pa

tent

dru

gs u

ntil

2016

11.

Alth

ough

gen

eric c

ompe

titio

n is

acr

itica

l fa

ctor

in

redu

cing

pric

es (se

eGra

ph 1

, w

here

the

pric

es t

rend

of a

sam

ple

ARV

trip

le t

hera

pyco

mbi

natio

n is

sho

wn

over

the

perio

d M

ay 2

000-

April

200

3), it

cann

ot b

e a

stan

d-al

one

stra

tegy

as

new

er d

rugs

may

not

be

avai

labl

e in

gene

ric for

m im

med

iate

ly. Th

ere

is a

nur

gent

nee

d to

dev

elop

a m

ore

syst

emat

ic, tran

spar

ent

appr

oach

to

diffe

rent

ial pr

icin

g of

orig

inat

orpr

oduc

ts in

addi

tion

to s

timul

atin

gge

neric

com

petit

ion.

The

chal

leng

e of

pae

diat

ricfo

rmul

atio

ns

Child

ren

livin

g w

ith H

IV/A

IDS

are

one

of t

he m

ost

negl

ecte

d po

pula

tions

:pa

edia

tric for

mul

atio

ns a

re lac

king

and/

or for

mul

atio

ns d

o no

t m

eet

child

ren’s

and

care

give

rs’ne

eds

(unp

leas

ant

tast

ing

syru

p, t

able

ts t

oobi

g to

sw

allo

w, ne

ed t

o re

frig

erat

eso

me

prod

ucts

, un

brea

kabl

e ta

blet

s,la

ck o

f fix

ed d

ose

com

bina

tions

(FDCs

), a

nd n

on-a

dapt

ed d

osag

es.

For ex

ampl

e th

ere

are

curren

tly n

ofix

ed d

ose

com

bina

tions

for

paed

iatric u

se.

6 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Rese

arch

and

deve

lopm

ent fo

rHIV

/AID

S

Paed

iatric for

mul

atio

ns is

not th

e on

lyar

ea w

here

the

re is

a ne

ed for

R&

D.

For bo

th a

dults

and

chi

ldre

n, n

ewdr

ugs

and

diag

nost

ic too

ls, as

wel

l as

vacc

ines

are

nee

ded

for HIV

/AID

S.Ph

arm

aceu

tical

inv

estm

ent in

res

earc

han

d de

velo

pmen

t la

rgel

y co

rres

pond

sto

dev

elop

ed c

ount

ry p

atie

nt n

eeds

,w

here

the

epi

dem

ic h

as m

ore

or les

sst

abili

zed.

We

need

to

ensu

re tha

tth

ere

is a

stron

g fo

cus

on the

nee

dsof

pat

ient

s in

dev

elop

ing

and

leas

tde

velo

ped

coun

trie

s an

d th

at the

R&D m

omen

tum

is

not lo

st.

Janu

ary

2001

-Apr

il 20

03

May

200

0-Ap

ril 20

0312

000U

S$

1000

0US$

8000

US$

6000

US$

4000

US$

2000

US$

0

Origi

nato

r $1

0439

Origi

nato

r $9

31Origi

nato

r $7

27

Bra

zil $2

767

May

00

Ju

ly

Sep

t

Nov

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n 01

Mar

May

July

01

Sep

t

Nov

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02

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ay

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ly

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ept

Nov

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02

Mar

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Jul

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Sept

Nov

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Origi

nato

r $7

27

Auro

bind

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09Het

ero

$201

Auro

bind

o $2

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ero

$201

Ranb

axy

$295

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$347

Cipl

a $3

50

Cipl

a $3

50

Origi

nato

r

Gen

eric

The

Effe

cts

of G

ener

ic C

ompe

titio

nSa

mpl

e of

ARV

tripl

e-co

mbi

nation

: st

avud

ine

(d4T

) +

lam

ivud

ine

(3TC

) +

nevi

rapi

ne (

NVP). L

owes

t w

orld

price

s pe

r pa

tien

t pe

r ye

ar.

Gen

eric

com

petition

has

sho

wn

to b

e th

e m

ost

effe

ctiv

e m

eans

of lo

wer

ing

drug

price

s. D

urin

g th

e la

st t

hree

yea

rs, or

igin

ator

com

pani

es h

ave

ofte

n re

spon

ded

to g

ener

icco

mpe

tition

.

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

7

Gui

de to

read

ing

and

usin

g ta

bles

Qua

lity:

This

doc

umen

t st

rictly

rel

ates

to

prices

: pr

oduc

ts fro

m s

pecific

man

ufac

ture

rs h

ave

not

nece

ssar

ily b

een

asse

ssed

for

qua

lity

stan

dard

s.Th

eref

ore,

pro

cure

men

t ag

encies

sho

uld

follo

w t

heir

own

proc

edur

e in

thi

sre

spec

t.

Prices

:ta

ble

1 sh

ows

the

best

pric

e of

fers

of so

me

gene

ric m

anuf

actu

rers

and

orig

inat

or p

rodu

cers

for

eac

h an

tiret

rovi

ral dr

ug, in

clud

ing

fixed

-dos

eco

mbi

natio

ns. Figu

res

with

in b

rack

ets

indi

cate

pric

e in

US$

per

uni

t (c

apsu

les,

tabl

ets

etc.

). Pr

ices

par

pat

ient

per

yea

r ha

ve b

een

calcul

ated

acc

ordi

ng t

oda

ily d

oses

giv

en e

ither

in

WHO g

uide

lines

or in

CDC

guid

elin

es (fo

r th

ose

prod

ucts

not

rec

omm

ende

d in

WHO g

uide

lines

). Pr

ices

can

be

used

as

are

fere

nce

with

sup

plie

rs.

Rest

rictio

ns:ta

bles

2a)

and

2b)

sho

w res

trictio

ns im

pose

d by

gen

eric a

ndor

igin

ator

com

pani

es a

nd p

rovi

de ind

icat

ions

abo

ut t

he a

vaila

bilit

y of

offe

rs in

indi

vidu

al c

ount

ries.

The

re is

no u

nifo

rm d

iffer

entia

l pr

icin

g sy

stem

and

eac

hco

mpa

ny s

ets

geog

raph

ical

lim

its t

o th

eir pr

ogra

mm

es.

Acce

ss:si

nce

ARVs

are

not

alw

ays

regi

ster

ed a

nd/o

r av

aila

ble

in ‘s

elec

ted

coun

trie

s’, m

any

offe

rs fro

m p

harm

aceu

tical

com

pani

es m

ay rem

ain

‘theo

retic

al’

until

the

com

pani

es a

re c

halle

nged

to

follo

w t

hrou

gh o

n th

eir of

fers

, by

regi

ster

ing

the

prod

ucts

and

cre

atin

g pr

oper

dis

trib

utio

n ch

anne

ls a

t na

tiona

l or

regi

onal

lev

el.

Plea

se ref

er t

o An

nexe

s 1, 2

and

4 for

upd

ated

cou

ntry

cla

ssifi

catio

n by

UNCT

AD (Le

ast

Dev

elop

ed C

ount

ries)

, UNDP

(Hum

an D

evel

opm

ent

Inde

x) a

ndW

orld

Ban

k (L

ow inc

ome

Coun

trie

s). A

nnex

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

Gui

de to

read

ing

and

usin

g ta

bles

8 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

stav

udin

e(d

4T)

30 Zerit

®(B

MS)

2 49*

(0.0

66/u

nit)

48 (0.0

65/u

nit)

36 (0.0

49/u

nit)

Tabl

e 1a

– N

ucle

osid

e Re

vers

eTr

ansc

ripta

se Inh

ibito

rs (NRT

Is)

All pr

ices

are

in

US$

. Pr

ices

are

giv

enbo

th for

a y

early

adu

lt do

se a

nd b

yun

it.

For de

tails

on

elig

ibili

ty a

nd o

ffer

rest

rictio

ns for

cou

ntrie

s an

din

stitu

tions

, pl

ease

ref

er to

tabl

e 2a

.

Prod

ucts

on

the

WHO lis

t of

Pilo

tPr

ocur

emen

t, Q

ualit

y an

d So

urcing

Pro

ject

:Ac

cess

to

HIV

/AID

S dr

ugs

and

diag

nost

ics

ofac

cept

able

qua

lity

(Six

th e

ditio

n, 5

th M

ay20

03)

are

inbo

ld a

nd h

ave

anas

teris

k *

next

to t

he p

rice.

Alw

ays

chec

k w

ebsi

te for

mos

tre

cent

ly u

pdat

ed lis

t. Bes

t pr

ices

are

in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ng t

om

anuf

actu

rers

.

Annu

al c

ost

is c

alcu

late

d ac

cord

ing

to t

heda

ily d

oses

giv

en in

the

WHO ‘Sc

alin

g-up

Antir

etro

vira

l Th

erap

y in

Res

ourc

e Li

mite

dSe

ttin

gs: Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch’(Ju

ne 2

002)

and

/or th

e ‘G

uide

lines

for th

e Use

of An

tiret

rovi

ral A

gent

s in

HIV

-In

fect

ed A

dults

and

Ado

lesc

ents

’from

the

Pane

l on

Clin

ical

Pra

ctices

for

the

Tre

atm

ent

of H

IV (20

02).

Tabl

e 1:

Sum

mar

y of

sel

ecte

d ph

arm

aceu

tical

com

pani

es’ be

st A

RV p

rice

offe

rs for

elig

ible

dev

elop

ing

coun

trie

s

(§) BM

S se

lls d

dI (

Vide

x®) in

oth

er d

oses

(pe

r m

g pr

ice

rem

ains

the

sam

e)

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

9

NRT

I(A

bbre

viat

ion)

Stre

ngth

(m

g)

Trad

e na

me

Euro

pe/U

S

Dai

ly d

ose

BM

S(U

S)

GSK

(UK)

Auro

bind

o(Ind

ia)

Cipl

a(Ind

ia)

GPO

(Tha

iland

)

Het

ero

(Ind

ia)

Ran

baxy

(Ind

ia)

Com

bino

phar

m(S

pain

)

abac

avir

(ABC)

300

Ziag

en®

(GSK

)

2 986*

(1.3

50/u

nit)

821

(1.1

25/u

nit)

1325

(1.8

15/u

nit)

dida

nosi

ne(d

dI)

100

(§)

Vide

x®(B

MS)

4 310*

(0.2

12/u

nit)

197

(0.135

/uni

t)

426

(0.2

92/u

nit)

650

(0.4

45/u

nit)

185

(0.1

27/u

nit)

dida

nosi

ne(d

dI)

EC 4

00

Vide

x®(B

MS)

1 Not

appl

icab

le

271

(0.7

41/u

nit)

335

(0.9

17/U

nit)

lam

ivud

ine

(3TC

)

300

Epiv

ir®(G

SK)

1 124

(0.3

40/u

nit)

lam

ivud

ine

(3TC

)

150

Epiv

ir®(G

SK)

2 128*

(0.1

75/u

nit)

66 (0.0

90/u

nit)

126*

(0.1

72/u

nit)

163

(0.2

23/u

nit)

65 (0.0

89/u

nit)

100*

(0.1

37/u

nit)

stav

udin

e(d

4T)

40 Zerit

®(B

MS)

2 55*

(0.0

75/u

nit)

31 (0.0

43/u

nit)

53 (0.0

72/u

nit)

73 (0.100

/uni

t)

31 (0.0

42/u

nit)

47 (0.0

64/u

nit)

zido

vudi

ne(Z

DV o

r AZ

T)

300

Retrov

ir®(G

SK)

2 274*

(0.3

75/u

nit)

140

(0.1

92/u

nit)

198*

(0.2

71/u

nit)

277

(0.3

80/u

nit)

175

(0.2

40/u

nit)

180*

(0.2

46/u

nit)

292*

(0.4

00/u

nit)

Tabl

e 1b

– N

on-N

ucle

osid

e Re

vers

eTr

ansc

ripta

se Inh

ibito

rs (NNRT

Is)

All pr

ices

are

in

US$

. Pr

ices

are

giv

enbo

th for

a y

early

adu

lt do

se a

nd b

yun

it.

For de

tails

on

elig

ibili

ty a

nd o

ffer

rest

rictio

ns for

cou

ntrie

s an

din

stitu

tions

, pl

ease

ref

er t

o ta

ble

2b.

Prod

ucts

on

the

WHO lis

t of

Pilo

tPr

ocur

emen

t, Q

ualit

y an

d So

urcing

Pro

ject

:Ac

cess

to

HIV

/AID

S dr

ugs

and

diag

nost

ics

ofac

cept

able

qua

lity

(Six

th e

ditio

n, 5

th M

ay20

03)

are

inbo

ld a

nd h

ave

anas

teris

k *

next

to t

he p

rice.

Alw

ays

chec

k w

ebsi

te for

mos

tre

cent

ly u

pdat

ed lis

t. Bes

t pr

ices

are

in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ng t

om

anuf

actu

rers

.

Annu

al c

ost

is c

alcu

late

d ac

cord

ing

to t

heda

ily d

oses

giv

en in

the

WHO ‘Sc

alin

g-up

Antir

etro

vira

l Th

erap

y in

Res

ourc

e Li

mite

dSe

ttin

gs: Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch’(Ju

ne 2

002)

and

/or th

e ‘G

uide

lines

for th

e Use

of An

tiret

rovi

ral A

gent

s in

HIV

-In

fect

ed A

dults

and

Ado

lesc

ents

’from

the

Pane

l on

Clin

ical

Pra

ctices

for

the

Tre

atm

ent

of H

IV (20

02).

NNRT

Ief

avire

nzef

avire

nzne

vira

pine

(Abb

revi

atio

n)(E

FV)

(EFV

)(N

VP)

Stre

ngth

(m

g)

200

600

200

Trad

e na

me

Stoc

rin®

or Su

stiv

a®St

ocrin

®or

Sus

tiva®

Vira

mun

e®in

Eur

ope/

US

(Mer

ck &

Co.

, In

c.)(**

) (M

erck

& C

o., In

c.)(**

) (B

oehr

inge

r-Ing

elhe

im)

Dai

ly d

ose

3 1

2

Boe

hrin

ger-I

ngel

heim

438*

(Ger

man

y)

(0.6

00/u

nit)

Mer

ck &

Co.

, In

c.50

034

6.75

(US)

(0.4

57/u

nit)(†

)(0

.950

/uni

t)(†

)

Auro

bind

o43

811

2(In

dia)

(0.4

00/u

nit)

(0.153

/uni

t)

Cipl

a 46

246

220

8*(In

dia)

(0.4

22/u

nit)

(1.2

67/u

nit)

(0.2

85/u

nit)

GPO

244

(Tha

iland

)(0

.334

/uni

t)

Het

ero

548

105

(Indi

a)(0

.500

/uni

t)(0

.144

/uni

t)

Ranb

axy

578

166*

(Indi

a)(1

.583

/uni

t)(0

.228

/uni

t)

(**)

Kno

wn

as S

ustiv

a® (BM

S) in

US,

Can

ada,

UK,

Rep

ublic

of Ire

land

, Fr

ance

, Sp

ain,

Ita

ly a

nd G

erm

any.

(†)

Prices

giv

en in

this

tab

le a

re for

Low

Hum

an D

evel

opm

ent

Inde

x (H

DI) c

ount

ries

plus

med

ium

HDI co

untrie

s w

ithad

ult

HIV

pre

vale

nce

of 1

% o

r gr

eate

r. In

tab

le 2

b, p

rices

for

med

ium

HDI co

untrie

s w

ith a

dult

HIV

pre

vale

nce

less

tha

n 1%

, ar

e gi

ven.

10 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

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)

Price

is in

US$

. Pr

ice

is g

iven

bot

hfo

r a

year

ly a

dult

dose

and

by

unit.

For de

tails

on

elig

ibili

ty, of

fer

rest

rictio

ns for

cou

ntrie

s an

din

stitu

tions

, In

cote

rm a

nd w

ays

toap

ply, p

leas

e re

fer to

tab

le 2

c.

Prod

ucts

on

the

WHO lis

t of

Pilo

tPr

ocur

emen

t, Q

ualit

y an

d So

urcing

Pro

ject

:Ac

cess

to

HIV

/AID

S dr

ugs

and

diag

nost

ics

ofac

cept

able

qua

lity

(Six

th e

ditio

n, 5

th M

ay20

03)

are

inbo

ld a

nd h

ave

anas

teris

k *

next

to

the

price.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. Bes

t pr

ices

are

in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ngto

man

ufac

ture

rs.

Annu

al c

ost

is c

alcu

late

d ac

cord

ing

to t

heda

ily d

oses

giv

en in

the

WHO ‘Sc

alin

g-up

Antir

etro

vira

l Th

erap

y in

Res

ourc

e Li

mite

dSe

ttin

gs: Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch’(Ju

ne 2

002)

and

/or th

e ‘G

uide

lines

for th

e Use

of An

tiret

rovi

ral A

gent

s in

HIV

-In

fect

ed A

dults

and

Ado

lesc

ents

’from

the

Pane

l on

Clin

ical

Pra

ctices

for

the

Tre

atm

ent

of H

IV (20

02).

NtR

TIte

nofo

vir

(TDF)

Stre

ngth

(m

g)30

0 m

g

Trad

e na

me

inEu

rope

/US

Vire

ad®

(Gile

ad)

Dai

ly d

ose

1

Gile

ad (US)

475

(1.3

0/un

it)

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

11

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

Trad

e na

me

Crixiv

an®

Vira

cept

®Nor

vir®

Invi

rase

®in

Eur

ope/

US

(Mer

ck &

Co.

Inc

.)(R

oche

) (A

bbot

t)

(Roc

he)

Dai

ly d

ose

4 (*

*)

10 (**

*)

2 (§

) 10

(#)

Abbo

tt83

*(U

S)

(0

.114

/uni

t)

Mer

ck &

Co.

, In

c.40

0(U

S)

(0.2

74/u

nit)

Roch

e88

0*92

0*(S

witz

erla

nd)

0.24

1/un

it(†)

0.25

2/un

it(†)

Auro

bind

o39

315

3333

6(In

dia)

(0.2

69/u

nit)

(0.4

20/u

nit)

(0.4

60/u

nit)

Cipl

a40

620

2610

84(In

dia)

(0.2

78/u

nit)

(0.5

55/u

nit)

(1.4

85/u

nit)

Het

ero

387

1500

219

1335

(Indi

a)

(0.2

65/u

nit)

(0.4

11/u

nit)

(0.3

00/u

nit)

(0.3

66/u

nit)

Ranb

axy

467

(Indi

a)(0

.320

/uni

t)

Tabl

e 1d

- P

rote

ase

Inhi

bito

rs (PI

s)

All pr

ices

are

in

US$

. Pr

ices

are

giv

enbo

th for

a y

early

adu

lt do

se a

nd b

yun

it.

For de

tails

on

elig

ibili

ty a

nd o

ffer

rest

rictio

ns for

cou

ntrie

s an

din

stitu

tions

, pl

ease

ref

er to

tabl

es 2

d.

Prod

ucts

on

the

WHO lis

t of

Pilo

tPr

ocur

emen

t, Q

ualit

y an

d So

urcing

Pro

ject

:Ac

cess

to

HIV

/AID

S dr

ugs

and

diag

nost

ics

ofac

cept

able

qua

lity

(Six

th e

ditio

n, 5

th M

ay20

03)

are

inbo

ld a

nd h

ave

anas

teris

k *

next

to

the

price.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. Bes

t pr

ices

are

in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ngto

man

ufac

ture

rs.

Annu

al c

ost

is c

alcu

late

d ac

cord

ing

to t

heda

ily d

oses

giv

en in

the

WHO ‘Sc

alin

g-up

Antir

etro

vira

l Th

erap

y in

Res

ourc

e Li

mite

dSe

ttin

gs: Gui

delin

es for

a P

ublic

Hea

lthAp

proa

ch’(Ju

ne 2

002)

and

/or th

e ‘G

uide

lines

for th

e Use

of An

tiret

rovi

ral A

gent

s in

HIV

-In

fect

ed A

dults

and

Ado

lesc

ents

’from

the

Pane

l on

Clin

ical

Pra

ctices

for

the

Tre

atm

ent

of H

IV (20

02).

For Ro

che,

pric

es a

re g

iven

in

Swis

s Fr

ancs

and

wer

e co

nver

ted

in U

S$ (1

US$

= 1

.40

CHF

on 1

5 Ap

ril 2

003)

(**)

The

dai

ly d

ose

refe

rred

to

is 8

00m

g ID

V tw

ice

daily

with

rito

navi

r 10

0mg

twice

daily

as

boos

ter.

The

pres

crib

ing

info

rmat

i on

give

nby

the

man

ufac

ture

r is 8

00m

g th

ree

times

dai

ly(*

**) Th

e da

ily d

ose

refe

rred

to

is 1

250

mg

twice

daily

alth

ough

the

dos

age

of 9

tab

lets

(3

tabl

ets

thre

e tim

es a

day

) ca

n al

so b

e us

ed.

(§) Th

e da

ily d

ose

refe

rred

to

is 1

00m

g tw

ice

daily

, fo

r us

e as

boo

ster

med

icat

ion.

Thi

s do

se is

not in

dica

ted

in the

man

ufac

ture

r’s lab

el.

(#) In

vira

se s

houl

d be

use

d in

com

bina

tion

with

low

-dos

e rit

onav

ir as

Saq

uina

vir/R

itona

vir 10

00m

g/10

0mg

twice

daily

(†) Pr

ices

giv

en in

this tab

le a

re for

sub

-Sah

aran

Africa

and

Leas

t Dev

elop

ed C

ount

ries

as U

N d

efin

ed. In

tab

le 2

d, a

lso

prices

for

Low

Inco

me

and

Low

er M

iddl

e In

com

e Co

untrie

s, a

s clas

sifie

d by

the

Wor

ld B

ank,

are

giv

en.

12 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Prod

ucts

on

the

WHO lis

t of

Pilo

t Pr

ocur

emen

t, Q

ualit

y an

d So

urcing

Pro

ject

: Ac

cess

to

HIV

/AID

S dr

ugs

and

diag

nost

ics

of a

ccep

tabl

e qu

ality

(Si

xth

editi

on, 5t

h M

ay 2

003)

are

in

bold

and

have

an

aste

risk

(*)

next

to

the

price.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. Bes

t pr

ices

are

in

bold

& u

nder

lined

. In

cote

rms

vary

acc

ordi

ng t

o m

anuf

actu

rers

.

Annu

al c

ost

is c

alcu

late

d ac

cord

ing

to t

he d

aily

dos

es g

iven

in

the

WHO ‘Sc

alin

g-up

Ant

iretrov

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’

(June

200

2) a

nd/o

r th

e‘G

uide

lines

for

the

Use

of An

tiret

rovi

ral A

gent

s in

HIV

-Infe

cted

Adu

lts a

nd A

dole

scen

ts’from

the

Pan

el o

n Cl

inical

Pra

ctices

for

the

Tre

atm

ent

of H

IV (20

02).

Tabl

e 1e

– F

ixed

Dos

e Co

mbi

natio

ns (FD

Cs)

All pr

ices

are

in

US$

. Pr

ices

are

giv

en b

oth

for a

year

ly a

dult

dose

and

by

unit.

For 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

es 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+

150

300

+ 15

030

0+15

0+30

0 15

0 +3

0+20

0

150

+40+

200

(m

g)+

200

Ther

apeu

tic

PI

NRT

I NRT

INRT

I NRT

I +

NRT

INRT

Is +

NRT

I +

clas

s(es

)NNRT

I

NNRT

I NNRT

I

Trad

e na

me

Kale

tra®

Com

bivi

r®Tr

iziv

ir®in

Eur

ope/

US

(A

bbot

t)

(G

SK)

(GSK

)

Dai

ly d

ose

6 2

22

2 2

2 2

Abbo

tt

50

0*(U

S)(0

.228

/uni

t)

GSK

32

9*12

41*

(UK)

(0.4

50/u

nit)

(1.7

00/u

nit)

Auro

bind

o20

4(In

dia)

(0

.280

/uni

t)

Cipl

a 16

217

229

2*41

830

430

4(In

dia)

(0

.222

/uni

t)(0

.236

/uni

t)(0

.400

/uni

t)(0

.573

/uni

t)(0

.417

/uni

t)(0

.417

/uni

t)

GPO

407

325

358

(Tha

iland

)(0

.558

/uni

t)(0

.445

/uni

t)(0

.490

/uni

t)

Het

ero

3833

135

141

276

383

1648

281

286

(Indi

a)

(1.7

50/u

nit)

(0.185

/uni

t)(0

.193

/uni

t)(0

.378

/uni

t)(0

.525

/uni

t)(2

.258

/uni

t)(0

.385

/uni

t)(0

.392

/uni

t)

Ranb

axy

125*

135

265*

285

292

(Indi

a)

(0.1

71/u

nit)

(0.1

85/u

nit)

(0.3

63/u

nit)

(0.3

90/u

nit)

(0.4

00/u

nit)

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

13

ARV

Com

pany

Stre

ngth

/Dos

age

form

Pr

esen

tatio

nPr

ice

per

pack

Ad

ditio

nal in

form

atio

n

(Abb

revi

atio

n)(tra

de n

ame)

zido

vudi

neGSK

(Re

trov

ir®)

10m

g/m

l or

al s

olut

ion

200m

l US$

7.9

0*Co

st p

er d

ay a

s in

dica

ted

by the

m

anuf

actu

rer (a

vera

ge p

aedi

atric

dos

age

base

d on

25k

g av

erag

e w

eigh

t): US$

1.5

8.

Cipl

a (Z

idov

ir®)

50m

g/5m

l or

al s

olut

ion

100m

l US$

1.5

3*GPO

(An

tivir®

) 10

mg/

ml sy

rup

60m

l/200

ml

US$

1.17/

3.40

Co

mbi

noph

arm

50

mg/

5ml or

al s

olut

ion

200m

l US$

4.2

0

lam

ivud

ine

GSK

(Ep

ivir®

) 10

mg/

ml or

al s

olut

ion

240m

l US$

7.4

5*Co

st p

er d

ay a

s in

dica

ted

by the

man

ufac

ture

r (a

vera

ge p

aedi

atric

dos

age

base

d on

25k

g av

erag

e w

eigh

t): US$

0.6

2.

Cipl

a (L

amiv

ir®)

10m

g/m

l or

al s

olut

ion

100m

l US$

2.0

0*GPO

(La

miv

ir®)

10m

g/m

l sy

rup

60m

l US$

1.4

0

dida

nosi

ne

BM

S (V

idex

®)

pow

der: 2

g of

act

ive

prin

cipl

e US$

16.

61So

ld in

loca

l cu

rren

cy in

Sout

hern

Africa

– so

ld a

s a

bottle

for

(1

6.61

Eur

o)Ra

nd a

nd E

ast Af

rica

- sh

illin

gs.

Sold

in

Euro

re

-con

stitu

tion

with

wat

er a

nd

(**)

to

Wes

t Af

rican

cou

ntrie

s.w

ith a

ntac

ids

ef

avire

nzM

erck

&Co

.Inc

50m

g ca

psul

esBot

tle

of 3

0US$

3.4

7US$

0.1

16/u

nit.

(Sto

crin

®)

abac

avir

GSK

(Zi

agen

®)

20m

g/m

l or

al s

olut

ion

240m

l US$

34.

80*

Cost

per

day

as

indi

cate

d by

man

ufac

ture

r:

US$

2.9

0.

stav

udin

eBM

S (Z

erit®

) 1m

g/m

l po

wde

r fo

r sy

rup

200m

l US$

10.

71So

ld in

loca

l cu

rren

cy in

Sout

hern

Africa

- (1

0.71

Eur

o)(*

*)

Rand

and

Eas

t Af

rica

- sh

illin

gs. So

ld in

Euro

to

Wes

t Af

rican

cou

ntrie

s.

BM

S (Z

erit®

) 15

mg

caps

ules

Bl

iste

r pa

ckNot

ava

ilabl

e*

of 5

6BM

S (Z

erit®

) 20

mg

caps

ules

Bl

iste

r pa

ckUS$

5.2

5*

US$

0.0

94/u

nit.

of 5

6GPO

(St

avir®

) 15

mg

caps

ules

Box

of 60

US$

3.5

0 US$

0.0

58/cap

sule

.

GPO

(St

avir®

) 20

mg

caps

ules

Box

of 60

US$

4.2

0 US$

0.0

70/cap

sule

.

GPO

(St

avir®

) 1m

g/m

l dr

y sy

rup

60m

lUS$

0.6

5GPO

(St

avir®

) 5m

g/m

l dr

y sy

rup

60m

lUS$

0.8

5ne

vira

pine

BI (V

iram

une®

) 10

mg/

ml su

spen

sion

24

0ml

US$

17.

50*

Cipl

a (N

evim

une®

) 50

mg/

5ml su

spen

sion

10

0ml &

25m

l US$

2.4

5 &

US$

2.0

0

PMTC

Tdo

se: 25

ml.

(P

MTC

T)(P

MTC

T)

riton

avir

Abbo

tt (Nor

vir®

) 80

mg/

ml or

al s

olut

ion

450m

l(5x9

0ml)

US$

41.

67*

riton

avir

+ lop

inav

irAb

bott (Ka

letra®

) 20

mg

+ 80

mg/

ml or

al s

olut

ion

300m

l(5x6

0ml)

US$

41.

67*

nelfi

navi

r Ro

che

(Vira

cept

®)

50m

g/g,

pow

der fo

r su

spen

sion

144g

US$

35*

(**)

(/)

(**)

on

15 A

pril

2003

, 1

US$

=1.40

CHF

and

on 1

5 Ap

ril 2

003,

1Eu

ro =

1$U

S. (/) A

ll pr

ices

of Ro

che

prod

ucts

are

in

Swis

s fran

cs (CH

F). Pr

ices

giv

en in

this

tab

le a

re for

sub

-Sah

aran

Africa

and

Leas

t Dev

elop

ed C

ount

ries

as U

Nde

fined

. In

tab

le 2

c, a

lso

prices

for

Low

Inc

ome

and

Low

er M

iddl

e In

com

e Co

untrie

s, a

s clas

sifie

d by

the

Wor

ld B

ank,

are

giv

en. Pr

oduc

ts o

n th

e W

HO lis

t of

Pilo

t Pr

ocur

emen

t, Q

ualit

y an

d So

urcing

Pro

ject

: Ac

cess

to

HIV

/AID

Sdr

ugs

and

diag

nost

ics

of a

ccep

tabl

e qu

ality

(Si

xth

editi

on, 5t

h M

ay 2

003)

are

in

bold

and

have

an

aste

risk

(*)

next

to

the

price.

Alw

ays

chec

k w

ebsi

te for

mos

t re

cent

ly u

pdat

ed lis

t. Bes

t pr

ices

are

in

bold

& u

nder

lined

.In

cote

rms

vary

acc

ordi

ng t

o m

anuf

actu

rers

.

Tabl

e 1f

– 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

es 2

.

14 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

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

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

15

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

or

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

or

thro

ugh

the

AAI).

Tabl

e 2

Com

pany

ARV

offe

rs a

nd r

estrictio

ns 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

(Zia

gen®

)

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, in

tern

atio

nal,

UN

agen

cies

, ot

her no

t-fo

r-pro

fitor

gani

satio

ns a

nd int

erna

tiona

lpu

rcha

se fun

ds s

uch

as the

Glo

bal

Fund

to

fight

AID

S, T

B a

nd M

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

dire

ctly

to

thei

r st

aff th

roug

hw

orkp

lace

clin

ics

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 fo

r pr

ofit

basis.

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, in

tern

atio

nal,

UN

agen

cies

, ot

her no

t-fo

r-pro

fitor

gani

satio

ns a

nd int

erna

tiona

lpu

rcha

se fun

ds s

uch

as the

Glo

bal

Fund

to

fight

AID

S, T

B a

nd M

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

dire

ctly

to

thei

r st

aff th

roug

hw

orkp

lace

clin

ics

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 fo

r pr

ofit

basis.

Price

in U

S$

US$

986

/yea

r1.35

0/un

it

US$

34.

80 p

erbo

ttle

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

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.

’

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

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[5]

CIP

CIP

Com

pany

Bristo

l-Mye

rsSq

uibb

Co.

Gla

xoSm

ithKl

ine

Gla

xoSm

ithKl

ine

Prod

uct

dida

nosi

ne10

0mg

(Vid

ex®

)

lam

ivud

ine

150m

g ta

blet

(Epi

vir®

)

lam

ivud

ine

10m

g/m

l or

also

lutio

n24

0ml

(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.)

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

or

thro

ugh

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

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

or

thro

ugh

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.

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, in

tern

atio

nal,

UN a

genc

ies,

othe

r no

t-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.

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, in

tern

atio

nal,

UN a

genc

ies,

othe

r no

t-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

rUS$

0.2

12/u

nit

Low

er tab

let

dosa

ges

prices

in

line

with

thi

s of

fer

US$

128

/yea

rUS$

0.175

/uni

t

US$

7.4

5 pe

rbo

ttle

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).

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[5]

DDU to

gove

rnm

ent

purc

hasing

entit

ies.

CIP

CIP

16 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

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

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

17

Prod

uct

stav

udin

e30

mg

and

40m

g ca

ps(Z

erit®

)

zido

vudi

ne30

0mg

tabl

ets

(Ret

rovi

r®)

zido

vudi

ne10

mg/

ml or

also

lutio

n20

0ml

(Ret

rovi

r®)

Com

pany

Bristo

l-Mye

rsSq

uibb

Co.

Gla

xoSm

ithKl

ine

Gla

xoSm

ithKl

ine

Elig

ibili

ty (co

untrie

s)

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.)

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

or th

roug

h th

e AA

I.)

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

or th

roug

h th

e AA

I.)

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.

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, in

tern

atio

nal,

UN a

genc

ies,

othe

r no

t-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

e w

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 fo

r pr

ofit

basis.

Gov

ernm

ents

, ai

d or

gani

satio

ns,

char

ities

, in

tern

atio

nal,

UN a

genc

ies,

othe

r no

t-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

e w

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 fo

r pr

ofit

basis.

Price

in U

S$

30m

g:

US$

49/

year

(US$

0.06

6/un

it)

40m

g:US$

55/

year

(US$

0.07

5/un

it)

US$

274

/yea

r(U

S$ 0

.375

/uni

t)

US$

7.90

per

bottle

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

cks

per m

onth

,th

is req

uire

men

tm

ay b

e w

aive

d.)

Supp

ly A

gree

men

tre

quire

d.

(For

NGOs

requ

iring

less

tha

n 10

pat

ient

spa

cks

per m

onth

,th

is req

uire

men

tm

ay b

e w

aive

d.)

Del

iver

y of

good

s[5]

DDU to

gove

rnm

ent

purc

hasing

entit

ies

CIP

CIP

Tabl

e 2b

Non

-Nuc

leos

ide

Reve

rse

Tran

scrip

tase

Inh

ibito

rs (NRT

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[5]

CIF

CIF

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

r10.

Med

ium

HDI co

untrie

s w

ith a

dult

HIV

pre

vale

nce

less

tha

n 1%

10.

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

.10/

unit)

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

.

18 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

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[5]

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$

475

/yea

r (U

S$ 1

.30/

unit)

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

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

19

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[5]

CIP

CIP

Term

s an

dco

nditi

ons:

Effe

ctive

date

1st M

arch

2003

. FC

ABa

sel

(Switz

erla

nd),

CAD (Ca

shAg

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$

714

3)

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

10.

Med

ium

HDI co

untrie

s w

ithad

ult HIV

pre

vale

nce

less

than

1%

10.

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

, 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$

US$

400

/yea

r(U

S$ 0

.274

/uni

t)

US$

686

/yea

r(U

S$ 0

.470

/uni

t)

Bot

tle o

f 27

0ta

blet

s:

CHF

3o0.

00

US$

214

.29

US$

289

8/ye

ar(U

S$ 0

.794

/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

.

Tabl

e 2d

Pro

teas

e In

hibi

tors

(PI

s)

20 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Prod

uct

nelfi

navi

r 25

0mg

tabl

ets

(Vira

cept

®)

nelfi

navi

rpo

wde

r fo

r or

also

lutio

n 14

4g50

mg/

g(V

irace

pt®

)

nelfi

navi

rpo

wde

r fo

r or

also

lutio

n 14

4g

50m

g/g

(Vira

cept

®)

Com

pany

Roch

e

Roch

e

Roch

e

Del

iver

y of

good

s[5]

Term

s an

dco

nditi

ons:

Effe

ctiv

e da

te 1

stM

arch

200

3. F

CABa

sel

(Sw

itzer

land

),CA

D (Ca

shAg

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$

714

3)

Term

s an

dco

nditi

ons:

Effe

ctiv

e da

te 1

stM

arch

200

3. F

CABa

sel

(Sw

itzer

land

),CA

D (Ca

shAg

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$

714

3)

Elig

ibili

ty (co

untrie

s)

All co

untrie

s in

sub

-Sah

aran

Afric

a an

d al

l UN

defin

edLe

ast Dev

elop

ed C

ount

ries.

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.

All co

untrie

s in

sub

-Sah

aran

Afric

a an

d al

l UN d

efin

edLe

ast Dev

elop

ed C

ount

ries.

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

sCH

F 90

.90

(US$

64.

93)

US$

880

/yea

r(U

S$ 0

.241

/uni

t)

CHF

55.0

0 pe

r bo

ttle

(US$

32.

29)

CHF

49.0

0 pe

r bo

ttle

(US$

35.

00)

Addi

tiona

lco

mm

ents

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

21

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[5

]

FOB

FOB

Term

s an

dco

nditi

ons:

Effe

ctiv

eda

te 1

st M

arch

2003

. FC

ABa

sel

(Sw

itzer

land

), CA

D(C

ash

Agai

nst

Doc

umen

ts) 30

days

at sigh

t.M

inim

um o

rder

and

deliv

ery

amou

nt

per sh

ipm

ent is

CHF

10,0

00

(US$

714

3)Te

rms

and

cond

ition

s:Ef

fect

ive

date

1st

Mar

ch20

03. FC

ABa

sel

(Sw

itzer

land

), CA

D(C

ash

Agai

nst

Doc

umen

ts) 30

days

at sigh

t.M

inim

um o

rder

and

deliv

ery

amou

nt

per sh

ipm

ent is

CHF

10,0

00

(US$

714

3)

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.

All co

untrie

s in

sub

-Sah

aran

Afric

a an

d al

l UN

defin

edLe

ast Dev

elop

ed C

ount

ries.

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

14.2

9)

US$

289

8/ye

ar(U

S$ 0

.794

/uni

t)

Bot

tle o

f 27

0ca

psul

es:

CHF

95.4

0(U

S$ 6

8.14

)

US$

920

/yea

r(U

S$ 0

.252

/uni

t)

Addi

tiona

lco

mm

ents

22 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

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

®)

3TC

+ Z

DV30

0mg

+15

0mg

tabl

ets

(Com

bivi

r®)

Com

pany

Abbo

tt

Abbo

tt

Gla

xoSm

ithKl

ine

Del

iver

y of

good

s[5]

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 b

ilate

rally

or 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,

inte

rnat

iona

l, UN a

genc

ies, o

ther

not

-for-

prof

it or

gani

satio

ns a

nd in

tern

atio

nal

purc

hase

fun

ds s

uch

as the

Glo

bal F

und

to fig

ht A

IDS,

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(0

.228

/uni

t)

US$

41.67

per

bottle

US$

329

/yea

r(U

S$ 0

.450

/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

cks

per 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

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

23

Prod

uct

abac

avir

+3T

C + Z

DV30

0 + 1

50 +

300m

g ta

blet

s(T

riziv

ir®)

Com

pany

Gla

xoSm

ithKl

ine

Del

iver

y of

good

s[5]

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 b

ilate

rally

or thr

ough

the

AAI

.

Elig

ibili

ty (bo

dy)

Gov

ernm

ents

, ai

d or

gani

satio

ns, ch

ariti

es,

inte

rnat

iona

l, UN a

genc

ies, o

ther

not

-for-

prof

it or

gani

satio

ns a

nd in

tern

atio

nal

purc

hase

fun

ds s

uch

as the

Glo

bal F

und

to fig

ht A

IDS,

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.(F

or N

GOs

requ

iring

less

tha

n 10

pat

ient

spa

cks

per m

onth

,th

is req

uire

men

t m

aybe

wai

ved.

)

The

man

ufac

ture

rre

com

men

ds tha

t‘p

resc

riber

s m

ust

ensu

re tha

t pa

tient

sar

e fu

lly inf

orm

edre

gard

ing

hype

rsen

sitiv

ityre

actio

n to

aba

cavi

r.Pa

tient

s de

velo

ping

sign

s or

sym

ptom

sof

hyp

erse

nsiti

vity

mus

t co

ntac

t th

eir

doct

or im

med

iate

lyfo

r ad

vice

.’

24 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Com

pany

Auro

bind

o

Cipl

a

GPO

Het

ero

Ranb

axy

Com

bino

phar

m

Del

iver

y of

goo

ds[5

]

FOB H

yder

abad

(Indi

a)

FOB M

umba

i(In

dia)

FOB B

angk

ok(T

haila

nd)

FOB M

umba

i(In

dia)

FOB D

elhi

/Mum

bai

(Indi

a)

FOB B

arce

lona

(Spa

in)

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

Elig

ibili

ty (bo

dy)

NGOs

and

Gov

ernm

enta

lOrg

anizat

ions

.

NGOs

and

Gov

ernm

enta

lOrg

anizat

ions

.

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.

No

rest

rictio

n.

Price

in U

S$

See

Tabl

e 1.

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).

See

Tabl

e 1.

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.

Paym

ent at

the

con

firm

atio

n of

the

ord

er.

Onl

y av

aila

ble

dire

ctly

thr

ough

Cip

la H

QM

umba

i.

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.

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.

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.

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

Méd

ecin

s Sa

ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

25

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

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

://hd

r .und

p.or

g/re

ports/

glob

al/2

002

/en/

pdf/b

acko

ne.p

df

Med

ium

hum

an d

evel

opm

ent

Alba

nia;

Alg

eria

; Ar

men

ia; Az

erba

ijan;

Bel

arus

; Bel

ize;

Bol

ivia

; Bot

swan

a;Bra

zil;

Bul

garia

; Ca

mbo

dia;

Cam

eroo

n; C

ape

Verd

e; C

hina

;Co

lom

bia;

Com

oros

; Co

ngo;

Cub

a;Dom

inica;

Dom

inican

Rep

ublic

;Ec

uado

r; E

gypt

; El

Sal

vado

r;Eq

uato

rial Gui

nea;

Fiji

; Gab

on;

Geo

rgia

; Gre

nada

; Gha

na; Gua

tem

ala;

Guy

ana;

Hon

dura

s; Ind

ia; In

done

sia;

Iran

(Isla

mic R

ep. of

); Jam

aica

;Jo

rdan

; Ka

zakh

stan

; Ke

nya;

Kyrg

yzst

an; Le

bano

n; L

esot

ho; Li

byan

Arab

Jam

ahiri

ya; M

aced

onia

(TF

YR);

Mal

aysi

a; M

aldi

ves;

Mau

ritiu

s;M

exico;

Mol

dova

(Re

p. o

f ); M

ongo

lia;

Mor

occo

; M

yanm

ar; Nam

ibia

;Nicar

agua

; Om

an; Pa

nam

a; P

apua

New

Gui

nea;

Par

agua

y; P

eru;

Phili

ppin

es; Ro

man

ia; Ru

ssia

nFe

dera

tion;

Sai

nt L

ucia

; Sa

int Vi

ncen

t&

the

Gre

nadi

nes;

Sam

oa (

Wes

tern

);Sã

o To

mé

& P

rincipe

; Sa

udi A

rabi

a;So

lom

on Isl

ands

; So

uth

Afric

a; S

riLa

nka;

Sur

inam

e; S

waz

iland

; Sy

rian

Anne

x 1:

Leas

t Dev

elop

ed C

ount

ries

(LDCs

)

Sour

ce: UNCT

ADht

tp://

ww

w.u

ncta

d.or

g/Te

mpl

ates

/Web

Flye

r.asp

?int

Item

ID=21

61&

lang

=1

Forty-

nine

cou

ntrie

s ar

e cu

rren

tlyde

sign

ated

lea

st d

evel

oped

cou

ntrie

s(L

DCs

). Th

e lis

t is

rev

iew

ed e

very

thre

e ye

ars.

Afgh

anis

tan;

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

frican

Rep

ublic

; Ch

ad;

Com

oros

; Dem

ocra

tic R

epub

lic o

fCo

ngo;

Djib

outi;

Equ

ator

ial Gui

nea;

Eritr

ea; Et

hiop

ia; Gam

bia;

Gui

nea;

Gui

nea

Bis

sau;

Hai

ti; K

iriba

ti; L

aoPe

ople

’s D

emoc

ratic

Rep

ublic

;Le

soth

o; L

iber

ia; M

adag

asca

r;M

alaw

i; M

aldi

ves;

Mal

i; M

aurit

ania

;M

ozam

biqu

e; M

yanm

ar; Nep

al; Nig

er;

Rwan

da; Sa

moa

, Sa

o To

me

and

Prin

cipe

; Se

nega

l; Si

erra

Leo

ne;

Solo

mon

Isl

ands

; So

mal

ia; Su

dan;

Togo

; Tu

valu

; Uga

nda;

Uni

ted

Repu

blic o

f Ta

nzan

ia; Va

nuat

u;Ye

men

; Za

mbi

a.

Arab

Rep

ublic

; Ta

jikis

tan;

Tha

iland

;Tu

nisi

a; T

urke

y; T

urkm

enis

tan;

Ukr

aine

; Uzb

ekis

tan;

Van

uatu

;Ve

nezu

ela;

Vie

t Nam

; Zi

mba

bwe.

Low

hum

an d

evel

opm

ent

Ango

la; Ban

glad

esh;

Ben

in; Bhu

tan;

Bur

kina

Fas

o; B

urun

di; Ce

ntra

lAf

rican

Rep

ublic

; Ch

ad; Co

ngo

(Dem

.Re

p. o

f th

e); Cô

te d

’Ivoi

re; Djib

outi;

Eritr

ea; Et

hiop

ia; Gam

bia;

Gui

nea;

Gui

nea-

Bis

sau;

Hai

ti; L

ao P

eopl

e’>s

Dem

. Re

p.; M

adag

asca

r M

alaw

i;M

ali;

Mau

ritan

ia; M

ozam

biqu

e;Nep

al; Nig

er; Nig

eria

; Pa

kist

an;

Rwan

da; Se

nega

l; Si

erra

Leo

ne;

Suda

n; T

anza

nia

(U. Re

p. o

f); To

go;

Uga

nda;

Yem

en; Za

mbi

a.

Anne

xes

26 •

Unta

nglin

g th

e W

eb o

f Pr

ice

Redu

ctio

ns•

May

200

3 •

ww

w.a

cces

smed

-msf

.org

•M

édec

ins

Sans

Fro

ntiè

res

Anne

xes

Anne

x 3:

Sub-

Saha

ran

coun

trie

s

Sour

ce: W

orld

Ban

kht

tp://

ww

w.w

orld

bank

.org

/afr/

coun

trie

s/ht

m(A

pril

2003

)

Ango

la; Ben

in; Bot

swan

a; B

urki

naFa

so; Bur

undi

; Ca

mer

oon;

Cap

eVe

rde;

Cen

tral

African

Rep

ublic

; Ch

ad;

Com

oros

; Co

ngo

(Dem

. Re

p); Co

ng(R

ep.);

Côt

e d’

Ivoi

re; Eq

uato

rial

Gui

nea;

Erit

rea;

Eth

iopi

a; G

abon

;Gam

bia;

Gha

na; Gui

nea;

Gui

nea-

Bis

sau;

Ken

ya; Le

soth

o; L

iber

ia;

Mad

agas

car; M

alaw

i; M

ali;

Mau

ritan

ia;

Mau

ritiu

s; M

ozam

biqu

e; N

amib

ia;

Nig

er; Nig

eria

; Rw

anda

; Sã

o To

mé

and

Prin

cipe

; Se

nega

l; Se

yche

lles;

Sier

ra L

eone

; So

mal

ia; So

uth

Afric

a;Su

dan;

Sw

azila

nd; Ta

nzan

ia; To

go;

Uga

nda;

Zam

bia;

Zim

babw

e.

Anne

x 4:

Wor

ld B

ank

low

-inco

me

coun

trie

s

Sour

ce: W

orld

Ban

kht

tp://

ww

w.w

orld

bank

.org

/dat

a/co

untryc

lass

/cla

ssgr

oups

/htm

(Apr

il20

03)

Low

-inco

me

coun

trie

sAf

ghan

ista

n; A

ngol

a; A

rmen

ia;

Azer

baija

n; B

angl

ades

h; B

enin

;Bhu

tan;

Bur

kina

Fas

o; B

urun

di;

Cam

bodi

a; C

amer

oon;

Cen

tral

African

Repu

blic; Ch

ad; Co

mor

os; Co

ngo

(Dem

. Re

p.), C

ongo

(Re

p.); C

ôte

d’Iv

oire

; Eq

uato

rial Gui

nea;

Erit

rea;

Ethi

opia

; Gam

bia;

Geo

rgia

; Gha

na;

Gui

nea;

Gui

nea-

Bis

sau;

Hai

ti; Ind

ia;

Indo

nesi

a; K

enya

; Ko

rea,

Dem

. Re

p.;

Kyrg

yz R

epub

lic; La

o PD

R; L

esot

ho;

Libe

ria; M

adag

asca

r; M

alaw

i; M

ali;

Mau

ritan

ia; M

oldo

va; M

ongo

lia;

Moz

ambi

que;

Mya

nmar

; Nep

al;

Nicar

agua

; Nig

er; Nig

eria

; Pa

kist

an;

Papu

a New

Gui

nea;

Rw

anda

; Sã

oTo

mé

and

Prin

cipe

; Se

nega

l; Si

erra

Leon

e; S

olom

on Isl

ands

; So

mal

ia;

Suda

n; T

ajik

ista

n; T

anza

nia;

Tim

or-

Lest

e; T

ogo;

Uga

nda;

Ukr

aine

;Uzb

ekis

tan;

Vie

tnam

; Ye

men

(Re

p.),

Zam

bia;

Zim

babw

e.

Low

er-m

iddl

e-in

com

e ec

onom

ies

Alb

ania

; Alg

eria

; Bel

arus

; Bel

ize;

Bol

ivia

; Bos

nia

and

Her

zego

vina

;Bul

garia;

Cap

e Ve

rde;

Chi

na;

Colo

mbi

a; C

uba;

Djib

outi;

Dom

inic

anRe

publ

ic;

Ecua

dor; E

gypt

, Ara

b Re

p.;

El S

alva

dor; F

iji;

Gua

tem

ala;

Guy

ana;

Hon

dura

s; Ira

n, Isl

amic

Rep

.; Ira

q;Ja

mai

ca;

Jord

an;

Kaz

akhs

tan;

Kirib

ati;

Mac

edon

ia, FY

R;

Mal

dive

s; M

arsh

all

Isla

nds;

Mic

rone

sia,

Fed

. St

s.;

Mor

occo

; Nam

ibia

; Pa

ragu

ay;

Peru

;Ph

ilipp

ines

; Ro

man

ia;

Russ

ian

Fede

ration

; Sa

moa

; So

uth

Afric

a; S

riLa

nka;

St. V

ince

nt a

nd t

heGre

nadi

nes;

Sur

inam

e; S

waz

iland

;Sy

rian

Ara

b Re

publ

ic; Th

aila

nd;

Tong

a; T

unis

ia; Tu

rkey

; Tu

rkm

enis

tan;

Vanu

atu;

Wes

t Ban

k an

d Gaz

a;Yu

gosl

avia

, Fe

d. R

ep.

Upp

er-m

iddl

e-in

com

e ec

onom

ies

Am

eric

an S

amoa

; Ant

igua

and

Bar

buda

; Arg

entina

; Bar

bado

s;Bot

swan

a; B

razi

l; Ch

ile;

Cost

a Ric

a;Cr

oatia;

Cze

ch R

epub

lic;

Dom

inic

a;Es

toni

a; G

abon

; Gre

nada

; Hun

gary

;Is

le o

f M

an;

Latv

ia;

Leba

non;

Lib

ya;

Lith

uani

a; M

alay

sia;

Mal

ta;

Mau

ritius

;M

ayot

te;

Mex

ico;

Om

an;

Pala

u;Pa

nam

a; P

olan

d; P

uerto

Ric

o; S

audi

Ara

bia;

Sey

chel

les;

Slo

vak

Repu

blic

;St

. Kitts

and

Nev

is;

St. Lu

cia;

Trin

idad

and

Tob

ago;

Uru

guay

;Ve

nezu

ela,

RB;

Anne

x 5:

Com

pany

con

tact

s

Abbo

tt:

Rob

Din

truf

fEm

ail:

r ob.

dint

ruff@

abbo

tt.c

om

AXIO

S In

tern

atio

nal m

anag

es t

heap

plicat

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proc

ess

and

serv

es a

s th

ece

ntra

l co

ntac

t:

The

Prog

ram

me

Man

ager

Acce

ss t

o HIV

Car

e Pr

ogra

mm

eAX

IOS

Inte

rnat

iona

lP.

O. Box

692

4Ka

mpa

la, Uga

nda.

Tel:

+256

75

693

756

Fax:

+256

41

543

021

Emai

l: A c

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toHIV

Care

@ax

iosi

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ebsi

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cces

stoh

ivca

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o Ph

arm

a Lt

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nkat

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gion

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l: +9

1 40

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irect

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mai

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bms.

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Méd

ecin

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ns F

ront

ière

s •

ww

w.a

cces

smed

-msf

.org

•M

ay 2

003

•Un

tang

ling

the

Web

of Pr

ice

Redu

ctio

ns •

27

Wes

t Af

rica:

info

rmat

ion

can

beob

tain

ed fro

m M

s M

arie

-Ast

ridM

ercier

, BM

S Ac

cess

Coo

rdin

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in

BM

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ris o

ffice

(m

arie

-as

trid

.mer

cier

@bm

s.co

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East

Africa:

info

rmat

ion

can

beob

tain

ed fro

m B

MS

mai

n di

strib

utor

in E

ast Af

rica

– M

. M

ukes

h M

ehta

at

Phill

ips

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mac

eutic

als

in N

airo

bi(p

pl@

phill

ipsp

harm

a.co

m).

Sout

hern

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inf

orm

atio

n ca

n be

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ined

fro

m M

s Ta

man

y Gel

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MS

offic

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llips

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r pr

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logi

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e: +

49

6132

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Fax:

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ail:

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don

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g Pr

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iptio

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logi

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Tel:

+ 49

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Emai

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28 •

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g th

e W

eb o

f Pr

ice

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ctio

ns•

May

200

3 •

ww

w.a

cces

smed

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édec

ins

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Com

pany

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Nat

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Acc

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eUN (UNFP

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oehr

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mbH

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tol-

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rs S

quib

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laxo

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e,M

erck

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o., In

c., an

d F. H

offm

ann-

La R

oche

Ltd

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che)

; Ab

bott

Labo

rato

ries

Ltd.

joi

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the

initi

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ela

ter) t

o in

crea

se a

cces

s to

HIV

/AID

Sca

re, trea

tmen

t an

d su

ppor

t. AA

Ipl

ays

a ro

le in

facilit

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g pr

ice

nego

tiatio

ns b

etw

een

deve

lopi

ngco

untry

gove

rnm

ents

and

‘orig

inat

or’

drug

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pani

es t

hat

are

particip

atin

g in

the

AAI

.

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abac

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ller de

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good

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any

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ter th

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retran

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sel

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buye

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CIP[5

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arria

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uran

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aid

to...

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tha

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s th

ego

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to the

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min

ated

by

him

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add

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the

cost

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sary

to

brin

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ego

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to the

nam

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estin

atio

n. T

his

mea

ns tha

t th

e bu

yer be

ars

all th

eris

ks a

nd a

ny a

dditi

onal

cos

tsoc

currin

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ter th

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have

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so h

as to

proc

ure

insu

ranc

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ains

t th

e bu

yer’s

risk

of los

s of

or

dam

age

to the

goo

ds d

urin

g th

eca

rria

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nseq

uent

ly, th

e se

ller

cont

ract

s fo

r in

sura

nce

and

pays

the

insu

ranc

e pr

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ucle

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sel

ler de

liver

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yer,

not

clea

red

for im

port,

and

not

unlo

aded

fro

m a

ny a

rriv

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mea

ns o

f tran

spor

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nam

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estin

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n. T

he s

elle

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sto

bea

r th

e co

sts

and

risks

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olve

din

brin

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goo

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to, ot

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here

app

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stom

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ties,

tax

esan

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her ch

arge

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im

port in

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coun

try

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estin

atio

n. S

uch

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y’ha

s to

be

born

e by

the

buy

er a

s w

ell

as a

ny c

osts

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ks c

ause

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eim

port t

ime.

EML

Esse

ntia

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edicin

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ist.

Firs

tpu

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hed

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HO in

1977

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afe

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the

nam

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l co

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loss

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mag

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goo

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mth

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oint

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ller to

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eric d

rug

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phar

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aila

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is lis

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[5] In

cote

rms

2000

http

://w

ww.ic

cwbo

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cote

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asp

[6] “S

calin

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Res

ourc

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mite

d Se

ttin

gs:

Gui

delin

es for

a P

ublic

Hea

lthap

proa

ch”,

Jun

e 20

02ht

tp://

ww

w.w

ho.in

t/HIV

_AID

S/CA

RE/S

cal

ingU

p_Gui

delin

es_F

inal

0210

02.p

df

[7] “G

uide

lines

for

the

Use

of

Antir

etro

vira

l Age

nts

in H

IV-In

fect

edAd

ults

and

Ado

lesc

ents

, by

the

Pan

elon

Clin

ical

Pra

ctices

for

the

Tre

atm

ent

of H

IV”,

200

2 ht

tp://

ww

w.h

ivat

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[8] Pa

tent

Situ

atio

n of

HIV

/AID

Sre

late

d dr

ugs

in 8

0 co

untrie

s,W

HO/U

NAI

DS,

200

0ht

tp://

who

.int/m

edicin

es/li

brar

y/pa

r/hiv

rela

tedd

ocs/

pate

ntsh

ivdr

ugs.

pdf

Refe

renc

es[1] Pi

lot

Proc

urem

ent, Q

ualit

y an

dSo

urcing

Pro

ject

: Ac

cess

to

HIV

/AID

Sdr

ugs

and

diag

nost

ics

of a

ccep

tabl

equ

ality

http

://w

ww.w

ho.in

t/m

edicin

es/o

rgan

iza

tion/

qsm

/act

iviti

es/p

ilotp

roc/

pilo

tpro

c.s

htm

l

[2]So

urce

s an

d pr

ices

of se

lect

eddr

ugs

and

diag

nost

ics

for pe

ople

livin

g w

ith H

IV/A

IDS.

Ajo

int

UNIC

EF,

UNAI

DS

Secr

etar

iat, W

HO, M

SFpr

ojec

t. M

ay 2

003

(WHO/E

DM

/PAR

/200

3.2)

.ht

tp://

ww

w.w

ho.in

t/m

edicin

es/li

brar

y/p

ar/h

ivre

late

ddoc

s/so

urce

sand

prices

ma

y.do

c

[3] A

cces

sing

ARV

s: U

ntan

glin

g th

eW

eb o

f Pr

ice

Redu

ctio

ns for

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elop

ing

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trie

s, firs

t ed

ition

,Oct

ober

200

1 an

d se

cond

edi

tion,

June

200

2 an

d th

ird e

ditio

n,Dec

embe

r 20

02

[4] Oth

er g

ener

ic m

anuf

actu

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know

n to

be

prod

ucin

g on

e or

mor

eAR

Vs b

ut n

ot inc

lude

d in

thi

sdo

cum

ent

are:

Richm

ond

Labo

rato

rios,

Pan

alab

, Fila

xis

(Arg

entin

a); Ph

arm

aqui

ck (Ben

in); F

arM

angu

inho

s, F

URP

, La

pefe

, La

ob,

Ique

go, IV

B (Bra

zil);

Apo

tex,

Nov

opha

rm (Ca

nada

); S

hang

hai

Des

ano

Bio

phar

mac

eutic

al c

ompa

ny,

Nor

thea

st G

ener

al P

harm

aceu

tical

Fact

ory

(Chi

na); B

ioge

n (C

olom

bia)

;

[9] ht

tp://

ww

w.a

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smed

-m

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ocum

ents

/pat

ents

_200

3.pd

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[10]

To

find

the

HIV

pre

vale

nce

stat

usof

cou

ntrie

s se

eht

tp://

ww

w.u

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[11] M

ore

info

rmat

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abou

t th

e W

orld

Trad

e Org

anis

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TO) Ag

reem

ent

on T

rade

-rel

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asp

ects

of

inte

llect

ual pr

oper

ty rig

hts

(TRI

PS)

can

be fou

nd a

tht

tp://

ww

w.w

to.o

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nglis

h/trat

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/tri

ps_e

/trip

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htm

. Th

e fu

ll de

clar

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als

o av

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on t

he W

TO s

ite.

[12]

Abb

revi

atio

ns for

the

ARV

s ar

eta

ken

from

the

WHO d

raft g

uide

lines

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up A

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Reso

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Lim

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Settin

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delin

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r a

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ealth

app

roac

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ne20

02ht

tp://

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inal

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df

Méd

ecin

s Sa

ns F

ront

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s •

ww

w.a

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-msf

.org

•M

ay 2

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•Un

tang

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Cam

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lac

12,

CP

6090

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Gen

eva,

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Tel:

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price

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compa

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sources & prices of selected medicines and diagnostics for people living with hiv-aids

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