Antiretrovirals for low income countries: an analysis of the commercial viability of a highly competitive market

Nakakeeto, Olive N; Elliott, Brian V

doi:10.1186/1744-8603-9-6

Globalization and Health

Table 3 Profits and losses made from the sale of antiretroviral drugs to low income countries

From: Antiretrovirals for low income countries: an analysis of the commercial viability of a highly competitive market

Formulation and defined daily dose	2010							2012
	Me-dian price	Lowest API cost quoted to WHO	Total production cost	Profit or loss at API cost				Me-dian price	Lowest API cost quoted to WHO	Total production cost	Profit or loss at API cost
				quoted to WHO	20%	40%	60%				quoted to WHO	20%	40%	60%
					less	less	less					less	less	less
1) Scenario “Indian manufacturers”
Three drug combination tablets
[lamivudine 150 mg + stavudine 30 mg + nevirapine 200 mg], b.i.d	63	37	78	−15	−2	11	25	57	39	81	−28	−10	4	18
[lamivudine 150 mg + zidovudine 300 mg + nevirapine 200 mg] b.i.d.	131	87	166	−4	−4	27	58	119	90	171	−53	−21	11	43
[lamivudine 300 mg + tenofovir 300 mg + efavirenz 600 mg] q.d.	192	126	230	−38	7	52	97	162	102	187	−25	11	47	84
[emtricitabine 200 mg + tenofovir 300 mg + efavirenz 600 mg] q.d.	242	136	243	−1	47	94	142	186	126	224	−38	6	50	93
Two drug combination tablets
[lamivudine 150 mg + stavudine 30 mg] b.i.d.	39	24	54	−15	−7	2	10	36	24	55	−19	−10	−1	7
[lamivudine 150 mg + zidovudine 300 mg] b.i.d.	101	73	142	−41	−23	3	30	94	75	145	−51	−25	2	29
[lamivudine 300 mg + tenofovir 300 mg] q.d.	109	71	133	−24	2	27	52	65	58	109	−44	−23	−3	18
[emtricitabine 200 mg + tenofovir 300 mg ] q.d.	143	78	145	−2	26	54	82	87	73	136	−49	−23	3	29
[lopinavir 200 mg + ritonavir 50 mg], 4 tablets/day	433	405	745	−313	−169	−24	121	359	314	583	−223	−112	0	112
Single drug formulations
[efavirenz 600 mg] q.d.	56	55	103	−47	−28	−8	11	46	44	84	−37	−22	−6	9
[nevirapine 200 mg] b.i.d.	31	13	35	−4	1	6	10	30	16	40	−10	−5	1	7
[zidovudine 300 mg] b.i.d	88	57	113	−25	−5	15	36	82	59	117	−35	−14	8	29
[didanosine 250 mg] b.i.d	159	52	105	54	73	92	110	165	55	109	55	75	94	114
Summary
Column total	1787	1214	2292	−475	−82	351	784	1488	1074	2041	−557	−173	210	592
Arithmetic mean profit margin (%)				−27	−5	20	44				−37	−12	14	40
Decrease in profit margin between 2010 and 2012 (%)											11	7	6	4
Average decrease in profit margin across sensitivity analysis outcomes (%)											7
2) Scenario “Publicly owned producer”
Three drug combination tablets
[lamivudine 150 mg + stavudine 30 mg + nevirapine 200 mg], b.i.d	63	37	91	−28	−21	−13	−6	57	38.8	92	−35	−27	−20	−12
[lamivudine 150 mg + zidovudine 300 mg + nevirapine 200 mg] b.i.d.	131	87	140	−9	8	26	43	119	89.6	143	−24	−6	12	30
[lamivudine 300 mg + tenofovir 300 mg + efavirenz 600 mg] q.d.	192	126	153	40	65	90	115	162	102	128	34	54	74	95
[emtricitabine 200 mg + tenofovir 300 mg + efavirenz 600 mg] q.d.	242	136	159	83	109	136	162	186	126	149	37	62	86	111
Two drug combination tablets
[lamivudine 150 mg + stavudine 30 mg] b.i.d.	39	24	77	−38	−33	−29	−24	36	24	77	−42	−37	−32	−27
[lamivudine 150 mg + zidovudine 300 mg] b.i.d.	101	73	127	−25	−18	−3	11	94	75	128	−34	−19	−4	11
[lamivudine 300 mg + tenofovir 300 mg] q.d.	109	71	98	11	25	40	54	65	58	85	−19	−8	4	15
[emtricitabine 200 mg + tenofovir 300 mg] q.d.	143	78	105	38	54	70	85	87	73	99	−13	2	16	31
[lopinavir 200 mg + ritonavir 50 mg], 4 tablets/day	433	405	512	−79	2	83	164	359	314	374	−14	48	111	174
Single drug formulations
[efavirenz 600 mg] q.d.	56	55	81	−25	−14	−3	7	46	44	70	−24	−15	−6	2
[nevirapine 200 mg] b.i.d.	31	13	66	−35	−33	−30	−27	30	16	69	−40	−36	−33	−30
[zidovudine 300 mg] b.i.d	88	57	110	−22	−11	0	12	82	59	112	−30	−18	−6	5
[didanosine 250 mg] b.i.d	159	52	106	54	64	75	85	165	55	108	57	67	78	89
Summary
Column total	1787	1214	1825	−35	197	442	681	1488	1074	1634	−147	67	281	494
Arithmetic mean profit margin (%)				−2	11	25	38				−10	4	19	33
Decrease in profit margin between 2010 and 2012 (%)											8	7	6	5
Average decrease in profit margin across sensitivity analysis outcomes (%)											6

(amounts in whole $US per person-year).

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ISSN: 1744-8603

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