@article{fdi:010074644,
  title = {{A}n analysis of volumes, prices and pricing trends of the pediatric antiretroviral market in developing countries from 2004 to 2012},
  author = {{L}ee, {J}.{S}.{F} and {S}agaon {T}eyssier, {L}uis and {D}ongmo {N}guimfack, {B}. and {C}ollins, {I}.{J}. and {L}allemant, {M}arc and {P}erriens, {J}. and {M}oatti, {J}.{P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground : {T}he pediatric antiretroviral ({ARV}) market is poorly described in the literature, resulting in gaps in understanding treatment access. {W}e analyzed the pediatric {ARV} market from 2004 to 2012 and assessed pricing trends and associated factors. {M}ethods : {D}ata on donor funded procurements of pediatric {ARV} formulations reported to the {G}lobal {P}rice {R}eporting {M}echanism database from 2004 to 2012 were analyzed. {O}utcomes of interest were the volume and mean price per patient-year {ARV} formulation based on {WHO} {ARV} dosing recommendations for a 10 kg child. {F}actors associated with the price of formulations were assessed using linear regression; potential predictors included: country income classification, geographical region, market segment (originator versus generic {ARV}s), and number of manufacturers per formulation. {A}ll analyses were adjusted for type of formulations (single, dual or triple fixed-dose combinations ({FDC}s)) {R}esults: {D}ata from 111 countries from 2004 to 2012 were included, with procurement of 33 formulations at a total value of {USD} 204 million. {U}se of dual and triple {FDC} formulations increased substantially over time, but with limited changes in price. {U}pon multivariate analysis, prices of originator formulations were found to be on average 72 % higher than generics (p < 0.001). {A} 10 % increase in procurement volume was associated with a 1 % decrease (p < 0.001) in both originator and generic prices. {T}he entry of one additional manufacturer producing a formulation was associated with a decrease in prices of 2 % (p < 0.001) and 8 % (p < 0.001) for originator and generic formulations, respectively. {T}he mean generic {ARV} price did not differ by country income level. {P}rices of originator {ARV}s were 48 % (p < 0.001) and 14 % (p < 0.001) higher in upper-middle income and lower-middle income countries compared to low income countries respectively, with the exception of {S}outh {A}frica, which had lower prices despite being an upper-middle income country. {C}onclusions : {T}he donor funded pediatric {ARV} market as represented by the {GPRM} database is small, and lacks price competition. {I}t is dominated by generic drugs due to the lower prices offered and the practicality of {FDC} formulations. {T}his market requires continued donor support and the current initiatives to protect it are important to ensure market viability, especially if new formulations are to be introduced in the future.},
  keywords = {{TRAITEMENT} {MEDICAL} ; {SIDA} ; {ENFANT} ; {MEDICAMENT} ; {MARCHE} ; {PRIX} ; {ANALYSE} {ECONOMIQUE} ; {ANALYSE} {MULTIVARIABLE} ; {ECONOMIE} {DE} {LA} {SANTE} ; {TIERS} {MONDE}},
  booktitle = {},
  journal = {{BMC} {P}edaitrics},
  volume = {16},
  numero = {},
  pages = {art. no 41 [8  ]},
  ISSN = {1471-2431},
  year = {2016},
  DOI = {10.1186/s12887-016-0578-x},
  URL = {https://www.documentation.ird.fr/hor/fdi:010074644},
}