Estimated costs of production and potential prices for the WHO Essential Medicines List

Hill, Andrew; Barber, Melissa; Gotham, Dzintars

doi:10.1136/bmjgh-2017-000571

Cited by 69 publications

(67 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The current price for rifabutin per 150 mg tablet is $0.94 . Estimated generic prices for rifabutin regimens were calculated using a previously validated cost estimation algorithm . Per‐kilogram price of active pharmaceutical ingredient exported from India was collected from the http://www.infodriveindia.com database.…”

Section: Cost Considerationsmentioning

confidence: 99%

Global access of rifabutin for the treatment of tuberculosis – why should we prioritize this?

et al. 2019

Self Cite

View full text Add to dashboard Cite

Introduction Rifabutin, a rifamycin of equivalent potency to rifampicin, has several advantages in its pharmacokinetic and toxicity profile, particularly in HIV co‐infected patients on combined antiretroviral therapy (cART). In this commentary, we evaluate evidence supporting increased global use of rifabutin and highlight key recommendations for action. Discussion Although extrapolation of data from HIV uninfected patients would suggest non‐inferiority, there has been no randomized controlled study comparing rifabutin versus rifampicin in the outcomes of relapse‐free cure, in drug susceptible tuberculosis (TB), in HIV co‐infected patients on currently utilized cART regimens or in paediatric populations. An important advantage of rifabutin is that compared to the dose adjustments required with rifampicin, it can be co‐administered with the integrase strand transfer inhibitors raltegravir or dolutegravir without the need for dose adjustments. This strategy would be easier to implement in a programmatic setting and would save costs. We have assessed cost incentives to utilize rifabutin and have estimated generic costs for a range of rifabutin dosage scenarios. Where facilities are present for drug re‐challenge and monitoring for drug toxicity and cross‐reactivity, rifabutin offers a switch alternative for adverse drug reactions (ADR)s attributed to rifampicin. This would negate the need to prolong treatment in the absence of a rifamycin as part of short‐course multidrug therapy. There is evidence of incomplete cross‐resistance to rifampicin and rifabutin. Rifabutin may be useful in rifampicin‐resistant TB, in an estimated 20% of cases, based on phenotypic or genotypic rifabutin susceptibility testing. Conclusions Rifabutin should be available globally as a first‐line rifamycin in HIV co‐infected individuals and as a switch option in cases of rifampicin associated ADRs. Further studies are needed to ascertain the utility of rifabutin in rifampicin‐resistant rifabutin‐susceptible TB.

show abstract

Section: Cost Considerationsmentioning

confidence: 99%

Global access of rifabutin for the treatment of tuberculosis – why should we prioritize this?

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Growth in off-patent pharmaceutical prices is also worrying. For example, a recent analysis found that most of the medicines on the WHO essential medicines list are sold in the UK and South Africa at prices significantly higher than those estimated from production costs; some generic medicines are priced at more than 100 times their estimated cost of production 27. Such prices suggest that market power is being exercised in ways inconsistent with the notion that off-patent pharmaceuticals should be available at prices close to the cost of production—the hallmark of ideal economic markets characterised by truly competitive pricing.…”

Section: Concerning Trendsmentioning

confidence: 99%

Pricing of pharmaceuticals is becoming a major challenge for health systems

Morgan

Bathula

Moon

2020

BMJ

View full text Add to dashboard Cite

Achieving FAir Pricing oF Medicines Pricing of pharmaceuticals is becoming a major challenge for health systems Manufacturers using their market power to maximise profits results in prices that are unjustifiable and unaffordable, argue Steven Morgan and colleagues P harmaceutical innovations over the past half century have enabled effective treatment and prevention of a wide range of illnesses. These advances were so important in modern healthcare that equitable access to them has been deemed to be a fundamental human right. 1 Fulfilling that right creates tremendous social value but poses a significant policy challenge owing to its costs. Global expenditure on pharmaceuticals reached $1.135tn in 2017, up 56% from 2007. 2 Although demand for medicines is one of the drivers of pharmaceutical expenditure, rising prices are a primary concern for health system managers because medicines are increasingly being priced at levels that appear "unfair." In this article, we review evidence that drug prices often exceed value for money and reasonable compensation for firms' investment in research. We argue that pharmaceutical pricing is a growing challenge for all countries, calling into question the sustainability of the systems that are supposed to drive pharmaceutical innovation.

show abstract

“…Data on manufacturing costs are not usually made public. Costs may be discovered, however, by prices under competitive market conditions or estimated by experts using prices of inputs 1516. Medicines have considerable economies of scale, and predictability of orders and payment enables suppliers to manufacture efficiently.…”

Section: Fairness To Sellersmentioning

confidence: 99%