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Brazil's ability to negotiate price reductions with pharmaceutical companies for patented HIV/AIDS drugs saved the country US$1 billion between 2001 and 2005, according to a study.

Researchers from the US-based Harvard School of Public Health looked at the cost of antiretroviral (ARV) drugs in Brazil. 

Since 1996, Brazil has provided free access to highly active antiretroviral therapy (HAART). The number of patients receiving treatment has increased each year, from around 38,000 in 1997 to 180,000 in 2006.

Prices reported for patented ARVs were found to be lower in Brazil than in other developing countries. The price reductions negotiated by the government halved the potential costs of ARVs, from US$2 billion to US$1 billion between 2001 and 2005.

"Brazil has been efficient in the price negotiations with the pharmaceutical companies, combining political determination and technical ability," says co-author Francisco Bastos, from the Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro.

He added that the study indicates Brazil's stability in this area, despite fluctuating rates of currency exchange globally.

"The challenge is to strengthen our leadership as the developing country with the most extensive AIDS program worldwide, and acquire agility in terms of acquisition and importation of essential components of ARVs, without losing quality," says Bastos.


However, the cost of generic ARVs has gone up in Brazil in recent years — and is higher than those in other developing countries — while it has fallen in the international marketplace. The researchers have not been able to completely explain these findings.

Mauro Schechter, an AIDS researcher from the Federal University of Rio de Janeiro, says the results indicate that local production may not be an advantage.

He adds that better distribution of ARVs also depends on improving infrastructure, to train medical workers and equip laboratories for example, which he says is a costly expenditure in Brazil's treatment model.

The study found that the cost of HAART in Brazil doubled in 2005. The number of patients receiving HAART increased over the year and, as patients live longer, treatment becomes more expensive and the cost shifts from first-line to more costly second and third-line drugs.

The study was published in the journal PLoS Medicine earlier this month.

Link to full paper in PLoS Medicine

Reference: PLoS Medicine doi 10.1371/journal.pmed.0040305