From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><<a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a>></span><br><div class="gmail_quote">crossposted from: <a href="mailto:EQUIDAD@listserv.paho.org">EQUIDAD@listserv.paho.org</a><br>
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<p class="MsoNormal" style="margin-left:.5in"><b><font color="maroon" size="3" face="Arial"><span style="font-size:12.0pt;font-family:Arial;color:maroon;font-weight:bold" lang="EN-GB">A win-win solution?: <br>
A critical analysis of tiered pricing to improve access to medicines in
developing countries<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><b><font color="maroon" size="3" face="Arial"><span style="font-size:12.0pt;font-family:Arial;color:maroon;font-weight:bold" lang="EN-GB"><br>
</span></font></b><font size="1" face="Arial"><span style="font-size:9.0pt;font-family:Arial" lang="EN-GB">Suerie Moon1*, Elodie Jambert2, Michelle Childs2 and
Tido von Schoen-Angerer2 <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="1" face="Arial"><span style="font-size:9.0pt;font-family:Arial" lang="EN-GB">1 Harvard Kennedy School
and <u></u>School<u></u> of <u></u>Public
Health<u></u>, <u></u><u></u>Boston<u></u>,
<u></u>USA<u></u><u></u> <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="1" face="Arial"><span style="font-size:9.0pt;font-family:Arial" lang="EN-GB">2 Médecins Sans
Frontières, Campaign for Access to Essential Medicines, <u></u><u></u>Geneva<u></u>, <u></u>Switzerland<u></u><u></u>
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</span></font><b><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">Globalization and Health 2011, 7:39
doi:10.1186/1744-8603-7-39<br>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial" lang="EN-GB">Available online at: <a href="http://bit.ly/vOOoAb" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/vOOoAb</span></font></a>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial" lang="EN-GB"><br>
“…………Tiered pricing - the concept of selling
drugs and vaccines in developing countries at prices systematically lower than
in industrialized countries - has received widespread support from industry,
policymakers, civil society, and academics as a way to improve access to
medicines for the poor. We carried out case studies based on a review of
international drug price developments for antiretrovirals, artemisinin
combination therapies, drug-resistant tuberculosis medicines, liposomal
amphotericin B (for visceral leishmaniasis), and pneumococcal vaccines. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial" lang="EN-GB"><u></u> <u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial" lang="EN-GB">We found several critical
shortcomings to tiered pricing: it is inferior to competition for achieving the
lowest sustainable prices; it often involves arbitrary divisions between
markets and/or countries, which can lead to very high prices for middle-income
markets; and it leaves a disproportionate amount of decision-making power in
the hands of sellers vis-à-vis consumers. In many developing countries,
resources are often stretched so tight that affordability can only be approached
by selling medicines at or near the cost of production. Policies that
"de-link" the financing of R&D from the price of medicines merit
further attention, since they can reward innovation while exploiting robust
competition in production to generate the lowest sustainable prices. However,
in special cases - such as when market volumes are very small or multi-source
production capacity is lacking - tiered pricing may offer the only practical
option to meet short-term needs for access to a product. In such cases, steps
should be taken to ensure affordability and availability in the longer-term. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial" lang="EN-GB"><u></u> <u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial" lang="EN-GB">Summary<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial" lang="EN-GB">To ensure access to
medicines for populations in need, alternate strategies should be explored that
harness the power of competition, avoid arbitrary market segmentation, and/or
recognize government responsibilities. Competition should generally be the
default option for achieving affordability, as it has proven superior to tiered
pricing for reliably achieving the lowest sustainable prices……………”</span></font><br></p></div></div></div><br>