GENERIC COMPETITION, PRICE AND ACCESS TO
MEDICINES: THE CASE OF ANTIRETROVIRALS IN UGANDA

Author(s): Oxfam

Produced by: Oxfam (2002)

This paper outlines the findings of Oxfam research into the
accessibility of ARV therapy in Uganda since 2000. During
that year two important events improved access to these
medicines. First, five drug companies agreed to reduce the
price of some ARVs under a UNAIDS scheme. Second, the Joint
Clinical Research Centre (JCRC), the biggest provider of
this therapy in Uganda, imported low-cost generic ARVs from
India.

The study's conclusions are:
* The crucial role of generic competition. When generic
medicines entered the market, the price of patented
medicines fell dramatically. This finding reinforces the
view that an important determinant of price, and therefore
accessibility of ARVs, is competition from generic
medicines
* The need for a systematic tiered pricing
mechanism. The difficulties that Oxfam researchers
encountered in obtaining information about the offer from
the five companies reinforces the need for a transparent
system of tiered pricing in developing countries. Generic
competition provides the vital benchmark for low prices.
* Poor people can use ARVs if the price is right.
Interviews clearly showed that relatively poor people in low-
income countries do buy medicines for life-threatening
diseases, but that they have to make huge sacrifices to do
so. As a result of price cuts and generic importation, JCRC
was able to increase the number of patients treated by ARVs
from 962 to 3000.
* The need to maximise the use of TRIPS safeguards and
ensure that public health takes precedence over patent
rights. After 2005, Uganda will no longer be able to import
generic versions of newly patented medicines because
generic-producing countries, such as India, will no longer
be allowed to export them. Rich-country trade ministers
committed themselves at Doha in November 2001 to find a
solution to this problem by the end of 2002, but are
backsliding on this pledge by putting forward temporary,
impracticable, and highly restrictive solutions.
* The urgent need to fund health services to deliver
treatment. Funding health services should go hand-in-hand
with massive cuts in prices. The Global Fund provides
opportunities for countries such as Uganda to deliver
comprehensive programmes which include treatment using ARVs.

[Authors' abstract]

Available online at:
http://www.oxfaminternational.org/eng/pdfs/pp020710_no26_generic
_competition_briefing_paper.p
df