Projects band together to buy lowest-cost generic drugs
Polly Clayden HIV i-Base
Established in February of this year by a group of 19 South African treatment projects, the Generic Antiretroviral Procurement Project (GARRP) aims to improve access to ART through the promotion of good quality generic antiretrovirals at the lowest possible cost.
In a session focusing on generic antiretrovirals Colwyn Poole and Wilbert Bannenberg described the operation, scope and “The world of GARPP”.
There are currently 10 GARPP-associate projects providing 600 people with treatment in the public sector. Models of care vary but members have contractual obligations to GARPP: all must meet the minimum standard of care by the Southern Africa HIV/AIDS Clinicians Society guidelines on use of antiretrovirals, use WHO-recommended regimens and share experience and knowledge of implementation in a variety of settings.
GARPP will only procure generics approved by the South African Medicines Control Council (MCC). Currently registered are zidovudine, lamivudine, stavudine, nevirapine and lamivudine/zidovudine combined. However, it recognises that there are significant gaps – there are no registered generic paediatric formulations and no three in one fixed dose combinations, which are only being manufactured by generic companies and which Dr Eric Goemaere of MSF described as “extraordinarily useful for adherence”. So GARPP is applying for exemption from MCC registration for those products where clinically indicated.
“GARPP can get a first-line combination of ARVs for 308 Rand [£26.13] per month, more than four times lower than the current retail price for the same combination and about 1.5 times lower than the price the government would get if benefiting from the best offers of originator companies,” Poole explained. GARPP believes these prices can be reduced even further.
They anticipate that this network will extend to 30 projects with 4,000 patients over the next year.
“GARPP will take all necessary steps to ensure that we are able to procure these life saving drugs.”
- Poole C, Darder M, Karim QA et al. Antiretroviral therapy provision in the public sector and the Generic AntiRetroviral Procurement Project (GARPP) Abstract T4-S2-A8
- Bannenberg W and Darder M. The Generic Antiretroviral Procurement Project (GARPP). Abstract T4-S2-A9