Access and procurement to ARVs in the Russian federation
ITPCru have published their annual report on ARV procurement monitoring in Russia in 2019.
The summary points are very important for a broader awareness of how ART differs compared to current treatment in western Europe.
The report contains the following:
- Volume and structure of procurements of ARV drugs in 2019.
- Procurement structure of ARV drugs by expenses.
- Cost of ARV drugs in 2019.
- Cost of the most common treatment regimens.
- Number of patients on ART, treatment coverage.
- Conclusions and recommendations.
The main findings in the Russian Federation in 2019 include:
- The estimated number of annual courses of ART in 2019 was 464,318. This covers about 60% of the total number of people under regular medical care, and about 43% of all registered people living with HIV.
- Overall, 64% of the budget was spent on five drugs. All of them are under patent in the Russian Federation: lopinavir/ritonavir (18%), raltegravir (14%), dolutegravir (14%), etravirine (9%), rilpivirine/tenofovir/emtricitabine (9%).
- Atazanavir is no longer in the top five drugs in terms of cost. This is due to an approximate 80% reduction in prices procurements of the Ministry of Health of the Russian Federation.
- Dolutegravir for the first time is one of the top five drugs. Although its price decreased at the end of 2019, at the time of procurement it was the same as in 2018. Dolutegravir budget almost doubled – from 7% to 13%.
- ART combinations are still mainly purchased as separate drugs rather than combination pills: (a) tenofovir + lamivudine + efavirenz and (b) tenofovir + lamivudine + lopinavir/ritonavir.
- The weighted average cost of an annual treatment course with efavirenz in the centralised procurements in 2019 was approximately $180 USD. This was 9% lower than in 2018.
- The cost of an annual treatment course with lopinavir/ritonavir was ~930 USD (similar to 2018).
- Only 1.6% of patients use fixed dose combinations; Only 3.3% use dual 2-in-1 drugs.
- Most drugs are generics, including almost 100% of NRTIs. As with other countries this was linked to expired patents.
- The website pereboi.ru recorded 455 reports of interruptions in the provision of ARV therapy. This doubled compared to 2018. In 37% of cases reported substituting drugs without a medical indications due to the lack of drugs (in 2018 – 31%), 26% of reports were related to the refusal to provide ARV drugs (in 2018 – 27%).
- The report is available in English and Russian.
- Community-driven procurement monitoring was successfully replicated by Armenia, Belarus, Kazakhstan, Kyrgyzstan and other EECA countries. The reports are available on our web-site in Russian.
The Analysis of Procurement of ARV Drugs in the Russian Federation in 2019. Available in English and Russian.