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1.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335489

ABSTRACT

Background: High drug prices can limit treatment access. Patented drugs can be sold for prices far higher than the costs of production. This analysis aimed to determine prices currently feasible to treat COVID-19, HIV, and Hepatitis B or C, with WHO/FDA/NICE approved oral medications assuming competitive generic manufacture. Methods Data on Active Pharmaceutical Ingredients (API) exported from India were collected from the Panjiva database ( www.panjiva.com ) – an online database of global exports – and were used to calculate current weighted mean cost/kg of API. Target prices were calculated based on the per-pill cost of API, plus costs of manufacture ($0.01/pill), 10% profit margin, and assumed 27% tax on profit. We selected a range of the most commonly used oral treatments based on WHO guidelines for treatment of COVID-19, HIV, HBV and HCV. Current lowest global prices were obtained from public reports and the Pan American Health Organization Antiretroviral Report. Our target prices were compared with national pricing data from a range of low, middle, and high-income countries. Results The main results table shows current prices of antiretrovirals for SARS-CoV-2 (5–14-day course), HIV or HBV (per 365-day course), and HCV treatments (per 12-week course). COVID-19 can be treated with molnupiravir for $12.40, baricitinib for $0.60, or dexamethasone for $0.19 per course. HIV can be treated with DRV/r for $286 per year, ATV/r for $140 per year, TDF/3TC/DTG for $74 per year, TAF/FTC/DTG for $89 and TDF/FTC for $59. HBV can be treated with TDF for $23 per year and TAF for $38 per year. HCV could be cured with sofosbuvir/daclatasvir for $35 per patient and sofosbuvir/velpatasvir for $79 per patient. Maximum list prices (typically from US) were up to 600 times higher than costs of production (e.g. for TDF). Conclusions Key viral infections can be treated or cured with generic drugs at prices far below those of branded equivalents. Use of branded drugs at high prices can limit the potential for countries to achieve the UNAIDS 95-95-95 targets.

2.
Vaccines (Basel) ; 10(2)2022 Jan 28.
Article in English | MEDLINE | ID: covidwho-1667370

ABSTRACT

BACKGROUND: High vaccine uptake requires strong public support, acceptance, and willingness. METHODS: A longitudinal cohort study gathered survey data every four weeks between 1 October 2020 and 9 November 2021 in Victoria, Australia. Data were analysed for 686 participants aged 18 years and older. RESULTS: Vaccine intention in our cohort increased from 60% in October 2020 to 99% in November 2021. Vaccine intention increased in all demographics, but longitudinal trends in vaccine intention differed by age, employment as a healthcare worker, presence of children in the household, and highest qualification attained. Acceptance of vaccine mandates increased from 50% in October 2020 to 71% in November 2021. Acceptance of vaccine mandates increased in all age groups except 18-25 years; acceptance also varied by gender and highest qualification attained. The main reasons for not intending to be vaccinated included safety concerns, including blood clots, and vaccine efficacy. CONCLUSION: COVID-19 vaccination campaigns should be informed by understanding of the sociodemographic drivers of vaccine acceptance to enable socially and culturally relevant guidance and ensure equitable vaccine coverage. Vaccination policies should be applied judiciously to avoid polarisation.

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