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0257/2025 - Price as a challenge to the sustainability of the universal access policy to antiretrovirals in the SUS: the case of dolutegravir
Preço como um desafio à sustentabilidade da política de acesso universal a antirretrovirais no SUS: o caso dolutegravir

Author:

• Luciana de Melo Nunes Lopes - Lopes, LMN - <luciana.lopes@aids.gov.br>
ORCID: https://orcid.org/0000-0001-5520-6813

Co-author(s):

• Carolinne Thays Scopel - Scopel, CT - <carol.thays@gmail.com>
ORCID: https://orcid.org/0000-0003-3254-2800
• Ronaldo Campos Hallal - Hallal, RC - <ronaldo.hallal@aids.gov.br>
ORCID: https://orcid.org/0000-0002-4750-2417
• Gustavo Luís Meffe Andreoli - Andreoli, GLM - <gustavo.andreoli@aids.gov.br>
ORCID: https://orcid.org/0000-0002-0532-013X
• Draurio Barreira - Barreira, D - <draurio.barreira@aids.gov.br>
ORCID: https://orcid.org/0000-0002-9626-7740
• Marcela Vieira Freire - Freire, MV - <marcela.vieira@aids.gov.br>
ORCID: https://orcid.org/0000-0003-0255-8780
• Francisco Alisson Paula de França - França, FAP - <francisco.franca@aids.gov.br>
ORCID: https://orcid.org/0000-0002-5579-6785


Abstract:

The price of antiretrovirals (ARV) remains a challenge for guaranteeing universal, comprehensive and equitable pharmaceutical services. The article aimed to analyze the acquisition of the most widely used ARV in Brazil, comparing national and international prices. A documentary analysis of the history of dolutegravir (DTG) national procurement between 2017 and 2023 was carried out. The price comparison was based on reports from the Clinton Health Access Initiative (CHAI), considering exchange rate and inflation variations. The procurement of DTG began in 2016 with GSK. In 2022, generic versions from Farmanguinhos and Lafepe were distributed, but a patent barrier restricted the procurement from Lafepe. There was a large difference between national and international prices, even with the entry of generics into the Brazilian market: in 2023, the price of international generics was almost 12 times lower than that of the national procurement. The DTG case highlights the importance of monitoring prices, patent barriers, local production and of getting to know the structure of production costs in order to negotiate fair prices and ensure the sustainability of the national pharmaceutical assistance policy.

Keywords:

Access to Essential Medicines and Health Technologies; Drug Price; Anti-Retroviral Agents; Intellectual Property of Pharmaceutic Products and Process

Content:

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How to

Cite

Lopes, LMN, Scopel, CT, Hallal, RC, Andreoli, GLM, Barreira, D, Freire, MV, França, FAP. Price as a challenge to the sustainability of the universal access policy to antiretrovirals in the SUS: the case of dolutegravir. Cien Saude Colet [periódico na internet] (2025/Jul). [Citado em 28/01/2026]. Está disponível em: http://www.cienciaesaudecoletiva.com.br/en/articles/price-as-a-challenge-to-the-sustainability-of-the-universal-access-policy-to-antiretrovirals-in-the-sus-the-case-of-dolutegravir/19733



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