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Table 3 Profits and losses made from the sale of antiretroviral drugs to low income countries

From: Antiretrovirals for low income countries: an analysis of the commercial viability of a highly competitive market

Formulation and defined daily dose 2010 2012
  Me-dian price Lowest API cost quoted to WHO Total production cost Profit or loss at API cost Me-dian price Lowest API cost quoted to WHO Total production cost Profit or loss at API cost
     quoted to WHO 20% 40% 60%     quoted to WHO 20% 40% 60%
      less less less      less less less
1) Scenario “Indian manufacturers”               
Three drug combination tablets               
[lamivudine 150 mg + stavudine 30 mg + nevirapine 200 mg], b.i.d 63 37 78 −15 −2 11 25 57 39 81 −28 −10 4 18
[lamivudine 150 mg + zidovudine 300 mg + nevirapine 200 mg] b.i.d. 131 87 166 −4 −4 27 58 119 90 171 −53 −21 11 43
[lamivudine 300 mg + tenofovir 300 mg + efavirenz 600 mg] q.d. 192 126 230 −38 7 52 97 162 102 187 −25 11 47 84
[emtricitabine 200 mg + tenofovir 300 mg + efavirenz 600 mg] q.d. 242 136 243 −1 47 94 142 186 126 224 −38 6 50 93
Two drug combination tablets               
[lamivudine 150 mg + stavudine 30 mg] b.i.d. 39 24 54 −15 −7 2 10 36 24 55 −19 −10 −1 7
[lamivudine 150 mg + zidovudine 300 mg] b.i.d. 101 73 142 −41 −23 3 30 94 75 145 −51 −25 2 29
[lamivudine 300 mg + tenofovir 300 mg] q.d. 109 71 133 −24 2 27 52 65 58 109 −44 −23 −3 18
[emtricitabine 200 mg + tenofovir 300 mg ] q.d. 143 78 145 −2 26 54 82 87 73 136 −49 −23 3 29
[lopinavir 200 mg + ritonavir 50 mg], 4 tablets/day 433 405 745 −313 −169 −24 121 359 314 583 −223 −112 0 112
Single drug formulations               
[efavirenz 600 mg] q.d. 56 55 103 −47 −28 −8 11 46 44 84 −37 −22 −6 9
[nevirapine 200 mg] b.i.d. 31 13 35 −4 1 6 10 30 16 40 −10 −5 1 7
[zidovudine 300 mg] b.i.d 88 57 113 −25 −5 15 36 82 59 117 −35 −14 8 29
[didanosine 250 mg] b.i.d 159 52 105 54 73 92 110 165 55 109 55 75 94 114
Summary               
Column total 1787 1214 2292 −475 −82 351 784 1488 1074 2041 −557 −173 210 592
Arithmetic mean profit margin (%)     −27 −5 20 44     −37 −12 14 40
Decrease in profit margin between 2010 and 2012 (%)            11 7 6 4
Average decrease in profit margin across sensitivity analysis outcomes (%)            7    
2) Scenario “Publicly owned producer”               
Three drug combination tablets               
[lamivudine 150 mg + stavudine 30 mg + nevirapine 200 mg], b.i.d 63 37 91 −28 −21 −13 −6 57 38.8 92 −35 −27 −20 −12
[lamivudine 150 mg + zidovudine 300 mg + nevirapine 200 mg] b.i.d. 131 87 140 −9 8 26 43 119 89.6 143 −24 −6 12 30
[lamivudine 300 mg + tenofovir 300 mg + efavirenz 600 mg] q.d. 192 126 153 40 65 90 115 162 102 128 34 54 74 95
[emtricitabine 200 mg + tenofovir 300 mg + efavirenz 600 mg] q.d. 242 136 159 83 109 136 162 186 126 149 37 62 86 111
Two drug combination tablets               
[lamivudine 150 mg + stavudine 30 mg] b.i.d. 39 24 77 −38 −33 −29 −24 36 24 77 −42 −37 −32 −27
[lamivudine 150 mg + zidovudine 300 mg] b.i.d. 101 73 127 −25 −18 −3 11 94 75 128 −34 −19 −4 11
[lamivudine 300 mg + tenofovir 300 mg] q.d. 109 71 98 11 25 40 54 65 58 85 −19 −8 4 15
[emtricitabine 200 mg + tenofovir 300 mg] q.d. 143 78 105 38 54 70 85 87 73 99 −13 2 16 31
[lopinavir 200 mg + ritonavir 50 mg], 4 tablets/day 433 405 512 −79 2 83 164 359 314 374 −14 48 111 174
Single drug formulations               
[efavirenz 600 mg] q.d. 56 55 81 −25 −14 −3 7 46 44 70 −24 −15 −6 2
[nevirapine 200 mg] b.i.d. 31 13 66 −35 −33 −30 −27 30 16 69 −40 −36 −33 −30
[zidovudine 300 mg] b.i.d 88 57 110 −22 −11 0 12 82 59 112 −30 −18 −6 5
[didanosine 250 mg] b.i.d 159 52 106 54 64 75 85 165 55 108 57 67 78 89
Summary               
Column total 1787 1214 1825 −35 197 442 681 1488 1074 1634 −147 67 281 494
Arithmetic mean profit margin (%)     −2 11 25 38     −10 4 19 33
Decrease in profit margin between 2010 and 2012 (%)            8 7 6 5
Average decrease in profit margin across sensitivity analysis outcomes (%)            6    
  1. (amounts in whole $US per person-year).