Procurement of new alternative drugs for VHC treatment
09 august 2018
The procurement of a new low-cost alternative drug for viral hepatitis C treatment was advocated at All-Ukrainian level.
Ukrainians used only high-cost monopoly products in VHC treatment program before (peginterferons, sofosbuvir, sofosbuvir/ledipasvir, ombitasvir/paritaprevir/ritonavir/dasabuvir).
As there is no patent for daclatasvir in Ukraine, it is possible to procure it in generic version. Also, due to absence of originator company (BMS) in Ukrainian market, the product was not included into clinical guidelines, procurement lists, had no marketing authorization and much support from key medical opinion leaders in Ukraine. The All-Ukrainian Network of PLWH efforts were applied to include daclatasvir in the nomenclature list for the state procurements.
The efforts were hindered by resistance of several key-opinion medical experts, corrupted incumbents.
According to the Law № 269-VIII of Ukraine “On amendments to some laws of Ukraine on ensuring timely access of patients to the necessary medicines and medical products through the implementation of state procurement with the involvement of specialized procurement organizations”, since 2016 the medicines are being procured through International organizations (via WHO and UNICEF procedures). Network of PLWH had conducted dialogue with generic manufacturers to stimulate them to participate in state procurements with daclatasvir. As a result of tender conducted by UNDP, daclatasvir was procured at 34$ price for daclatasvir 3-months treatment course, which is the lowest price for daclatasvir in the Eastern Europe Central Asia region.
The price for pegylated interferons (which were used before in combination with sofosbuvir in Ukraine), is 735 $, with treatment efficiency being 80%, while the efficiency of sofosbuvir with daclatasvir reaching 98%.
The next steps to be taken are advocacy of inclusion of daclatasvir into national clinical guidelines and national essential medicines list, raising awareness of clinicians on its availability and efficiency.
Case implementer: CO “100 percent life”