Background: In 1996, two important legislative changes tool place in Brazil: the law 9.313 established universal access to ARVs and the law 9.276 that changed the intellectual property (IP) laws, allowing patents on pharmaceuticals. ABIA/GTPI is a civil society organization working to reduce the impact of monopolies in public health. Tenofovir (TDF) is a drug to treat HIV, incorporated by the Brazil under monopoly with high prices. ABIA/GTPI struggled in many ways to lower TDF price.
In 2012, the Brazilian patent office rejected the TDF''s patent. In the same year, TDF became part the new policy to strengthen the Brazilian pharmaceutical industry by the Ministry of Health (MoH). A Partnership for Product Development (PDPs). A contract setting the API price was signed between a public (FUNED) and private laboratory (NORTEC) to produce TDF locally. After years in the public domain and local produced, ABIA/GTPI expected to see significant reductions TDF prices. That did not happened. Therefore, ABIA/GTPI investigated the composition of the national TDF price and compared it with other prices.
Methods: ABIA/GTPI calculated possible TDF prices, estimating the cost of production and with the different API prices. With this, we compare the prices actually acquired by the MoH with the prices that the medicines produced through the PDP should have and the lowest international prices.
Results: In 2014, the TDF price paid by the MoH was $580.81 ppy. This was 5.5 times higher than the price projected considering the costs and API price fixed in the FUNED-NORTEC contract; 3.4 times higher than the price calculated using the highest price of national available API in 2014; and 12 times higher using the costs and the international lowest generic API price.
Conclusions: The TDF price paid by MoH were at least three times higher than they should be. After all the efforts of civil society and other sectors to put TDF in the public domain in Brazil, even the generic price did not accomplished to contribute to the sustainability of the universal access policies. There is need for further debate on national generic prices from a human rights perspective.

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