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Optimizing Paediatric ARV Treatment

J Rodrigues (IATT secretariat), A Ojoo (UNICEF Supply Division) and G Sakhuja (UNICEF Supply Division) • 

The market for pediatric ARVs is significantly smaller than that for adult ARVs and more fragmented due to the changing needs of growing children. This leads to a complicated ARV market further challenged by the availability of a wide variety of different but often duplicative drug products. Guidance from the 2013 WHO Consolidated ARV Guidelines for paediatric use resulted in the need to further shift regimens as new evidence and recommendations necessitate procurement of more optimal drugs.

The market for pediatric ARVs is significantly smaller than that for adult ARVs and more fragmented due to the changing needs of growing children. This leads to a complicated ARV market further challenged by the availability of a wide variety of different but often duplicative drug products. Guidance from the 2013 WHO Consolidated ARV Guidelines for paediatric use resulted in the need to further shift regimens as new evidence and recommendations necessitate procurement of more optimal drugs.

This has led to a difficult situation for many program and procurement supply chain managers in deciding what product to select and purchase. In turn, this has reduced the commercial attractiveness of this market sector for manufacturers faced with low-volume orders for multiple products.

The purpose of the IATT Update to the Optimal List of Paediatric ARV Formulations is to provide advice and guidance to implementing partners and procurement and supply chain managers on the recommended products that will enable programs to deliver the best care in accordance with the current WHO regimen selection and consolidate procurements around a small number of key products to stabilize this market sector. The updated Paediatric ARV Formulary list can be found at this link. http://goo.gl/nV95vD

In order to secure and sustain the paediatric ARV market, The Paediatric ARV Procurement Working Group (PAPWG) has been formed. It brings together partners to support country paediatric procurement practices and supply management so as to ensure the sustained access to paediatric formulations whilst reducing fragmentation through streamlined product selection and aligning supply to treatment guidelines. The PAPWG has actively through its Buyers’ Consortium (MSF, GF PPM, SCMS, CHAI, UNICEF) addressed challenges to maintain access to pediatric formulations for countries such as low volume orders, long and variable lead times, stock out response and transitioning products. Members of the Consortium align and collaborate their activities around product selection and optimization at the transactional levels, whilst providing advice on recommended optimal products of the IATT Formulary, pooling and coordination of ordering and consultations with ARV manufacturers/suppliers. The full article can be found here.

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