Global health. The current scenario and future perspectives

273 estimated. It was a captive market situation. For the treatment of HIV, Darunavir was a product that was about to lose its patent in Chile and its acquisition price was USD 7 40 per tablet; but as a result of negotiations, the product ended up being priced at USD 1.2 per tablet and was obtained from a generic company in India that participates in the Strategic Fund mechanism of the PAHO mentioned above, which makes low-priced medications available for countries. This mechanism is similar to the PAHO’s Revolving Fund where vaccines are provided for regional immunization programs. Thus begins the process for acquiring Darunavir at USD 1.2 through CENABAST, a situation following which the company holding the registration of Darunavir, whose patent has expired, filed a claim with the General Comptroller’s Office requiring reports from the Ministry of Health, the ISP, Cenabast and even OPS Chile. Finally, the ruling establishes that there is no illegality in purchasing management through the OPS Strategic Fund (General Comptroller’s Office, 2018). In the negotiation for Hepatitis C treatment, Interferon and Ribavirin were included as procedures under GES 41 (Explicit Guarantees on Healthcare) but did not yield good results. However, advanced generation treatments that completely cured the disease and prevented progression to cirrhosis or transplantation were already available worldwide. That is why they were chosen for negotiation. This new family of drugs called Direct- Acting Antivirals or DAAs are based on Sofosbuvir and are combined with other drugs from the same DAA family to exert their action. The initial market price for Sofosbuvir treatment was USD 84,000; during negotiations it could be obtained for USD 30,000. Nevertheless, it was an unaffordable price even for wealthy countries who found themselves facing unreachable access situations for the first time ever. Representatives from negotiating countries, accompanied by the PAHO, met with the companies and managed to obtain Sofosbuvir treatment for USD 7,800. Though a price reduction for other DAAs was not possible. This example shows the impact of patents on prices. Compulsory licensing for Chile? An important and historic health event originated in March 2017 when Innovarte Corporation 42 , along with some parliamentarians and patient 40 The price is expressed in dollars to standardize values among all countries (Editor’s note). 41 Explicit Health Guarantees. More information at: http://www.supersalud.gob.cl/difusion/665/w3- propertyvalue-1962.html. 42 Organization website: https://www.corporacioninnovarte.org/.