Prices versus costs of production for molnupiravir as a COVID-19 treatment

2021 ◽  
Author(s):  
Andrew Hill ◽  
Leah Ellis ◽  
Junzheng Wang ◽  
Toby Pepperrell
Keyword(s):  
Middle Income ◽  
Pharmaceutical Ingredients ◽  
Middle Income Countries ◽  
The Past ◽  
Drug Prices ◽  
The United Kingdom ◽  
Patent Pool ◽  
International Prices ◽  
Current Availability ◽  
Made In

Abstract Background Molnupiravir has been recently approved in the United Kingdom for the treatment of COVID-19 for showing promising survival benefits in clinical trials. This analysis will estimate and compare potential generic minimum costs of molnupiravir as well as observe countries eligible for pricing discounts as agreed by Merck and The Medicines Patent Pool (MPP). Methods Drug prices were searched for molnupiravir using active pharmaceutical ingredients (API) data extracted from global shipping records. This was compared with national pricing data from a range of low, medium, and high-income countries. Annual API export volumes from India were used to estimate the current availability. Trends of molnupiravir drugs prices were also evaluated for the last 6-month period. Mean daily COVID-19 diagnosis rates were calculated for the countries eligible for voluntary licensing. Results Molnupiravir can be generically manufactured at the very low per-course cost of $9.00. Over the past 6 months, prices of molnupiravir have fallen significantly, and when comparing reported international prices, we found wide variations between countries. Only 9% of diagnosed patients worldwide were in the countries eligible for voluntary licensing. Conclusions Prices of molnupiravir range from $20 to $750 per course. Only 9% of worldwide COVID-19 diagnoses are made in countries covered by voluntary licenses. Middle income countries not eligible for voluntary licensing may need to issue compulsory licenses to secure access to molnupiravir at affordable prices.

scholarly journals Obesities: A New Peer-Reviewed Open-Access Interdisciplinary Journal Fostering Research on Multifactorial Obesity and Associated Cardiometabolic Disorders

Obesities ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 26-28
Author(s):  
Bruno Guigas
Keyword(s):  
Open Access ◽  
Industrialized Countries ◽  
Obesity Prevalence ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past ◽  
Urban Transition ◽  
Cardiometabolic Disorders ◽  
Interdisciplinary Journal ◽  
Low And Middle Income

Obesity prevalence has increased continuously over the past 50 years, a dramatic worldwide expansion not only limited to industrialized countries but also observed in a large number of low- and middle-income countries experiencing rapid rural–urban transition [...]

scholarly journals Tobacco Control in Low- and Middle-Income Countries: Changing the Present to Help the Future

2018 ◽  
Vol 13 (4) ◽  
pp. 187-188 ◽  
Author(s):  
Bethany Hipple Walters ◽  
Ionela Petrea ◽  
Harry Lando
Keyword(s):  
World Health Organization ◽  
World Health ◽  
Second Hand Smoke ◽  
Vulnerable Children ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past ◽  
Second Hand Smoke Exposure ◽  
Health Organization ◽  
Low And Middle Income

While the global smoking rate has dropped in the past 30 years (from 41.2% of men in 1980 to 31.1% in 2012 and from 10.6% of women in 1980 to 6.2% in 2012), the number of tobacco smokers has increased due to population growth (Ng et al., 2014). This tobacco use and second-hand smoke exposure continue to harm people worldwide. Those harmed are often vulnerable: children, those living in low- and middle-income countries (LMICs), those with existing diseases, etc. As noted by the World Health Organization (WHO), nearly 80% of those who smoke live in a LMIC (World Health Organization, 2017). Furthermore, it is often those who are more socio-economically disadvantaged or less educated in LMICs that are exposed to second-hand smoke at home and work (Nazar, Lee, Arora, & Millett, 2015).

scholarly journals Towards a Patent Pool for HIV Medicines: The Background

2010 ◽  
Vol 4 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Michelle Childs
Keyword(s):  
Pharmaceutical Product ◽  
First Line ◽  
Middle Income ◽  
Compulsory Licensing ◽  
Middle Income Countries ◽  
Medical Needs ◽  
Patent Pool ◽  
Patent Rights ◽  
Systematic Solution ◽  
Foreign Ministry

Recent WHO guidelines for antiretroviral therapy recommend switching to less toxic, but more expensive medicines for first-line and second-line ART, raising questions about the financial sustainability of many AIDS treatment programmes. At the same time, many key generic producing countries such as India now grant pharmaceutical product patents so competition between multiple manufacturers will not be able to play the role it has in bringing down the price of newer drugs. Overcoming these patent barriers will require a range of solutions, such as restricting patentability criteria, or compulsory licensing. One additional systematic solution is provided by the patent pool, a collective solution to the management of patent rights, initially presented by Médecins Sans Frontières to the French Foreign Ministry and subsequently the UNITAID Executive Board in 2006. A patent pool must not be implemented at any costs, but answer medical needs, be based on economic realities and meet the access needs of the developing world, including middle-income countries.

scholarly journals Global Burden of Stroke

2018 ◽  
Vol 38 (02) ◽  
pp. 208-211 ◽  
Author(s):  
Mira Katan ◽  
Andreas Luft
Keyword(s):  
Hemorrhagic Stroke ◽  
Middle Income ◽  
Stroke Incidence ◽  
Middle Income Countries ◽  
The Past ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Incidence And Mortality ◽  
Geographical Regions ◽  
Life Years Lost

AbstractStroke is the second leading cause of death and a major cause of disability worldwide. Its incidence is increasing because the population ages. In addition, more young people are affected by stroke in low- and middle-income countries. Ischemic stroke is more frequent but hemorrhagic stroke is responsible for more deaths and disability-adjusted life-years lost. Incidence and mortality of stroke differ between countries, geographical regions, and ethnic groups. In high-income countries mainly, improvements in prevention, acute treatment, and neurorehabilitation have led to a substantial decrease in the burden of stroke over the past 30 years. This article reviews the epidemiological and clinical data concerning stroke incidence and burden around the globe.

Confronting the Vector of Tobacco-Related Disease

2013 ◽  
Vol 39 (2-3) ◽  
pp. 308-331 ◽  
Author(s):  
Matthew Allen
Keyword(s):  
Tobacco Use ◽  
Evidence Base ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past ◽  
Premature Deaths ◽  
Current Trends ◽  
Significant Burden ◽  
Tobacco Epidemic ◽  
Low And Middle Income

It has been estimated that the use of tobacco kills nearly 6 million people each year, with most deaths occurring in low- and middle-income countries. This disparity is expected to increase over the next few decades. On the basis of current trends, tobacco use will kill more than 8 million people worldwide per annum by 2030, with eighty percent of those premature deaths occurring in low- and middle-income countries. The significant burden of morbidity and mortality associated with tobacco use is well documented and proven and will not be repeated here.The evidence base for addressing the tobacco epidemic domestically, regionally, and globally has developed in a systematic fashion over the past five decades. Effective measures for tobacco control are now well known and have been canvassed widely in the published literature.

scholarly journals Valuing Mortality Risk Reductions in Global Benefit-Cost Analysis

2019 ◽  
Vol 10 (S1) ◽  
pp. 15-50 ◽  
Author(s):  
Lisa A. Robinson ◽  
James K. Hammitt ◽  
Lucy O’Keeffe
Keyword(s):  
Mortality Risk ◽  
Income Elasticity ◽  
Lower Income ◽  
Middle Income ◽  
Income Differences ◽  
Benefit Cost Analysis ◽  
Middle Income Countries ◽  
Statistical Life ◽  
The Past ◽  
Benefit Cost

The estimates used to value mortality risk reductions are a major determinant of the benefits of many public health and environmental policies. These estimates (typically expressed as the value per statistical life, VSL) describe the willingness of those affected by a policy to exchange their own income for the risk reductions they experience. While these values are relatively well studied in high-income countries, less is known about the values held by lower-income populations. We identify 26 studies conducted in the 172 countries considered low- or middle-income in any of the past 20 years; several have significant limitations. Thus there are few or no direct estimates of VSL for most such countries. Instead, analysts typically extrapolate values from wealthier countries, adjusting only for income differences. This extrapolation requires selecting a base value and an income elasticity that summarizes the rate at which VSL changes with income. Because any such approach depends on assumptions of uncertain validity, we recommend that analysts conduct a standardized sensitivity analysis to assess the extent to which their conclusions change depending on these estimates. In the longer term, more research on the value of mortality risk reductions in low- and middle-income countries is essential.

scholarly journals Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors

2020 ◽  
Vol 5 (1) ◽  
pp. e002230 ◽  
Author(s):  
Agbessi Amouzou ◽  
Safia S Jiwani ◽  
Inácio Crochemore Mohnsam da Silva ◽  
Liliana Carvajal-Aguirre ◽  
Abdoulaye Maïga ◽  
...  
Keyword(s):  
Maternal Health ◽  
Child Health ◽  
Low Income ◽  
Health Surveys ◽  
Health Coverage ◽  
Middle Income ◽  
Child Illness ◽  
Middle Income Countries ◽  
The Past ◽  
And Child Health

IntroductionUniversal Health Coverage (UHC) is a critical goal under the Sustainable Development Goals (SDGs) for health. Achieving this goal for reproductive, maternal, newborn and child health (RMNCH) service coverage will require an understanding of national progress and how socioeconomic and demographic subgroups of women and children are being reached by health interventions.MethodsWe accessed coverage databases produced by the International Centre for Equity in Health, which were based on reanalysis of Demographic and Health Surveys, Multiple Indicator Cluster Surveys and Reproductive and Health Surveys. We limited the data to 58 countries with at least two surveys since 2008. We fitted multilevel linear regressions of coverage of RMNCH, divided into four main components—reproductive health, maternal health, child immunisation and child illness treatment—to estimate the average annual percentage point change (AAPPC) in coverage for the period 2008–2017 across these countries and for subgroups defined by maternal age, education, place of residence and wealth quintiles. We also assessed change in the pace of coverage progress between the periods 2000–2008 and 2008–2017.ResultsProgress in RMNCH coverage has been modest over the past decade, with statistically significant AAPPC observed only for maternal health (1.25, 95% CI 0.90 to 1.61) and reproductive health (0.83, 95% CI 0.47 to 1.19). AAPPC was not statistically significant for child immunisation and illness treatment. Progress, however, varied largely across countries, with fast or slow progressors spread throughout the low-income and middle-income groups. For reproductive and maternal health, low-income and lower middle-income countries appear to have progressed faster than upper middle-income countries. For these two components, faster progress was also observed in older women and in traditionally less well-off groups such as non-educated women, those living in rural areas or belonging to the poorest or middle wealth quintiles than among groups that are well off. The latter groups however continue to maintain substantially higher coverage levels over the former. No acceleration in RMNCH coverage was observed when the periods 2000–2008 and 2008–2017 were compared.ConclusionAt the dawn of the SDGs, progress in coverage in RMNCH remains insufficient at the national level and across equity dimensions to accelerate towards UHC by 2030. Greater attention must be paid to child immunisation to sustain the past gains and to child illness treatment to substantially raise its coverage across all groups.

scholarly journals Smartphone microendoscopy for high resolution fluorescence imaging

2016 ◽  
Vol 09 (05) ◽  
pp. 1650046 ◽  
Author(s):  
Xiangqian Hong ◽  
Vivek K. Nagarajan ◽  
Dale H. Mugler ◽  
Bing Yu
Keyword(s):  
High Resolution ◽  
Rural Areas ◽  
Ex Vivo ◽  
Cost Effective ◽  
Internal Organs ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past

High resolution optical endoscopes are increasingly used in diagnosis of various medical conditions of internal organs, such as the cervix and gastrointestinal (GI) tracts, but they are too expensive for use in resource-poor settings. On the other hand, smartphones with high resolution cameras and Internet access have become more affordable, enabling them to diffuse into most rural areas and developing countries in the past decade. In this paper, we describe a smartphone microendoscope that can take fluorescence images with a spatial resolution of 3.1 [Formula: see text]m. Images collected from ex vivo, in vitro and in vivo samples using the device are also presented. The compact and cost-effective smartphone microendoscope may be envisaged as a powerful tool for detecting pre-cancerous lesions of internal organs in low and middle-income countries (LMICs).

Notes and records of the Royal Society of London

1946 ◽  
Vol 4 (2) ◽  
pp. 133-145
Keyword(s):  
United Kingdom ◽  
General Problem ◽  
Royal Society ◽  
Agricultural Science ◽  
The Other ◽  
Standing Committee ◽  
The Past ◽  
The United Kingdom ◽  
Fundamental Science ◽  
Made In

A Conference of Fellows was held in the rooms of the Royal Society on 10 May 1945 to discuss certain questions arising from the Report on the Needs of Research in Fundamental Science, particularly in relation to ‘ rare subjects ’ in the universities. As a result of this meeting, a memorandum was drawn up by Professor A. V. Hill, then Biological Secretary. This memorandum, slightly abridged, was in the following terms: Under existing conditions there are various subjects of study for which little or no provision is made in any of the universities of the United Kingdom. There are sub/branches of subjects the study of which might be held to fall within the duties of some existing depart' ment but which, in fact, have been almost neglected. O n the other hand, there are subjects for which too widespread provision has been made in the past or for which too great a dispersion of effort has proved unhealthy. Certain subjects do not need to be studied at a higher level in more than a few places. A t Sir Charles Darwin’s suggestion to the Secretaries, a Conference was called at the Royal Society on 10 May to consider the general problem. Seventeen Fellows were present. A t this Conference it was decided to ask the Council of the Royal Society to invite the co-operation of the Sectional Committees, and of the newly formed Standing Committee on Agricultural Science, to explore it further.

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