Average Wholesale Price of HIV Drugs

Price Determines Both the Reimbursement and Retail Cost of Prescription Drugs

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The wholesale price of HIV drugs is determined by a number of factors. Firstly, an independent Wholesale Acquisition Cost (WAC) is released by the manufacturer, which is essentially the asking price of a drug before any discounts or rebates are added for volume purchases and/or prompt payment.

From this, a Suggested Wholesale Price (SWP) is set. This is the price recommended by the manufacturer to wholesalers when determining prices for their customers (i.e. retailers, hospitals, institutions).

The SWP is not the actual transaction cost but rather a baseline from which wholesalers can make competitive pricing decisions.

By contrast, the Average Wholesale Price (AWP) is the average price that retailers and others are reportedly paying for a particular drug. The AWP is reported by the manufacturers and compiled by independent publishers, the data of which is used by governments, insurance companies, and others to determine the reimbursement and retail prices of prescription drugs. Because AWP relies on third-party reporting—and is, therefore, vulnerable to price manipulation—some institutions have begun to abandon its use in favor of the SWP.

Finally, the Direct Price (DIRP or DP) is the price a non-wholesale buyer (e.g. you) would expect to pay at the cash register. Generally speaking, there's a 20-30% markup between the WAC and DIRP.

Average Wholesale Price of Adult Antiretroviral Drugs Per Month

Antiretroviral DrugAdult StrengthDoseCountAWP
Aptivus (tiprianavir)250mg capsule2 twice daily120$1,590.18
Atripla (tenofovir + emtricitabine + efavirenz)300/200/600mg tablet1 daily30$2,551.99
Combivir (zidovudine + lamivudine)300/150mg tablet1 twice daily60$1,081.70
Complera (tenofovir + emtricitabine + ripilvirine)300/200/25mg tablet1 daily30$2,948.70
Crixivan (indinavir)400mg capsule2 twice daily120$365.42*
Crixivan (indinavir)400mg capsule2 thrice daily180$548.12*
Edurant (ripilvirine)25mg tablet1 daily30$996.43
Emtriva (emtricitabine)200mg capsule1 daily30$602.27
Epivir (lamivudine)300mg tablet1 daily30$498.90
Epzicom (abacavir + lamivudine)600/300mg tablet1 daily30$1,416.35
Evotaz (atazanavir + cobicistat)350/150mg tablet1 daily30$1,684.44
Fuzeon (enfuvirtide)90mg injection1 twice daily60$3,759.43
Genvoya (elvitegravir + cobicistat + emtricitabine + tenofovir alafenamide)150/150/200/10mg tablet1 daily30$2,613.50
Intelence (etravirine)200mg tablet1 twice daily60$978.64
Intelence (etravirine)200mg tablet1 twice daily60$1,212.29
Isentress (raltegravir400mg tablet1 twice daily60$1,445.34
Invirase (saquinavir)500mg tablet2 twice daily120$1,260.01
Kaletra (lopinavir + ritonavir)200/50mg tablet2 twice daily or 4 daily120$977.22
Lexiva (fosamprenavir)700mg tablet2 twice daily120$2,408.86
Lexiva (fosamprenavir)700mg tablet1 twice daily or 2 once daily60$1,204.43
Norvir (ritonavir)100mg tablet1 daily30$308.60
Prezista (darunavir)400mg tablet2 daily60$1,509.79
Prezista (darunavir)600mg tablet1 twice daily60$1,509.79
Prezcobix (darunavir + cobicistat)80/150mg tablet1 daily60$1,725.29
Rescriptor (delavirdine)200mg tablet2 thrice daily180$365.45
Retrovir (zidovudine)300mg tablet1 twice daily60$390.97**
Reyataz (atazanavir)200mg capsule2 daily60$1,535.23
Reyataz (atazanavir)300mg capsule1 daily30$1,520.72
Selzentry (maraviroc)150mg tablet1 twice daily60$1,455.13
Selzentry (maraviroc)300mg tablet1 twice daily60$1,455.13
Stribild (tenofovir + emtricitabine + elvitegravir + cobicistat)300/200/150/ 150mg tablet1 daily30$2,948.70
Sustiva (efavirenz)600mg tablet1 daily30$1,011.97
Tivicay (dolutegravir)50mg tablet1 daily30$1,581.68
Tivicay (dolutegravir)50mg tablet1 twice daily60$3,163.36
Triumeq (abacavir + lamivudine + dolutegravir)600/300/50mg tablet1 daily30$2,648.84
Trizivir (abacavir + zidovudine + lamivudine)300/300/100mg tablet1 twice daily60$1,931.64
Truvada (tenofovir + emtricitabine)300/150mg tablet1 daily30$1,539.90
Tybost (cobicistat)150mg tablet1 daily30$216.00
Videx EC (didanosine)400mg capsule1 daily30$515.84
Viracept (nelfinavir)625mg tablet2 twice daily120$1,169.22
Viramune (nevirapine)200mg tablet1 twice daily60$861.19
Viramune XR (nevirapine)400mg tablet1 daily30$798.73
Viread (tenofovir)300mg tablet1 daily30$1,120.04
Vitekta (elvitegravir)85mg tablet1 daily30$1,352.05
Vitekta (elvitegravir)150mg tablet1 daily30$1,352.05
Zerit (stavudine)40mg capsule1 twice daily60$553.12
Ziagen (abacavir)300mg tablet2 daily60$670.37

* - AWP missing from April 8, 2015 update; AWP listed from March 27, 2015 update
** - generic drug price

Sources:

National Institutes of Health (NIH). "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents - Appendix B: Drug Characteristics Tables (Monthly Suggested Wholesale Price of Antiretroviral Drugs)." Bethesda, Maryland; updated April 8, 2015; accessed September 17, 2015.

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