Procurement in the public interest: Efforts to increase transparency and accountability for ARV drug supplies

The Global Fund to Fight AID, Tuberculosis and Malaria and the World Health Organization host public databases containing information of medicine procurement transactions. In this paper we describe how publicly available data can be obtained and enhanced towards the promotion of transparency and accountability in the pharmaceutical sector. Drawing on more than 5 years of data containing more than 10,000 procurement transactions for antiretroviral medicines, we present 2 different transparency tools to illustrate how transparency and accountability can be linked to promote better outcomes and value for money. The first tool is an outlier analysis to identify and investigate prices that are far in excess of the global distribution of prices paid for that same product. Both low and high price outliers are worthy of investigation. Applying this tool to our procurement database, we identified 38 low price outliers and 190 high price outliers. The second tool is a benchmark that compares prices paid in each country to global median prices paid for identical products. For each country, the percent of country procurements are summarized in quartiles across the global price distribution of prices in one year time periods. In this distribution, it is desirable for countries to have the largest percent of their procurements ranked in the 25-50th percentile and <25th percentile, meaning most of their prices were at or below global median prices for identical products. Countries would prefer to avoid rankings in the 50-75th percentiles and >75th percentiles, meaning the prices they paid were above global median prices for identical products.