METHODS: US wholesale acquisition cost (WAC) prices were collected from the online database RedBook (Truven Health Analytics) on Nov 17, 2016. Prices for public programs of the provinces of Quebec and Ontario were collected from the respective webpages on the same date. The defined daily dose (DDD) for each HIV ARV was extracted from online database of the World Health Organization. Prices for 30 DDD were calculated and converted into US dollars. Wilcoxon Signed rank test was conducted in the analysis using SPSS V21.0.

RESULTS: There were 38 HIV ARV drugs approved by the FDA and available in the US market, 29 in Ontario and 33 in Quebec. There were 8 drugs with generic competition in the US, and 8 in Ontario and Quebec. The study included 28 brand and 5 generic products that were available in the US, Ontario and Quebec. The median cost of brand HIV ARV drugs per 30-DDD was $833.50 (range=$412.20- $3086.04) in the US, $357.85 (range=$58.50-$1548.54) in Ontario (p<.05 vs. the US), and $325.81 (range=$56.80-$1518.17) in Quebec (p<.05 vs. the US). The median cost of generic HIV ARV drugs per 30-DDD was $276.49 (range=$23.15- $549.57) in the US, $166.86 (range=$42.60-$240.34) in Ontario, and $166.86 (range=$42.60-$240.34) in Ontario.

The price of generic nevirapine 200mg was lower in the US than in Ontario and Quebec.

CONCLUSIONS: The US had more HIV ARV drugs than Ontario and Quebec. Prices of brand HIV ARVs were significantly higher in the US than in Ontario and Quebec. Quebec had non-statistically significant lower prices than Ontario.