[Government spending on antiretrovirals in Brazil and its main determinants].

The development of public policies for the prevention and treatment of HIV/AIDS in Brazil is a history of struggle that has united public health officials, researchers and activists since the 1980s. An important part of this journey is linked to the production and distribution of antiretroviral drugs (ARVs), initiatives to reduce the price of ARVs and civil society mobilizations to guarantee rights, which have contributed to creating one of the most successful programs to combat the disease in the world. Based on this history, this study aimed to analyze government spending on the acquisition of selected ARVs between 2005 and 2020, comparing prices with international prices, in the light of factors related to patent disputes, voluntary licensing, PDPs and initiatives to reduction ARV prices. Among other results, it was possible to observe that there was no immediate relationship between the end of the patent concession and price reductions. The filing of other patent applications and the absence of nationally registered competitors, even after patent expired, may be significant factors in maintaining high prices.