However, the unmet medical need for a dengue drug might be limited if sufficient dengue vaccines are available at reasonable cost and the annual case rate is reduced nearly to zero. Therefore another objective of this study was to simulate the effect of vaccine introduction on annual case loads during the time frame of the potential introduction of a dengue drug. One of the most vexing issues in the marketing of drugs in emerging Afatinib mouse markets is the issue of pricing. Tiered pricing, where a drug is priced in two or three different bands for countries based on
GDP, has evolved as the global standard in response to sustained community pressure for greater patient access to drugs (Moon et al., 2011). However, this Tyrosine Kinase Inhibitor Library convention has recently been critiqued as arbitrary and
fails to account for income inequality within countries that are nominally middle income (discussed by Moon et al., 2011). The alternative is to segment the market into public and private sectors, but this approach may be inefficient and difficult to implement (Moon et al., 2011). A third approach is for a company to maintain the price in emerging markets at prices approaching the variable costs of manufacturing. This maintains prices at lower levels, but has been criticized as being anti-competitive (Moon et al., 2011). Therefore, the final objective of this study was to explore an alternative pricing scheme based on an objective, equitable distribution of the economic savings of drug intervention
with the intent of defining the maximum potential market for dengue drugs. Diseases impose an economic burden on society that includes direct medical costs to the health system or individuals, non-medical costs related to the treatment very of the disease, and lost productivity (work or school days lost by the patient or family members as a consequence of the disease). The per-case economic burden of dengue, using these cost inputs, has been reported by Suaya et al. (2009) and others for eight countries in Asia and the Americas, representing 64% of the global burden of this disease. We used these input data to determine the economic burden of dengue in these countries based on the number of reported cases (Table 1). We estimated the total and by segment cost per case and economic burden in the rest of the world (ROW, Table 1, right column) by adjusting for official caseload and on average threefold lower GDP per capita in other dengue markets (economic burden in countries studied by Suaya et al.*.36/.64*.33). For each of the four market segments (ambulatory versus hospitalization and public versus private) we then calculated an average cost per case (total burden/total number of cases, see Table 2). This was further adjusted to take into account the threefold lower GDP in countries not covered by Suaya et al. (2009), see Table 2.