Dear Mrs. Tabagari,

With excitement I read the meeting minutes provided by Grigori.

On behalf of Novartis Social Business I want to hereby express my gratitude and thanks for the opportunity to introduce and discuss our proposal.

The partnership we are proposing would focus on providing our Novartis Access portfolio of NCD medicines to patients covered by the ‘Program for Providing Medicines for Chronic Diseases’, which has been introduced by the Ministry of Health of Georgia in June 2017.

Through this partnership, we aim to contribute strengthening the local healthcare system by delivering high quality products at affordable cost to vulnerable populations in Georgia, and we are thus happy to provide more information on the quality and price aspect of our products, as mentioned by Grigori.

Our products are marketed not only across Europe, but also worldwide. Attached you will find the current registration status of our products highlighting some countries with high regulatory standards including most of the ICH countries. The products have been on the market for years, partly over decades, with a long history of safety and pharmacovigilance records. 

Our medicinal products are manufactured in our own Novartis sites meeting the high Novartis quality standards. Regular inspections, not only by the national authorities, but also by ICH member states and other high regulated countries guarantee the quality along the lifecycle of the products. All our generic products are registered and marketed in European countries and consequently meet the EU standards for bioequivalence studies or scientific justification following the WHO Model List of Essential Medicines for immediate release for solid oral dosage forms.

Apart from Salbutamol, none of the oral products in our program contain any alcohol (ethanol). Salbutamol Inhaler contains 2% of ethanol (necessary to stabilize the suspension). The manufacturing process of our medicinal products does not involve any raw material derived from pork origin.

Novartis offers its Novartis Access portfolio as a basket at a price of USD 1 per treatment per month (Incoterm FCA). E.g. for one pack including treatments for three months the price would be USD 3 (FCA). For the shipment to Georgia we would include USD 0.20 per pack in addition. The MOH of Georgia would have to pay for all warehousing, transportation in Georgia, import customs formalities and duty fees. From our experience this would result in an approximate end-price of USD 1.50 for the patients (depending on any additional markups from distributor or pharmacy). It is a priority for us to work with our partners to minimize mark-ups and keep the end-price to patients as low as possible. In Kenya for instance, the end price paid by patients is approximately USD 1.50 per treatment per month.

As a next step, we would be happy to follow up on the attached informal offering. Basis for product selection and volumes would be the tender issued last year (volume increase by 3.5 times).

Please let us know your thoughts and how potential next steps could look like.

We are very much looking forward to further explore possibilities on how to increase access to high quality treatments to vulnerable populations in Georgia.

Best regards,

Christopher Junge

As I informed you yesterday, we had a meeting with the Minister of Health.

At the meeting were Giorgi Chikovani as a representative of the NVS Pharma, Tamara Kakulia as representative of the NVS Onco and I as representative of the Sandoz.

The minister started a meeting with one question, how increase the availability of drugs for chronic patients.

We once again, recalled the main moments of the NVS Access project. We informed that in 2018 2 more products (Valsartan and Letrozole) will be registered. We, during the meeting, noted that from our side we also thought about increasing accessibility and told the project that we want to launch with local distributors. Also we informed, that Novartis Access is ok with new scope of beneficiaries (pensioners, children and disabled people).

The minister asked several times whether the NVS products would they get $ 1 for 1 month of treatment. We explained that on 1$ we need to add logistics costs and it will be up to $ 1.2. We explained, if MoH wants to get minimum price for NVS Access products, it is obligatory, that MOH and NVS Access should sign memorandum. I have gave them copy of MOU proposal.

The minister expressed interest, said that it is possible, that the ministry bought directly from the NVS Access without a tender. For this, the minister needs a justification so that he can confirm purchases without tender in the government. Two main points for this confirmation are the quality (that products are produced in Europe by the GMP standard) and of course the price. If they will need more arguments, they will inform us.

Of course for calculation you will need product list and an approximate number of packages, which will be announced in the tender. As we were informed, during the meeting, product list will be same and the amount will be increased by 3.5 times. The quantity of the previous tender you have.

Our arguments, why it is better to buy from NVS Access, should be submitted as soon as possible.

Best regards, Mit freundlichen Grussen, Meilleures salutations,

Grigori Pirtskhalaishvili

Country Head of Georgia

T +995 32 298 27 30

M +995 599 499 338 / +372 81 630 700

grigori.pirtskhalaishvili@sandoz.com

Sandoz Georgia

18 Galaktion Tabidze str., 3rd floor P.3

GE-0105 Tbilisi, Georgia