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Healthy Skepticism Library item: 16500

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Sukkar E
The frustration of high medicine prices
Scrip 2009 Sep 4
http://www.scripnews.com/therapysector/The-frustration-of-high-medicine-prices-175756?autnID=/contentstore/scripnews/codex/0d3ec828-9938-11de-8987-639eb03f4d86.xml


Full text:

There are ongoing concerns about the high price of medicines in
developing countries. Two recent surveys, taken in Vietnam and Thailand,
show that medicines in the public and private sectors are still
unaffordable to many people in those countries (scripnews.com, September
4th, 2009).

What is interesting about these two surveys is that they used the same
methodology – developed by the World Health Organization (WHO) and
Health Action International (HAI) – to determine medicine prices.

The methodology was first published as a manual in 2003, following
concerns from NGOs in the late 1990s. They had pointed out that prices
were high in developing countries, but the methodologies used were not
robust enough. WHO and HAI developed a standardised method to measure
patient prices and government procurement prices so that comparisons
could be made across sectors, both within a country and internationally.

The manual has been widely used, with 58 surveys completed across the
globe and 16 in the pipeline. Some of the countries that have used the
manual include China (two surveys), India (seven), Sudan (four), Kuwait,
Peru, South Africa (one province), Ghana and Cameroon. A number of
surveys are nearing completion in Latin America – namely Colombia,
Bolivia, Nicaragua, Ecuador, and a state in Brazil.

Most of the surveys have been undertaken or involve ministries of health
(the Thailand survey serves as an example here), but some are done by
academics, civil society organisations, and sometimes a mix of these
(for example, the Kenyan price survey involved the MoH and a civil
society group).

Thankfully, most of the surveys have been published which helps improve
transparency on the price of medicines; only a few countries have not
given permission to publish findings. “We need to know what people pay
for medicines and how affordable treatments really are,” says HAI’s Marg
Ewen, who is closely involved in the development of the manual.

The manual addresses four issues: medicine prices, affordability,
availability and price components (mark-ups and other charges in the
supply chain). In the most recent edition, revised last year, some minor
changes were made such as the number of regions and medicines to survey.

“High drug prices” can make good headlines, but some quarters may
question the quality of these surveys. HAI and WHO however do offer
countries technical support so that data checking and quality assurance
play an important part.

But what next? After a country does a survey and finds high drug prices
and/or poor availability, it needs to bring in the necessary policy
changes to make medicines affordable and available, be it encouraging
the use of generics, or controlling mark-ups by pharmacies and
wholesalers. The WHO and HAI are responding to requests from countries
and are now developing guidance on various price policies.

 

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