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Healthy Skepticism Library item: 16501

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
Vietnam's medicine prices are too high
Scrip 2009 Sep 4
http://www.scripnews.com/policyregulation/Vietnams-medicine-prices-are-too-high-175774?autnID=/contentstore/scripnews/codex/e02dfc91-9871-11de-97a4-f599b5abdca1.xml


Full text:

The prices of medicines in Vietnam are too high, and they are low in
availability, especially in the public sector, a new study finds.

Vietnam, the fifth most populous country in the Far East, with 86.9
million people, spends some 6.6% of its GDP on health, with the
government only contributing 32% of this; the remainder comes from
patients through out-of-pocket expenses, making access to healthcare
unaffordable for low-income groups. Significantly, some 53.3% of health
spending is on medicines.

Researchers from the school of public health and community medicine at
the University of New South Wales and the Hanoi University of Pharmacy
in Vietnam and others surveyed the price, availability and affordability
of 42 medicines in drug outlets and pharmacies in five regions in
Vietnam (Southern Med Review, vol 2, issue 2, September 2009).

They found that the public sector procurement prices were 8.29 times the
international reference price for 23 branded medicines and 1.82 times
the international reference price for 33 lowest-priced generic
equivalents.

The mean availability of branded medicines and lowest priced generic
equivalents was 19.6% and 33.6% respectively in the public sector; 34.7
and 58.1% respectively in the private sector, and 10.9% and 40.4%
respectively for insured patients in the not-for-profit public sector.

Overall, all sectors showed greater availability of lowest-priced
generic equivalents than branded medicines; there were a few exceptions
such as atenolol, nifedipine and salbutamol inhaler.

The researchers also make an international comparison for 15 out of the
42 medicines.

They say that while other low income countries have an average public
procurement price 17% higher than the international reference prices for
lowest-priced generic equivalents, the Western Pacific region and
Vietnam both had procurement prices averaging 44-45% more than the
international reference price.

The researchers also found that the mean percentage availability of the
sample of 15 lowest-priced generic equivalents in Vietnam was 34.8% in
the public sector and 56.0% in the private sector, similar to the
average of country-level mean percentage availability of medicines
across other low-income countries (as defined by the World Bank).

To make public facilities a primary treatment option for the poor,
Vietnam must reduce medicine prices in this sector by improving
procurement efficiency, ensuring and promoting low-priced generics, and
regulating reasonable mark-ups, the study advises.

The researchers say the study is significant as it provides the most
thorough picture of medicines prices in Vietnam to date, using
standardised World Health Organization/ Health Action International
methodology.

 

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...to influence multinational corporations effectively, the efforts of governments will have to be complemented by others, notably the many voluntary organisations that have shown they can effectively represent society’s public-health interests…
A small group known as Healthy Skepticism; formerly the Medical Lobby for Appropriate Marketing) has consistently and insistently drawn the attention of producers to promotional malpractice, calling for (and often securing) correction. These organisations [Healthy Skepticism, Médecins Sans Frontières and Health Action International] are small, but they are capable; they bear malice towards no one, and they are inscrutably honest. If industry is indeed persuaded to face up to its social responsibilities in the coming years it may well be because of these associations and others like them.
- Dukes MN. Accountability of the pharmaceutical industry. Lancet. 2002 Nov 23; 360(9346)1682-4.