E-DRUG: Drug prices in Pakistan
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Hi,
Drug prices, and linked phenomena are so many and so closely knitted that those can't be fully covered as each standing alone. But we have to start somewhere. So I take the branding science.
Brands of same drug with huge differences in price, manufactured by different pharmaceutical companies, are being sold in Pakistani market. The difference may be as much as 1000% in some cases.
There are about 45000 brands registered in Pakistan, and the difference among prices of the brands of same drug may range between 10 and 1000%. Insult to the injury is added by a universal unavailability of low priced brands, while the expensive ones are freely available.
Pharmaceutical industry itself has admitted that prices of medicine are quite high in Pakistan and there is a big profit margin for the manufacturers. Muhammad Asad, Chairman of Pakistan Pharmaceutical Manufacturers Association (PPMA), Punjab chapter, has told the media on 9th of this month that they intend to introduce an across the board decrease of 10-30% in the prices of life saving drugs, as drug prices are unreasonably high in Pakistan. But the move seems to be very much similar to a recent voluntary price decrease in India, where prices of those brands have been reduced that has never been sold or their sale is almost negligible. (Ref: Gopa Kumar CENTAD Delhi)
These sky high prices and huge number of unnecessary registrations has made the whole pharmaceutical scenario, a mess. Opposite to a short list of around 400-500 essential drugs, around 45000 brands are registered in Pakistan. This phenomenon of branding is nothing but a tool to earn as much profit as possible, and keep the drugs as away from the poor as possible.
Here are a few examples of different brands of the same drug and the differences among their prices.
S.No.
Name of the drug
No. of brands
Min. unit price (Rs)
Max.unit Price (Rs)
Maxi as % of mini
1
Atenolol tablet 50 mg
35
1.65
6.11
370.3
2
Captopril tablet 25 mg
17
1.50
6.67
444.7
3
Ceftriaxone injection 1g powder
63
99.00
543.60
549.1
4
Ciprofloxacin tablet 500 mg
84
5.50
50.46
917.5
5
Diazepam tablet 5 mg
20
0.09
0.70
777.8
6
Diclofenac Sodium tablet 50 mg
98
1.05
5.04
480.0
7
Fluconazole capsule 150 mg
19
79.00
384.40
486.6
8
Ibuprofen capsule/tablet 400 mg
43
0.75
2.50
333.3
9
Loratidine tablet 10 mg
72
1.30
11.65
896.2
10
Losartan Potassium tablet 50 mg
36
4.95
51.67
1043.8
11
Lovastatin tablet 20 mg
12
2.50
21.83
873.2
12
Omeprazole capsule 20 mg
86
5.64
49.15
871.5
Ironically, the price of each brand of a medicine is approved by the Drugs Control Organization of the Ministry of Health at the time of the registration of the product. The Ministry has a price review committee but its working is complete opaque. No one has any idea about how does this committee operates? What logic do they follow while approving Rs 1 price for a product of a company and Rs 100 for the same product of another company?
Quality is one major criterion which the prices and their differences should be based on. But regulatory authorities here have no such infrastructure and systems to assess either quality of product or that of manufacturing procedures, and the prices are thus allotted on something that is not known. Quality of expensive brands is not always better than the cheaper ones, according to a TheNetwork study.
No upper limit for number of brands for any single drug is set and anybody and everybody can get a new brand registered for whatever.
The proponents of liberalization of the medicine sector had been arguing that more drugs will increase competition and hence reduce prices ultimately benefiting the poor consumer. This has simply not happened as there are scores of brands for each medicine registered with the ministry but overall average prices of medicines have gone up.
This is only one issue that contributes towards making the drugs unaffordable for the poor. There are a number of others including unethical marketing practices by the pharmaceutical companies resulting in an increase in the price, very high profit margins, very high ex-factory prices and ultimately taxes and mark ups which are calculated on top of that etc.etc.
Hope that something would be said about all these aspects as the discussion progresses.
Regards
Tauqeer
TAUQEER MUSTAFA CHOUDHRY.
Project Officer
(Health and Pharmaceuticals)
The Network for Consumer Protection
40-A, Ramzan Plaza, G-9 Markaz
Islamabad, Pakistan
Ph# Off: 92-42-2261085
Hand Ph# 92-333-4101610
"Tauqeer Mustafa" <tauqeermustafa@yahoo.com>