E-DRUG: Drug Pricing in South Africa
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[crossposted from DRUGINFO with thanks. For the non-south
Africans: the Health System Trust issues a report on the
health situation in South Africa. This year drug prices
are analyzed in one of its chapters. Well done, Andy! WB]
Hi all
Today the Health Systems Trust's annual publication, the South
African Health Review 2000, was launched in Johannesburg. This
year I contributed, together with my colleague Thulani Matsebula
from the Wits Centre for Health Policy, a chapter on Drug Pricing.
An html version can be viewed at:
http://www.hst.org.za/sahr/2000/chapter9.htm
In addition, it is available as a .pdf file (276kB) at
ftp://ftp.hst.org.za/pubs/Sahr/2000/chapter9.pdf, with the
references as a separate file
(http://www.hst.org.za/sahr/2000/refs.htm#Chapter 9)
A summary brief issued at the launch is also available at:
http://www.hst.org.za/sahr/2000/summaries/drug.htm
The abstracts reads as follows: "Improving access to necessary
drugs requires attention to all four component parts of the access
equation � ensuring rational selection, providing sustainable
financing and efficient systems to distribute and use the drugs but
also making sure that prices are affordable. However, comparing
drugs prices across countries and health systems is not always
easy. Methodological pitfalls abound, and have in the past
ensnared the South African Ministry of Health. The National Drug
Policy contains a variety of proposed strategies to reduce the price
of medicines in South Africa. This chapter considers the complex
issue of drug pricing, the policy options outlined and available, and
provides recommendations on steps that will advance the
implementation of such policies".
The chapter calls for :
"* More detailed data on price trends in both the private and public
sectors
* More analysis of the impacts of policy decisions, with emphasis
on indicators of equity, affordability and availability
* Finality on those policy choices which seem to hold clear
advantages (such as fixed professional fees and non-discriminatory
exit pricing based on volume)
* Finality on the legal struggle to introduce generic substitution, to
regulate marketing practices and to exploit the safeguards provided
by the TRIPS Agreement
* Consideration of regional options, including bulk purchasing
across the SADC region".
It concludes that: "Crucial to the success of these options will be
strengthening of the national departments responsible, the
Directorate: Pharmaceutical Programmes and Planning (and in
particular the sub-directorate of Medical Stores and Systems,
which provides the secretariat to COMED) and the Directorate:
Medicines Administration (the secretariat to the Medicines Control
Council). Significant strengthening of the inspectorate functions of
the MCC will also be necessary if the potential pitfalls of parallel
trade and compulsory licensing are to be avoided. Strengthening
the entire system will ensure that the populace is not exposed to
counterfeit and sub-standard medicines and will demonstrate that
such exposure is not an inevitable consequence of the policy
choices outlined in this chapter. In this regard, South Africa
remains a test case, one watched closely by the international
community".
I would welcome any comments on the chapter from list
participants, or any updates on what is by now a document 4
months out of date!
regards
Andy