E-DRUG: Eastern Mediterranean Ministers tackle high medicines prices
--------------------------------------------------------------------
Dear E-druggers
Medicine price, availability, affordability and price component issues
were discussed by delegates at the recent meeting of the Regional
Committee for WHO's Eastern Mediterranean Region, held in Cairo 20-23
October 2007.
Dr Zafar Mirza, regional advisor on essential medicines and
pharmaceutical policies, presented the results from 11 surveys
undertaken in the region using the WHO/HAI medicine price measurement
methodology.
Key findings included:
- Substantial differences in government procurement prices
across countries in the region
- Government purchasing of expensive originator brands, as well
as cheaper generics, in all but 3 countries. On average, originator
brands were about 3 times more expensive than generics. Prices of
generics were often high.
- Availability in public sector facilities was very poor e.g. 16
of the 35 surveyed medicines were not found in any outlet surveyed in
Yemen, 23 of 29 medicines were not found in over 50% of the outlets in
Pakistan
- Excessive prices in the private sector for originator brands
and lowest priced generics e.g. Sudanese patients were paying 18 times
international reference prices for originator brands. Lowest priced
generics were over 5 times the reference prices in most countries
- Most treatments purchased in the private sector were
unaffordable (based on the salary of the lowest paid unskilled
government worker)
- Some countries were applying taxes to essential medicines
A lengthy discussion followed with comments from Ministers, or their
representatives, from 16 countries. They acknowledged the many problems
related to medicine prices in both public and private sectors. Many also
noted that the TRIPS Agreement had contributed to rising prices and
diminished access to medicines, especially in developing countries.
Various policy and programme options were mentioned including the
increased use of quality generics to improve affordability, regressive
mark-ups to encourage the dispensing of lower priced generics, pooled
procurement, plus greater transparency and the sharing of price
information. WHO Regional Director, Dr Gezairy, said the issue of
medicine pricing was sensitive and of the utmost importance, and offered
a number of options for countries to consider to reduce prices. Health
Action International urged countries to develop, implement and enforce
sound evidence-based policies and programmes, and monitor their impact,
to ensure medicines are affordable and available to all.
A resolution was passed that featured the establishment of a web-based
medicines prices hub in the region to share information on medicine
prices and pricing structures, as well as best practices in medicine
management. This innovative approach is welcomed as it will improve
price transparency and empower governments to negotiate for more
favourable prices. The resolution also urged governments to strengthen
pricing policies (including public procurement of generics, and enhanced
competition amongst suppliers) and rationalize supply chain costs in the
private sector. WHO EMRO resolved to support Members States in this work
including the development of guidelines on pricing policies and sharing
information on best practices from other regions.
You can access the resolution and the technical paper Medicine prices
and access to medicines in the Eastern Mediterranean region on WHO
EMRO's website http://www.emro.who.int/rc54/
Survey data can be found on HAIs website:
http://www.haiweb.org/medicineprices
Best wishes
Marg Ewen
Coordinator, Global Projects (Pricing)
Health Action International
Jacob van Lennepkade 334T
1053 NJ Amsterdam
The Netherlands
Tel: +31 20 489 1846 (direct), +31 20 683 3684 (office)
Fax: +31 20685 5002
Email: marg@haiweb.org
Web site: http://www.haiweb.org
Health Action International (HAI) is an independent, global network
working to increase access to essential medicines and improve their
rational use through research excellence and evidence-based advocacy.