E-DRUG: Expanding the WHO Model Essential Medicines List (6)
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Perhaps I have missed something, but surely cost is an important factor in whether a drug or vaccine is essential. As an example, the 2 new vaccines for HPV may be cost effective in the US at $360 per course of vaccination, (per Goldie, et al.) but certainly that price is much too high for widespread use in the less affluent countries wherein 93% of the mortality burden for cervical cancer occurs. The Merck vaccine has been considered essential enough for mandatory vaccination in some US states, but will not be affordable under current conditions in countries like India which suffer a significant number of deaths from cervical cancer.
Can you explain in more detail why "if available at generic prices" should not be a possible category? [Original message in this thread - May 3]
Kevin Outterson
Professor of Law
West Virginia University & Boston University (July 1)
304 293 8282 kevin.outterson@mail.wvu.edu
SSRN Author Page: ssrn.com/author=340746
"Kevin Outterson" <Kevin.Outterson@mail.wvu.edu>
E-DRUG: Expanding the WHO Model Essential Medicines List (8)
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I don't remember in the current thread if we earlier defined "generic
prices", but should this be taken to mean any price as long as the product
is generic?
Surely, we should guard against the impression that all generic
medicines are affordable. This may well be a matter of words, but what I
would like clarified is ; even if such a qualification should be made to a
product's inclusion in the WHO EML , how are countries then expected to
practically use this information in their decision making?
Murtada M. Sesay
Technical Officer (Pharmaceuticals)
UNICEF Supply Division
Tel: +45 3527 3098
Mobile: +45 28 23 28 07
E-mail: msesay@unicef.org
Web: www.unicef.org/supply
Murtada Sesay <msesay@unicef.org>
E-DRUG: Expanding the WHO Model Essential Medicines List (9)
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Dear Friends,
The position "..if available at generic prices" appears to suggest
that if such a product is not available at generic price, then it may
not be promoted to be on the Model List, etc? Is that a correct
assessment? As Kevin Outterson points out, a number of drugs are out
of reach of most governments. However, we should not discount the fact
that the access to essential commodities environment has changed over
the last few years, and so has the pharma industry (both patent and
generic).
In the former, there's recognition to use the most
appropriate therapeutic product available, as long the health system
can support or handle those commodities. Further, we now have a much
more articulate civil society and general public which demads that
systems are put in place (both at national and international level) to
assure access to these essential but expensive products.
In the case of pharma industry, we should recognise that this industry has also
changed and is williing to listen and negotiate prices that would
favour access by countries that would not afford the market price. I
give, without going into details, the example of multivalent vaccines,
and also ARVs and ACTs, where prices have been negotiated, resulting
in increasingly affordable unit prices (both generic and patent
products).
That seems to be the current environment we are working
in, whereby the "usefulness" of a product is the primary driver,
followed by commercial arrangements that would enable consumers to
afford product and therefore have long- term access to the same.
Regards,
Dr Bonnie Fundafunda
Drug Supply Budget Line,
Ministry of Health,
Lusaka,
Zambia
"BONFACE FUNDAFUNDA" <bcfunda@hotmail.com>