E-DRUG: Medicine prices and pharmaceutical markets in developing countries
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Dear E-druggers,
We would like to contribute to the ongoing debate on medicine prices in developing countries by bringing in the economic perspective on the issue. As part of my doctorate at the London School of Hygiene and Tropical Medicine, together with Prof. Barbara McPake from QMUC, we have been looking at medicine prices and their determinants in Mozambique from an economic point of view. Quantitative as well as qualitative methods were used to investigate the pharmaceutical retailing and importing sector in the country. Between 2004 and 2006 the WHO/HAI Medicine Price Survey methodology was used to assess prices from 56 facilities, and 21 semi-structured interviews were conducted with local policy-makers, pharmacists and pharmaceutical importers. The research preliminary results suggest that:
§ The pharmaceutical market in Mozambique is divided into one low-cost and one high-cost segment, and the two segments seem to respond effectively to the diverse needs of the changing population;
§ Drug treatment of most common diseases is affordable to the largest part of the population, but only if carried out with generics;
§ In the public sector generics were found to be relatively available, but only in tertiary care hospitals.
However,
§ The inability to guarantee the quality of generics is pushing consumers towards less affordable brands;
§ Competition appears to be more developed within the market for generics, rather than in that for brands;
§ Regulation does not appear to work effectively, especially price controls. All in all, this economic investigation suggests that questions on whether medicine prices may be too high, sometimes do not capture the complexity of pharmaceutical markets in developing countries, and that a careful investigation of market structure, conduct and performance is needed before designing adequate policies for the sector.
For further discussion and details of the study, please contact me at the address below.
Giuliano Russo
London School of Hygiene and Tropical Medicine
Health Policy Unit,
Public Health Department
Keppel Street,
London WC1E 7HT, UK
tel. 0044 20 7927 2438
giuliano.russo@lshtm.ac.uk