E-DRUG: Medicine prices, availability and affordability in Yemen
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Dear E-druggers
In July 2006, a medicine price, availability and affordability survey
was undertaken in Yemen using the WHO/HAI price measurement methodology.
The survey was undertaken by Dr Yaseen Ahmed Al-qubati and Eng.
Abdul-Karim Shaher Ahmed from the Supreme Board for Drugs and Medical
Appliances. Data was collected for 35 essential medicines (originator
brand and lowest priced generic equivalent) in a total of 20 public
sector facilities and 20 private pharmacies in Sana's City and the main
cities in 3 governates (Aden, Hodiedah and Taiz). MSH 2005 prices were
used as the reference.
Key findings include:
* public sector availability was extremely poor (median 5%).
Sixteen of the 35 medicines (45%) were not found in any of the
facilities including metformin, phenytoin, atenolol, salbutamol inhaler,
acyclovir, levothyroxine and beclometasone inhaler.
* availability was better in private retail pharmacies - median
90% for generics and 50% for originator brands.
* in private pharmacies, originator brands were on average 5 times
more expensive than lowest priced generics. Originator brand
ciprofloxacin (Ciprobay) was a massive 129 times the international
reference price, while the lowest priced generic equivalent was much
cheaper (about 5 times the reference price). The originator brand of
metronidazole tabs (Flagyl) was 35 times the reference price. The lowest
priced generic equivalent was less, but still high priced at 9 times the
reference price.
* In the private sector many standard treatments were simply not
affordable. The lowest paid unskilled government worker would have to
work nearly 2 days to pay a months treatment with amitriptyline, or 1.5
days for metformin, when purchasing the lowest priced generics. If
originator brands are purchased, it takes 3.5 days wages to purchase
each treatment.
The authors' acknowledged that steps were needed to improve the
availability of essential medicines in the public sector. Other
recommendations included reviewing manufacturer's prices, introducing
regressive mark-ups in the supply chain, and encouraging the prescribing
and dispensing of low priced generics to improve treatment
affordability, especially for the poor.
A report of the findings is available on HAI's web site:
http://www.haiweb.org/medicineprices/surveys/200607YE/survey_report.pdf
The data can be accessed in HAI's price database:
http://www.haiweb.org/medicineprices/
Best regards
Margaret 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