E-drug: Prices of essential drugs in developing countries (cont'd)
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I think that Hilbrand is asking a good question but the answer may be
a bit more complex than markups alone. There are many charges other
than those made by the pharmaceutical companies or pharmacies.
These include drug registration fees, (I am told that the fee in Russia
at the moment is $12,000). There are also customs duties, sales or
VAT taxes, handling charges, dispensing charges as well as markups.
To understand the situation we need to know the make up of these
charges.
However comparing the end result with an international standard can
be very interesting. I was in Macedonia recently and discovered that
the drugs there are costing 4-7 times the MSH/WB Drug Price
Indicator Guide prices. In an unpublished five country study of TB
drugs by Sato and Ishikawa the price of various drugs varied from
59.4% to 213% of the MSH/WB prices in the public sector.
I am advocating for the waiving of registration fees, customs duties
and taxes for TB drugs though this approach could be applied to all
Essential Drugs.
Richard Laing
Associate Professor of International Health
Boston University School of Public Health
715 Albany St, T4W, Boston MA 02118 USA
Tel 617 414-1444 Fax 617 638-4476
E-mail richardl@bu.edu
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