[e-drug] Results of HAI Global pill price 'snapshot' - ciprofloxacin

e-drug
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E-DRUG: Results of HAI Global pill price 'snapshot' - ciprofloxacin
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Global pill price 'snapshot' reveals large differences in the price of
ciprofloxacin

On 30 November 2009 Health Action International (HAI) undertook a global
"snapshot" of the price of ciprofloxacin, a commonly used off-patent
antibiotic. Individuals from HAI's extended network and partners visited
private retail pharmacies to collect the price of the originator brand
product and the lowest priced generic equivalent.

Data were collected from 93 countries, where the price for a 7 day
treatment course of ciprofloxacin ranged between US$0.42 and US$131. An
interactive map on HAI's website presents the results and shows large
price differentials across the world for this medicine (see
www.haiweb.org/medicineprices). While the prices should not be
considered representative, as great price variation exists within some
countries, these "snapshot" prices are indicative of what people have to
pay, when paying the full retail price, in those pharmacies on that day.

The findings confirm that prices can vary widely both between countries
and within countries. Although the patent on ciprofloxacin expired a
number of years ago, the price difference between the lowest priced
generic and the originator brand (the 'brand premium') is significant in
many countries. For example, Colombia showed the largest brand premium,
with the originator brand priced at 60 times the lowest priced generic.
Colombia also had the highest treatment cost for originator brand
ciprofloxacin in the private sector: a patient in Colombia pays more
than 200 times the price they would pay in five Asian countries where
the price of generics was lowest - a difference of almost 20,000%.

The average price of the originator brand shows very little variation
across countries of different wealth. In contrast, the average price of
generics decreased as the wealth of the country decreased.

The use of low priced generic medicines is a significant step towards
improving access to treatment. Generic ciprofloxacin is mostly available
at a much lower price than the originator brand product, and in many
cases, there is ample room to reduce the generic price further, making
treatment more affordable.

HAI believes governments need to further examine access to affordable
essential medicines in their country and give it the priority it
deserves. Being sick is enough of a misfortune; obtaining needed
medicines should never result in choices between impoverishment, going
without treatment or buying only a partial course of treatment.

Please refer to the HAI website to see the interactive map reporting the
price data, and the analysis of results and recommendations:
http://www.haiweb.org/medicineprices

For further information, contact Margaret Ewen at HAI Global, Amsterdam
(telephone +31 20 683 3684 or email medicineprices@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
http://www.haiweb.org

Margaret Ewen
HAI, Global
Amsterdam
medicineprices@haiweb.org

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E-DRUG: Results of HAI Global pill price 'snapshot' - ciprofloxacin (2)
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These are extremely interesting results. To me this study suggests
that when brand and generic are the only features studied in relation
to price the results do not explain all the reasons for the
differences nor their relative value in the cost equation. I suggest
study on the nature of the suppliers in the supply chain, how and how
well they are regulated and the sufficiency of national procurement
agencies will yield much more useful information as to where
regulatory interventions can successfully be directed.

Michele Forzley, JD, MPH
Lawyer, Professor, Global Health Consultant
301-565-0680
michele@micheleforzley.com

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E-DRUG: Results of HAI Global pill price 'snapshot' -ciprofloxacin (3)
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Dear E-druggers
In response to the comment by Michele Forzley

This snapshot illustrates the issue of high prices in a straightforward
way - and clearly demonstrates that medicine prices vary widely, and
medicines could be much more affordable - especially for those living in
poverty. It doesn't aim to fully describe why and what could be done.

However, the WHO/HAI Project on Medicine Prices and Availability has a
set of tools to measure and understand prices, affordability and
availability in more depth - including a methodology which unpacks the
components of the final patient price (describing the contribution of
the manufacturers price and all the add-ons in the supply chain,
including mark-ups, taxes, and other charges) - which will then
facilitate understanding of the points where the price is high
(www.haiweb.org/medicineprices).

Once the situation is better understood, then a tailored package of
appropriate policy strategies with the aim to improve the availability
and affordability of medicines could be developed and implemented -
providing there is sufficient political determination. The effects of
the implementation of the strategies must be monitored on an ongoing
basis to enable modification of the strategies to maintain the intent as
the stakeholders inevitably react.

Best regards
Marg Ewen
HAI Global
Amsterdam
"Marg Ewen" <Marg@haiweb.org>

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E-DRUG: Results of HAI Global pill price 'snapshot' -ciprofloxacin (4)
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[In many cases, purchasers and procurers are not aware that they could be accessing medicines at better prices. When they see the results of studies like this HAI study, they take their own steps to access medicines at better prices. BS. Moderator]

I appreciate the tool to measure the price components and that this
study simply measured price disparity. My comments were not a
critcism - rather a point to be made - that is once measurement occurs
how are appropriate and effective interventions to be selected to
correspond to the weak point in the price chain and how are these to
be applied? Is there literature or studies of "what works" in this
realm? My view is we need to understand how to fix this problem - I
think we have demonstrated, studied and denounced prices. It is time
to find fixes and fix"em".

Michele Forzley, JD, MPH
Lawyer, Professor, Global Health Consultant
301-565-0680
"Michele Forzley" <mforzley@comcast.net>

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E-DRUG: Results of HAI Global pill price 'snapshot' -ciprofloxacin (5)
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Hi Marg,

Medicine price policies and availabilty of essentail medicines around the globe is a moving scene. The situation analysis developed a few yaers ago in WHO/HAI Project on Medicine Prices and Availability may not hold when the strategy for change would be ready for implementation. Many of the findings of the studies would become dated and need to be revalidated/updated after some time. Therefore, it would be necessary that the changes are being actively monitored in order to keep track of interesting new developments. There would be good changes and bad changes and both must be monitored and recorded for appropriate strategies and responses.

Perhaps I am not very current on the pricing project but please do let me know if such active monitoring is happening at the moment or if there were plans to do so.

With kindest regards,

Ayyaz

Ayyaz Kiani (BPharm, MComH, RPh)
Consultant, Access to Medicines
House # 3, Street 7/B
Sector H, DHA 2
Islamabad
Pakistan
Mobile: +92-333-5751326
Office: +92-51-2566419
Ayyaz Kiani <ayyaz_kiani@hotmail.com>