E-DRUG: TB-treatment in Cameroon (4)
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I am surprised cost of treatment is said to be USD 150-200 in a Missionary
Health Provider in Cameroon. CENAME sells anti-TB drugs at normal
international prices, compared to AFRO price indicator july 98 minimum and
maximum prices:
ethambutol 400 mg : francs cfa 14.95 -> usd 0.024 (AFRO: from 0.0166 to
0.0284)
pyrazinamide 500 mg : francs cfa 20.65 -> usd 0.331 (AFRO :0.0378-0.0403)
rifampicine 150 mg + isoniazide 100 mg francs cfa 17.8 -> usd 0.028 (AFRO :
0.0247 -0.1029)
I made a rough computation for a six month treatment (regimen given by WHO
: "TB/HIV, a clinical manual , WHO/TB/96.200, page 84 for a 70 kg patient)
which gives a total cost of USD 43 (daily treatment) to USD 52
(intermittent treatment 3x week).
CENAME margins on these drugs are from 2.45 % (ethambutol) to 13.18 %
(pyrazinamide). CENAME selling prices could be lower but not much except if
CENAME accepts to subsidize anti-TB drugs. Cross subsidizing is a powerful
way to have low prices for selected treatments .
Conclusion : If the health provider buys anti-TB-drugs at international
prices and puts no margin, the cost will be around USD 40-50. This price is
yet too high for many patients. So central medical stores and health
providers should subsidize anti-tb drug as long as TB control is considered
as one of the more expensive treatments and is a priority.
This proposal doesn't exclude other actions proposed by Tom Puls and
Wilbert Bannenberg)
J�r�me Dumoulin
Institut de Recherche Economique sur la Production et le D�veloppement
Universit� Pierre Mend�s-France
BP 47
F 38040 Grenoble Cedex 9
tel : 33-(0)4 76 82 54 50
fax : 33-(0)4 76 82 59 89
Email: Jerome.Dumoulin@upmf-grenoble.fr [manually added; WB]
[Good to have a {pharmaco-} economist on board! Thanks Jerome, for that
calculation. Maybe someone should publish a list of costs for ordinary
standard treatments for the most frequent conditions? WB]
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