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Medicineprices,availability,andaffordabilityin?36developingandmiddle-incomecountries:asecondaryanalysisA Cameron,MEwen,D Ross-Degnan,DBall,RLaingSummaryBackground WHO and Health Action International (HAI) have developed a standardised method for surveyingLancet 2009;373:240-49medicineprices,availability,affordability,andpricecomponentsinlow-incomeandmiddle-incomecountries.HePublishedOnlineDecember1,2008we presenta secondary analysis of medicine availability in 45 national and subnational surveys doneusing theO:10.1016/S0140-WHO/HAI methodology.6736(08)61762-6Commentpage191Methods Data from 45 WHO/HAI surveys in 36countries were adjustedforinfation or deflation and purchasingitial Medicines andpowerparity.Intermational reference prices from open international procurements for genericproducts were usedasPharmaceuticalPolicies,Worldcomparators,Results arepresented for 15 medicines included in at least 80% of surveys and four individualHealthOrganization,Geneamedicines.Switzerland(A Cameron MPH);HealthAction InternationalAmsterdam,NetherlandsFindingsAveragepublicsectoravailabilityofgenericmedicinesrangedfrom29.4%to54.4%acrossWHOregions.(M Ewen Dip Pharm); HarvardMedian govermment procurement prices for 15 generic medicines were 1-11 times corresponding intermationaMedical School and HarvardPilgrimHealthCare,Bostonreferenceprices,althoughpurchasingefficiencyrangedfrom0.09to537timesinternationalreferenceprices.Low1MA, USA(DRoss-Degnan ScD);procurementpricesdidnotalwaystranslateintolowpatientprices.Privatesectorpatientspaid9-25timesinternationalPharmaceuticalconsultant,referencepricesforlowest-pricedgenericproducts andover20times international referencepricesfororiginatorManila, Philippines(DBall PhD);products acrossWHOregions.Treatments foracuteandchronic illnesswere largelyunaffordableinmanycountriesand Essential Medicines andPharmaceuticalPolicies,WorldIntheprivatesector,wholesalemark-upsrangedfrom2%to380%,whereasretailmark-upsrangedfrom10%HealthOrganization,Genevato552%.Incountrieswherevalueaddedtaxwasappliedtomedicines,theamountchargedvariedfrom4%to15%
PLOSMEDICINEOPENACCESSFreelyavailable onlineEvaluating Drug Prices, Availability,Affordability, and Price Components:Implications for Access to Drugs in MalaysiaZaheerUdDinBabar,MohamedIzhamMohamedIbrahim,Harpal Singh2,NadeemIrfanBukahri3,AndrewCreese1DisciplineofSocialandAdministrativePhamacySchoolofPhamaceutical Sciences,UniversitiSainsMalaysia,Penang,Malaysia,2SchoolofPharmaceuticalScienceUniversityCollegeSedayanternational,KualaLumpur,Malaysia,3SchoolfPharmacyInternational Medical UniversityKualaLumpur,Malaysia,4LaGrile,LesVentesdBourse, FranceFunding: Financial support to carryABSTRACTout this work was grantedby HealthActionInternational,Theprojectwasendorsed by the World HealthBackgroundOrganizationThefundershadnoroleinstudydesign,data collectionMalaysia's stablehealthcaresystemisfacing challengeswith increasingmedicinecosts.Toand analysis, decision to publish,orpreparation of the manuscript.investigate these issues a survey was carried out to evaluate medicine prices,availabilityaffordability,and the structure of price components.Competing Interests: The authorshavedeclaredthatno competinginterests existMethods and FindingsAcademicEditorKenHarvey,LaThe methodologydevelopedbythe World Health Organization(WHO)andHealthActionTrobeUniversityMelbourne,AustraliaInternational(HAl)wasused.Priceandavailabilitydatafor48medicineswascollectedfrom20publicsectorfacilities,32privatesectorretail pharmaciesand20dispensingdoctorsinfourCitation:BabarZUD,IbrahimMIM,geographical regions of West Malaysia,Medicine prices were compared with internationalSingh H, Bukahri Nl, CreeseA (2007)Evaluating drug prices, availability,referenceprices(IRPs)to obtain a medianprice ratio.Thedaily wageof thelowestpaidaffordability,andpricecomponents:unskilled government worker was usedto gauge the affordabilityof medicines. PriceImplicationsforaccesstodrugsincomponentdata were collectedthroughout the supply chain, and markups,taxes,and otherMalaysia.PLoS Med4(3):e82. doi:10
HealthPolicyandPlanningAdvanceAccesspublishedDecember1,2oo9Published by Oxford University Press in association with The London School of Hygiene and Tropical MedicineHeabhPvkyandPlanrbg2009;111TheAuthor 2009,all rights reserved.do:10.1093/heapol/czp056Prices,availability and affordability of essentialmedicines in rural areas of Hubei Province,ChinaHao Yang,12HassanH.Dib,MinminZhu,Gang Qi'and Xinping Zhang''Tongii Medical College, Huazhong University of Science and Technology,. 13 Hangkong Road, Wuhan, Hubei Province, 430030, P, R, China,The People'sHospital of Guangxi Zhuang Autonomous Region, 6Taoyuan Road, Nanning,Guangxi Zhuang Autonomous Region, 53o021,P.R. China, Peking University Health Science Center, School of Public Health, Health Policy and Management Department, 38 Xue YuanRoad, Haidian District, Beijing 1ooos3, P. R. China, *Shenzhen Nanshan Chronic Diseases Control Center, 7 Huaming Road, NanshanDistrict, Shenzhen, Guangdong Province, 518o54, P. R. China and The First People's Hospital of Xiangfan, Endocrine Department75Jiefang Road,FanchengDistrict,Xiangfan,HubeiProvince,441ooo, P.R.China+Corresponding author. Professor in Health Policy and Management, Tongi Medical College, Huazhong University of Science andTechnology.13 Hangkong Road, Wuhan,Hubeiprovince,430030,P.R.China.E-mail:xpzhang602@163.com.Tel:+86-27-8369-2332.Fax:+86-27-8369-2996Accepted23July2009ObjectiveTo investigate the availability of essential medicines and their prices in Hubeiprovince.MethodsThe survey assessed the prices and availability of essential medicines usingthe World Health Organization and Health Action International methodologyData were collected from18 public hospitals and 18 private pharmacies.At each facilitythe availability andprices of 39 innovator brand medicinesand lowest-price generic equivalent medicines were collected. Medicine prices
办营务会中中中杂骨零云务骨0T6中中六营老心POO#i子T#甲ere护种串车营Measuringmedicine prices,availability,affordability and pricecomponents2NDEDITIONhaiWorld HealthOrganizationDLOBAR