Transcript WHO-Health Action International project on drug price comparisons

WHO-Health Action International
project on drug price comparisons
A technical project of the WHO-Public interest NGO round
table on access to medicines
Background
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Evidence from small-scale studies that retail price for some drugs is
higher in low income countries than in high income settings
Practical difficulty of obtaining reliable, up-to-date information on
drug prices particularly in low income countries
Methodological difficulty of making international price comparisons
Approach to improve price transparency and empower actors
concerned with health and medicines policy
WHO-Public Interest NGO Roundtable an opportunity to launch such
an initiative
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Objectives
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To develop a simple and reliable methodology for collecting and
analysing retail drug prices across health care sectors both within and
between countries (primarily low- and middle-income).
To promote analysis of affordability, components of retail price, and
price differences within countries with a view to improving prices and
thus access to essential drugs.
To make data freely accessible on a public web site so international
price comparisons are possible
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Sources of financial support
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Netherlands government
Rockefeller Foundation
WHO
GTZ (cameroon pilot study)
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Elements covered
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“Core list” of 30 important drugs
“Supplementary lists” adapted to local needs encouraged
Retail prices at health facilities in public, private and notfor-profit sectors - NGOs -(where all three exist)
Prices of branded drug, best selling generic drug, and
lowest price generic drug to be collected
“Affordability” assessments for 9 conditions built into
worksheet (use STGs, local prices, local minimum wage)
Links in price chain (Price components) from manufacturer
to retailer to be identified
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Core list of drugs for price comparison
Amoxicillin
Ceftriaxone
Ciprofloxacin
Cotrimoxazole suspension
Phenytoin
Carbamazepine
Artesunate
Sulfadoxine + Pyrimethamine
Beclomethasone inhaler
Salbutamol inhaler
Aciclovir
Atenolol
Captopril
Hydrochlorothiazide
Nifedipine
Losartan
Lovastatin
Glibenclamide
Metformin
Omeprazole
Ranitidine
Fluconazole
Nevirapine
Zidovudine
Indinavir
Diclofenac
Amitriptyline
Fluoxetine
Diazepam
Fluphenazine
250 mg
1 g/vial
500 mg
8+40 mg/ml
100 mg
200 mg
100 mg
500+25 mg
0.05 mg/dose
0.1 mg/dose
200 mg
50 mg
25 mg
25 mg
10 mg
50 mg
20 mg
5 mg
500 mg
20 mg
150 mg
200 mg
200 mg
100 mg
400 mg
25 mg
25 mg
20 mg
5 mg
25 mg/ml
tab
vial
tab
100ml
tab
tab
tab
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200 dos
200 dos
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MSH
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category
AB
AB
AB
AB
AEP
AEP
AM
AM
asthma
asthma
AV
CV
CV
CV
CV
CV
CV
diab
diab
GI
GI
HIV
HIV
HIV
HIV
NSAID
psych
psych
psych
psych
type
acute
acute
acute
acute
chronic
chronic
acute
acute
chronic
chronic
acute
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
chronic
acute
chronic
route off-patent
oral
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injection
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oral
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oral
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oral
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oral
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oral
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oral
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inhalant
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inhalant
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oral
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oral
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oral
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oral
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oral
2
oral
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oral
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oral
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oral
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oral
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oral
1
oral
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oral
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oral
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oral
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oral
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oral
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oral
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oral
2
injection
2
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Data collection
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Self-contained Manual/Excel worksheet to guide surveys
Detailed guidance given on choosing a national or regional
representative sample (25-50 facilities) based on largest
urban area plus three other areas with randomly selected
public, private and (where applicable) NGO facilities
Core list of 30 drugs, 3 sectors, 3 prices
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International Drug Price Worksheet
Version 9 Release 01 October 2002
Press button to jump to page
Reference Prices
Country Data
Consolidation Procurement
Sector Summary
Consolidation Public
Drug Summary
Consolidation Private
Affordability
Consolidation Other Sector
Price Mark-ups
Price Composition
Press button to perform maintenance function
Erase Reference Prices
Erase Country Data
Erase Procurement Data
Erase Affordability Data
Erase Public Data
Erase Mark-ups Data
Erase Private Data
Erase Composition Data
Erase Other Sector Data
Erase & Reset All Data
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Country studies
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Armenia, Kenya, South Africa, Brazil, Sri Lanka first
pilots, then modification to methodology
Ongoing second round studies Cameroon, Philippines, Peru,
Pakistan, India, Ghana
Cost to project per country study between $0 and $8000
Overall project cost: < $300,000
Project finishes end 2002
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Data analysis & availability
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Recommended minimum analysis at country level built into
Manual
HAI web site being developed as repository for data,
allowing comparisons within and between countries for
individual drug prices and their make-up.
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Project management - advisory board
Dr Elias Mossialos, London School of Economics, UK (chair)
Dr K. Balasubramaniam, Consumers International, Malaysia
Dr. Jorge Bermudez, National School of Public Health, Brazil
Dr Jerome Dumoulin, University of Grenoble, France
Dr David Henry, Newcastle University, Australia
Ms Aarti Kishuna, Durban, South Africa
Dr Richard Laing, Boston University, USA
Dr Barbara McPake, London School of Hygiene and Tropical
Medicine, UK
Dr Zafar Mirza, Network for Consumer Protection, Pakistan
Dr Dennis Ross-Degnan, Harvard University.
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Project management - steering group
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Margaret Ewen, HAI (co-ordinator)
Andrew Creese, WHO (co-ordinator)
Harry Van Schooten, Netherlands Government
Anthony So, Rockefeller Foundation
Carmen Perez Casas, MSF
Mogha Smith, Oxfam
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