MeTA - Prices of medicines

The most effective medicine in the world is useless if it is priced too high. But the price of a medicine is not just the manufacturing cost; taxes, tariffs, wholesaler, supplier and retailer charges and transport and other costs, as well as corruption and fraud, all add to the final cost to the patient. Improving inefficient systems can help to reduce the costs of medicines.

Resources in this key list look at some of the reasons medicines prices are so high, how medicines prices can be measured, and how improvements in health systems might be made to help bring prices down.

We will add to this key list over time and would welcome suggestions or additions. Please send these to: sourceassistant@hi-uk.org

Selected resources

Books, reports, etc

Benchmarking antiretroviral prices in countries of the former Soviet Union

WANING, Brenda
et al
June 2008

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This study benchmarks ARV prices of former Soviet Union (FSU) countries against each other and against global and European region ARV prices. The study reveals that extreme price variation exists within and across FSU countries for identical ARVs, which suggests that some countries may be able to obtain ARVs at lower prices and therefore purchase additional ARVs to treat more people

Genocide by denial : how profiteering from HIV/AIDS killed millions

MUGYENYI, Peter
2008

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This open access book charts the spread of AIDS and its impact on people in villages in Uganda, sub-Saharan Africa and the rest of the world and the unnecessary numbers of deaths, particularly among poor people that it has caused. It also looks at the campaign to gain universal access to anti-retroviral therapy and the limited level of response from the rich world. The author challenges pharmaceutical companies to develop more ethical and humanitarian ways to trade, involving crucial life-saving drugs, and calls for a new world order to ensure entitlement of the poor to rapid humanitarian relief

Guidelines for price discounts of single-source pharmaceuticals

WORLD HEALTH ORGANIZATION (WHO). Essential Drugs and Medicines Policy
et al
2003

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These guidelines are designed to maximise the benefit of price discounts arrangements for single-source products. They are intended for policy makers and technical staff in international and bilateral agencies active in international health development support, for pharmaeutical companies and for governments and NGOs in recipient countries. It highlights a number of issues that WHO feels need to be considered when planning or negotiating offers of price discounts

Medicine prices : a new approach to measurement

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)
2003

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This manual describes a new approach to measuring the prices people have to pay for a selection of important medicines in different medicine outlets. The manual also describes how to collect information on price composition (taxes, mark-ups, fees) and assess the affordability and availability of medicines

Medicine prices surveys and proposed interventions to improve sustainable access to affordable medicines in 6 sub-Saharan African countries|Etudes des prix des medicaments et interventions proposeees pur ameliorer durablement l'acces aux medicaments dan

WORLD HEALTH ORGANIZATION (WHO)
2006

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This document brings together the outcomes of six surveys into medicine prices - for Ghana, Kenya, Mali, Tanzania, Chad and Uganda - and one for the East African Community (Kenya, Uganda and Tanzania) . The reports for Mali and Chad are written in French and the others in English

Price, availability and affordability : an international comparison of chronic disease medicines

GELDERS, Susanne
et al
2006

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This is an analysis of the data collected in recent surveys of originator and generic medicines used to treat chronic diseases, and demonstrates that the price, availability and affordability are optimal for neither product types in most of the countries surveyed. The report is intended to be used by policy-makers and programme managers responsible for pricing, price regulation, procurement and other regulatory affairs related to chronic diseases, and can also be used for civil society groups wanting to advocate for pricing policies to make medicines more affordable and available

Public and private sector approaches to improving pharmaceutical quality in Bangladesh

KOSTERMANS, Kees
et al
March 2008

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"Low-cost high-quality drugs benefit society and helps provide pharmaceutical companies a competitive edge. This study presents the issues that must be considered to achieve these common objectives in Bangladesh and explores options that the Government and the local industry could pursue. "Previous efforts to improve the drug quality in Bangladesh focused, without much success, on stricter regulation of the public market. This paper addresses this issue from a more private sector approach. The existing quality and price of pharmaceuticals are analysed and alternative mechanisms are explored to improve the quality and cost competitiveness of Bangladesh’s pharmaceuticals domestically and internationally"

Remuneration guidelines for non-voluntary use of a patent on medical technologies

WEISSMAN, Robert
Ed
2005

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This document provides guidelines for determining reasonable royalties or adequate remuneration for the manufacture or sale of medicines. The emphasis is on patent systems easy to administer and not overly complex, setting royalty levels that should not prevent access to medicines. The document includes an overview of WTO TRIPS provisions, examples of royalty setting, considerations for developing a policy framework for remuneration and non-voluntary use of patents on medicines, royalty guidelines and an evaluation of the Medical Innovation Prize Fund system of remuneration. This document is primarily aimed at policy makers and national governments

The push for local production, costs and benefits - a case study of Uganda’s Quality Chemicals|Africa Fighting Malaria policy paper

TAYLOR, James
et al
September 2009

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This research report considers the challenges faced by a local pharmaceutical firm - Quality Chemicals - in Uganda, which was started up as a 'solution' to reducing the high cost of medicines and improving access to medicines. "...many burdens and barriers to access continue to seriously hinder the success of such enterprises. Indirect government subsidies to exporters selling into African markets, and pressure by donors and lobbyists on innovator producers to offer developing countries subsidised prices, actually undermine the competitiveness and viability of these nascent firms. Furthermore, the focus on drug pricing and local production can actually undermine the overall aim to increase access to medicines"

Serials

Focus on pricing policies : EMRO ministers confront high prices

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)
2007

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The focus of this edition of HAI and WHO's bulletin for medicines prices surveys is a meeting of the regional committee of the WHO's Eastern Mediterranean region (EMRO) at which the results of 11 medicines pricing surveys carried out in the region were compared and discussed and it was decided to share information regionally

Guidelines on policies that affect medicine prices

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION(WHO)
2008

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At a time when over 50 medicines pricing surveys had been completed around the world using the HAI/WHO methodology, the lead article to this edition of the medicines pricing survey bulletin considers the need for guidelines to assist in the creation of policy changes that will help to reduce the price of essential medicines

Improved availability of essential medicines needed

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)

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The lead article in this edition of the HAI and WHO medicines prices survey quarterly bulletin focuses on the need to improve the availability of essential medicines. Since 2003, medicines prices surveys have been carried out in a number of countries using a survey tool designed by WHO and HAI

Taxing essential medicines : a sick tax that hinders access to treatment

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)
December 2009

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This issue of the bulletin includes articles about the taxes on medicines and access to medicines; a report of a survey about medicine prices and availability in Latin America and the Caribbean; and about poor access to diabetes care in the Philippines

The Lancet : essential medicines out of reach of most people

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)
December 2008

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The lead article of this edition of the WHO and HAI medicines pricing survey quarterly bulletin picks up on an article published in the Lancet which highlights the financial burden faced by many people living in low and middle income countries when having to pay for essential medicines

UN MDG gap task force report

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)
September 2008

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Making essential medicines more affordable and more widely available are essential in helping to meet the millennium development goals. The lead article of this edition of HAI and WHO's medicines pricing survey bulletin, looks at UN Secretary General Ban Ki Moon's response to a mid-term progress report from the MDG Gap Task Force

Journal articles

Special issue on access to medicines, pricing and generics

September 2009

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This issue has articles about medicine prices in Vietnam, Thailand and South Africa, generic medicines in Malaysia and Australia, anti-retroviral therapy in South Africa, and legislation and regulation in the retail pharmacy sector in low-income countries.
Southern Med Review : Vol 2, Issue 2

Towards equitable access to medicines for the rural poor : analyses of insurance claims reveal rural pharmacy initiative triggers price competition in Kyrgyzstan

WANING, Brenda
et al
December 2009

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This article examines medicines price competition that ensued in a rural village in Kyrgyzstan after the opening of a small network of non-profit pharmacies created and managed by an NGO. While the rural pharmacies were created to increase access to medicines in villages where no pharmacies existed, the project had unexpected, substantial spillover effects, spurring medicines price reductions in pharmacies quite far away

Multimedia

Measuring medicine prices, availability, affordability and price components

WORLD HEALTH ORGANIZATION (WHO)
HEALTH ACTION INTERNATIONAL (HAI)
2008

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This manual is to help governments, civil society groups and others concerned about the prices of medicines to collect and analyse: medicine prices (patient prices and government procurement prices) across sectors and regions in a country; medicine availability; treatment affordability; and all price components in the supply chain from manufacturer to patient (taxes, mark-ups etc.). It is accompanied by a CD-ROM which contains a more extensive collection resources and tools, such as sample training materials, frequently asked questions, and a report template for use in developing national survey reports

Websites

A call for transparency in medicine pricing

HARTIGAN-GO, Kenneth
October 2008

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This blog sets out the need for a transparent medicine pricing mechanism in the Philippines backed up by the development of a responsive, competitive pharmaceutical sector capable of undertaking science and technology activities

AIDS medicines and diagnostics services (AMDS)

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The AMDS is the secretariat of a network for supply management of HIV commodities and brokers cooperation between technical partners, funding agencies, manufacturing companies and other organisations. AMDS also operates a clearing house collecting and disseminating strategic information through Global price reporting mechanism, Drug regulatory data database, and ARV forecast integrated in this website or through a dedicated website for procurement and supply management (PSM Tools)

Medicine prices

HEALTH ACTION INTERNATIONAL, EUROPE

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This website contains a database of the results of over 50 surveys, along with survey reports and other information about the prices of medicines in different countries. The surveys were carried out following the publication by Health Action International and the World Health Organization (Department of Medicine Policy and Standards) of a working draft manual to collect and analyse the prices people pay for a selection of important medicines across sectors and regions in a country, as well as medicine availability, treatment affordability and all price components in the supply chain (taxes, mark-ups etc.) in 2003. Governments, NGOs and others concerned about the prices of medicines are encouraged to undertake a survey using the methodology outlined in the manual because reliable data is seen as the first step to exploring policy options and taking action to reduce prices and improve availability

Pan-African Treatment Access Movement (PATAM)

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PATAM is a social movement of individuals and organisations dedicated to mobilising communities, political leaders and all sectors to ensure access to antiretroviral (ARV) treatment, as a fundamental part of comprehensive care for all people with HIV/AIDS in Africa. The PATAM was created in response to the unacceptable situation where the greatest number of people living with HIV/AIDS in the world today are located on the African continent but do not have sufficient access to lifesaving medications. The site contains useful information on HIV and AIDS, advocacy strategies, and resources. It also provides links to information on treatment response strategies, treatment literacy and drug pricing

UNITAID : together to heal

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UNITAID’s mission is to contribute to scaling up access to treatment for HIV and AIDS, malaria and tuberculosis, primarily for people in low-income countries, by leveraging price reductions for quality diagnostics and medicines and accelerating the pace at which these are made available