Low availability, high prices keep essential medicines out of reach: WHO study
An alarming lack of availability of essential medicines in the public-sector drives patients to pay higher prices in the private sector or go without, according to this 2008 study.
The results show an average public-sector availability of only 38% across surveyed countries, forcing patients to buy medicine from the private sector where treatments are frequently unaffordable. Specifically, the study revealed that add-ons by wholesalers, distributers and retailers plus government taxes and duties are driving prices beyond affordability in many countries. In some countries, these costs can double the public-sector price of medicine, while in the private sector, wholesale mark-ups ranged from 2% to 380%, and retail mark-ups ranged from 10% to 552%.
In Africa, for example, the lowest-paid government worker needs to spend 2 days' salary each month to purchase diabetes treatment using the lowest-priced generic medicine. When the originator brand is used, costs escalate to over 8 days' wages.
The study also identified key steps that countries can take to make life-saving medicines more available and accessible including: national medicines policies that are measured and evaluated against pre-determined benchmarks at least every two years, with routine monitoring and reporting, as well as steps to improve financing and distribution efficiency, promote the use of generic products and control supply chain costs by limiting mark-ups and removing duties and taxes.
Conducted by World Health Organization (WHO) and others, the study analysed medicine availability and pricing data from 45 surveys in 36 countries spanning all WHO geographical regions and World Bank income groups. The figures are adjusted to account for differences in buying power of local currencies and then compared to international reference prices, allowing for cross-country comparison. The work is part of an ongoing joint effort between WHO and Health Action International (HAI) to highlight and improve availability and affordability of essential medicines, especially in low- and middle-income countries.
For access to country reports and survey data, visit the HAI website at: www.haiweb.org/medicineprices