PRICING – Worldwide survey on the actual cost of medicines

To illustrate the issue of high medicine prices, Health Action International (HAI) undertook a one day global ‘snapshot’ of the price of ciprofloxacin, a commonly-used off-patent antibiotic. The ‘snapshots’ indicate the full retail price a patient pays at a pharmacy on that day.  Data were collected from 93 countries. Individuals from HAI’s extended network collected the prices for both the originator brand product manufactured by Bayer and the lowest priced generic equivalent in the pharmacy. An interactive map is on HAI’s website, indicating the price variations between the Bayer originator product and the generic product, for a 7 day treatment course (14 tablets) in US$ using the exchange rate of 30 November 2009.


In South East Asia, on average both the originator brand price (US$17.46) and the price of the lowest priced generic (US$1.19) were substantially less than prices in other regions. For example the originator brand was 16 times the price of the lowest priced generic (as found in Africa). A course of the originator brand varied in price from about US$57 in Malaysia to about US$2 in Nepal and India. Generic prices ranged from about US$32 in Australia to less than US$1 in Myanmar (US$0.42), Sri Lanka (US$0.57), Indonesia (US$0.66), Viet Nam (US$0.66) and Lao PDR (US$0.59).  Indonesia had the largest brand premium with the originator brand priced at over 47 times the price of the lowest priced generic. By contrast, in India the originator brand was only 30% more than the generic.


The variation in price across countries within each income level was greater for the originator brand compared to the generics. For example, in lower middle-income countries the originator brand price varied from US$2 to US$131 whereas generics ranged from less than US$1 to US$27. Generic ciprofloxacin is available at much lower prices than the originator brand product. In many countries, the price of the generic versions could be much lower and more affordable. 


To improve treatment affordability, interventions are needed to *increase the use of low priced generics*. Governments need to ensure only good quality medicines are on the market and mandate generic substitution and create incentives for the dispensing of low priced generics. Sickness cure should not cost the sky.


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