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Evaluating drug prices, availability, affordability, and price components: implications for access to drugs in Malaysia.

Babar, Zaheer-Ud-Din, Ibrahim, Mohamed Izham Mohamed, Singh, Harpal, Bukahri, Nadeem Irfan and Creese, Andrew (2007) Evaluating drug prices, availability, affordability, and price components: implications for access to drugs in Malaysia. PLoS medicine, 4 (3). e82. ISSN 1549-1676

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Abstract

BACKGROUND

Malaysia's stable health care system is facing challenges with increasing medicine costs. To investigate these issues a survey was carried out to evaluate medicine prices, availability, affordability, and the structure of price components.

METHODS AND FINDINGS

The methodology developed by the World Health Organization (WHO) and Health Action International (HAI) was used. Price and availability data for 48 medicines was collected from 20 public sector facilities, 32 private sector retail pharmacies and 20 dispensing doctors in four geographical regions of West Malaysia. Medicine prices were compared with international reference prices (IRPs) to obtain a median price ratio. The daily wage of the lowest paid unskilled government worker was used to gauge the affordability of medicines. Price component data were collected throughout the supply chain, and markups, taxes, and other distribution costs were identified. In private pharmacies, innovator brand (IB) prices were 16 times higher than the IRPs, while generics were 6.6 times higher. In dispensing doctor clinics, the figures were 15 times higher for innovator brands and 7.5 for generics. Dispensing doctors applied high markups of 50%-76% for IBs, and up to 316% for generics. Retail pharmacy markups were also high-25%-38% and 100%-140% for IBs and generics, respectively. In the public sector, where medicines are free, availability was low even for medicines on the National Essential Drugs List. For a month's treatment for peptic ulcer disease and hypertension people have to pay about a week's wages in the private sector.

CONCLUSIONS

The free market by definition does not control medicine prices, necessitating price monitoring and control mechanisms. Markups for generic products are greater than for IBs. Reducing the base price without controlling markups may increase profits for retailers and dispensing doctors without reducing the price paid by end users. To increase access and affordability, promotion of generic medicines and improved availability of medicines in the public sector are required.

Item Type: Article
Subjects: R Medicine > RS Pharmacy and materia medica
Schools: School of Applied Sciences
Related URLs:
Depositing User: Zaheer Babar
Date Deposited: 24 May 2017 11:28
Last Modified: 25 May 2017 11:48
URI: http://eprints.hud.ac.uk/id/eprint/31989

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