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Comparing Medicine Prices Among Countries

Comparing Medicine Prices Among Countries. Why compare across countries?. Principal investigators want to know how their results differ from other countries’ results WHO/HAI and external users want to describe world drug markets from consumer perspective inform global drug policy discussions

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Comparing Medicine Prices Among Countries

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  1. Comparing Medicine Prices Among Countries

  2. Why compare across countries? • Principal investigators want to know how their results differ from other countries’ results • WHO/HAI and external users want to • describe world drug markets from consumer perspective • inform global drug policy discussions • examine variations in results in light of differences in local policy environments

  3. What can we compare? • Single drug comparisons, e.g.: • MPR – ratio of median price found to international reference price, in USD • affordability – # days wages for std. tx. • Summary statisticsacross many drugs in each country, e.g.: • median MPR for all innovators at retail • interquartile range of MPRs

  4. Most Sold Generic Innovator Brand Median Price Ratios for Nifedipine (Retail)

  5. Most Sold Generic Innovator Brand Days’ Wages for Nifedipine Tx (Retail)

  6. Summary stats: Retail MPR medians & IQRs,  Innovator Brand Most Sold Generic

  7. Challenges of cross-country comparisons… Single-drug comparisons • WHO/HAI core list of 30 drugs  • Opportunities for 1-drug comparisons • However: • local epidemiological profiles differ • local treatment approaches differ • national registration & patent status differ market share & role for drug differ

  8. Economic vagaries • currency exchange rate, currency values • purchasing power • generosity of min. government wage • Name-brand drugs • source & country of origin vary • quality may vary? • “Lowest priced” generics • names not specified • names vary within, between countries • quality varies – how much?

  9. Challenges of cross-country comparisons… Summary stats over many drugs • Variations in lists of drugs surveyed • core substance or strength not available • local supplementary drugs • To keep in mind: • multi-drug summary statistics are crude indices only • nevertheless, orders of magnitude are probably meaningful

  10. Median Price Ratios for omeprazole Most Sold Generic Innovator Brand

  11. Days’ wages for omeprazole treatment

  12. Caveats for making cross-country comparisons… • Single-drug comparisons: • good validity • but still not perfect • Multi-drug comparisons: • less valid when lists differ • matched drugs  always more valid • but matching drugs  smaller sample (less reliable)

  13. Caveats for making cross-country comparisons… • Give typical values, not extremes • Large differences more likely “real” than small differences • Be as transparent as possible • append details underlying analyses • post drug names & origins on HAI web • Use cautious language • Starting point only  keep digging

  14. WHO/HAI survey in Rajasthan, IndiaWeb-based pharmacies for US consumers, in US vs. abroad(using LPG)

  15. 8 Pilot Surveys + India + US websitesMedians and IQRs of MPRs(Private For-Profit)

  16. Lowest Priced Generics – Prices to PtsMedians and IQRs of MPRs Public Sector Mission Sector

  17. Public Procurement Prices for GenericsMedians and IQRs of MPRs * pub. teaching hosps buying on local private market

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