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Annual Report 2002 - Essential Drugs and Medicines Policy: Supporting Countries to Close the Access Gap
(2003; 20 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentDeveloping a monitoring culture to improve impact
View the documentTraditional and complementary medicine: putting policy into action
View the documentKey country support in Africa and Eastern Mediterranean
View the documentWHO Collaborating Centres: supplying active support for medicines work
View the documentHow is TRIPS affecting access to medicines?
View the documentDevelopment of the essential drugs concept over the past 25 years
View the documentMeasuring access to antimalarials
View the documentStrengthening regional and national bulk procurement
View the documentLearning from successful supply systems
View the documentWorking out the cost of medicines
View the documentSupporting MDG target on access to essential medicines
View the documentCommon guideline for evaluating new medicines in Baltic countries
View the documentNGO toolkit for improving access to HIV/AIDS treatment
View the documentHarmonizing medicines regulation in the Americas
View the documentGood manufacturing practice in China: rapid progress
View the documentPharmacovigilance: detecting and reporting adverse drug reactions
View the documentVariations in prescribing information in 26 countries
View the document10th ICDRA: an international basis for medicines regulation
View the documentFighting poor-quality drugs
View the documentImproving medicines use in hospitals in Cambodia and Lao PDR
View the documentWHO-India Essential Drugs Programme: multiplying impact
View the documentOman: improving antibiotic use in primary health care

Working out the cost of medicines

Civil society organizations took a prominent early lead in drawing attention to the need to increase access to medicines in the fight against poverty. Dialogue between such organizations and WHO led to a joint WHO-Health Action International project to promote greater openness and better information on medicines prices and availability, as a means of tackling access problems.

The first phase of the project was completed in December 2002. This included development of a methodology for monitoring medicines prices and publication of a manual on how to apply that methodology in individual developing country settings. The methodology can be used to establish whether prices are high or low, availability, price differences between branded medicines and generics, and between sectors, and the elements of price composition. A worksheet enables investigators to measure the affordability of treatment for 9 common conditions.

Field test results and potential impacts

Results from the field tests showed, for example, that in Kenya's private retail sector the median "brand premium" (median price ratio of branded to generic medicines) was "over 5" - meaning that innovator brands cost, on average, over 5 times more than the most-sold generic equivalents. In Brazil, by contrast, the "brand premium" was much lower - close to 0.33. Nevertheless, in Brazil's private sector, as in Kenya, big differences were observed between international prices for individual medicines (the price of brand ciprofloxacin was over 80 times higher than the international reference price. The methodology is also being used in Africa to investigate prices of antimalarials.

Private sector retail prices in 2002 for innovator brand ciprofloxacin, varied widely across 8 countries indicating considerable scope for more effective price regulation

In 2001, innovator brand and generic furosomide prices in relation to the international reference price varied considerably across five countries, indicating scope for improving the affordability of medicines


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