(2004; 62 pages)
Data on prices for fifty medicines (which included thirty medicines from a core list of medicines proposed by the standard methodology and twenty medicines frequently used for the top ten diseases in Ghana) were collected in the Public, Mission / NGO and Private-for-profit sectors in four regions: three were randomly selected while the Greater Accra Region was purposively selected as the host of the capital city. Data was collected on availability and patient prices for the innovator brand, most sold generic equivalent (MSG), and the lowest priced generic equivalent (LPG) for each of the fifty medicines. Public and Mission sector procurement prices were also collected. Finally, the components which contribute to the final patient price were collected both for the Public and the Private sectors through structured interviews. The cost of usual treatment was calculated for some common diseases and was compared to the daily wage of the lowest paid government worker.
Results: The results revealed that in Ghana, where about 45% of the population live on less than one US dollar per day, and the lowest paid government worker earns only about one US dollar per day, the prices of medicines were high and unaffordable for many. Further results of the study showed that there was no discernable relationship between the prices paid by patients and the procurement prices in the Public and Mission sectors. The Mission sector patient prices were on average twelve percent higher than the Public sector patient prices; the Private sector prices were considerably higher still. The prices of innovator brands were much higher than their generic equivalents. For a basic monthly treatment for peptic ulcer in the Private Retail Pharmacy, for example, the price would require 86.6 days’ wages for an innovator brand treatment and 10.9 days for treatment with its generic equivalent.
There was higher availability in Private Retail Pharmacy than in Public and Mission sectors. Availability was calculated for 39 medicines and it was found that for most (27 medicines), availability was less than 50% in the Public sector. Availability for 23 medicines was less than 50% in the Mission sector, while availability for 6 medicines was less than 50% in the Retail Pharmacy sector.
The percentage availability of innovator brands in the Public and Mission sectors was low, indicating a level of adherence to the policy of generic prescribing and dispensing in these sectors. Even though availability was generally higher in the Private Retail sector, prices were also relatively higher as noted above.
Duties, tariffs and markups significantly contributed to the final price of medicines (30- 40% for taxes and tariffs, and 50-200% for markups).