A. Creese

ANDREW CREESE

EVERY day millions of people throughout the world go without treatment because they cannot afford the medicines they need. People in industr- ialised countries generally have insurance or subsidies that cover most of the price of their medicines. But those in poorer countries with less well developed health systems, typically pay the full cost of almost all of their medicines themselves. These are the people who know that medicine prices are a problem. Although prices may vary quite a bit within a country, people usually do not have the information about what prices are, or where to find the best prices. The same is often true of government authorities dealing with medicines.

Enough to give you an ulcer? If someone actually has a peptic ulcer and requires a month's treatment, the brand version of ranitadine will cost the equivalent of:

• 13 day's wages in the Philippines' private sector;

• nearly 19 day's wages in Armenia;

• and 50.5 day's of pay in Cameroon - almost two month's pay for one month's treatment

It's easy to see how a family's whole income can easily be consumed by the medicines bill. Of course, people might be able to get their ulcer medicine at lower prices, if they can find generic equivalents from public sector sources. But in two of the three countries mentioned above (Armenia, Cameroon) the generic was not found. In the Philippines ulcer treatment costs are 12 day's pay - one day less than for the brand drug from the public sector.

There are dozens of medicines and hundreds of prices. The same medicine may have different prices, in its originator brand or generic form, in public, charitable agency or private pharmacies, in urban and rural areas. This makes it impossible for the public to know what is a "best buy" and where they can get it.

Medicine Prices - a new approach to measurement is an important step towards making price information for key medicines more widely available and more easily understood. The manual and the accompanying software and database also help to clarify what makes up today's prices. Reliable information on what prices are and how they are made up is a first step to better negotiation, management and policy to make medicines more affordable by bringing prices down.

The launch of the WHO/HAI Medicine Prices manual at the World Health Assembly 2003

Photo: HAI