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Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia

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 devel...

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Autores principales: Babar, Zaheer Ud Din, Ibrahim, Mohamed Izham Mohamed, Singh, Harpal, Bukahri, Nadeem Irfan, Creese, Andrew
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1831730/
https://www.ncbi.nlm.nih.gov/pubmed/17388660
http://dx.doi.org/10.1371/journal.pmed.0040082
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author Babar, Zaheer Ud Din
Ibrahim, Mohamed Izham Mohamed
Singh, Harpal
Bukahri, Nadeem Irfan
Creese, Andrew
author_facet Babar, Zaheer Ud Din
Ibrahim, Mohamed Izham Mohamed
Singh, Harpal
Bukahri, Nadeem Irfan
Creese, Andrew
author_sort Babar, Zaheer Ud Din
collection PubMed
description 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.
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spelling pubmed-18317302007-03-24 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 Creese, Andrew PLoS Med Research Article 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. Public Library of Science 2007-03 2007-03-27 /pmc/articles/PMC1831730/ /pubmed/17388660 http://dx.doi.org/10.1371/journal.pmed.0040082 Text en © 2007 Babar et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Babar, Zaheer Ud Din
Ibrahim, Mohamed Izham Mohamed
Singh, Harpal
Bukahri, Nadeem Irfan
Creese, Andrew
Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia
title Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia
title_full Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia
title_fullStr Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia
title_full_unstemmed Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia
title_short Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia
title_sort evaluating drug prices, availability, affordability, and price components: implications for access to drugs in malaysia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1831730/
https://www.ncbi.nlm.nih.gov/pubmed/17388660
http://dx.doi.org/10.1371/journal.pmed.0040082
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