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Insulin price components: case studies in six low/middle-income countries
INTRODUCTION: Understanding price components for insulin products can help design interventions to improve insulin affordability in low/middle-income countries. METHODS: An adapted WHO/Health Action International standardised methodology was used in Brazil (Rio de Janeiro), China (Hubei and Shaanxi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747921/ https://www.ncbi.nlm.nih.gov/pubmed/31565414 http://dx.doi.org/10.1136/bmjgh-2019-001705 |
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author | Ball, Douglas Ewen, Margaret Laing, Richard Beran, David |
author_facet | Ball, Douglas Ewen, Margaret Laing, Richard Beran, David |
author_sort | Ball, Douglas |
collection | PubMed |
description | INTRODUCTION: Understanding price components for insulin products can help design interventions to improve insulin affordability in low/middle-income countries. METHODS: An adapted WHO/Health Action International standardised methodology was used in Brazil (Rio de Janeiro), China (Hubei and Shaanxi Provinces), Ghana, India (Haryana State), Indonesia and Uganda. Selected insulin products had their prices traced backwards through the supply chain from public and private sector retail outlets in the capital city and a district town, supplemented with key informant interviews. RESULTS: Cumulative mark-ups ranged from 8.7% to 565.8% but the magnitude of mark-ups was country specific and variable within and across sectors and regions. The proportion of the patient price attributed to the manufacturer’s selling price varied from 15.0% to 92.0%. Pricing regulations in China, India and Indonesia reduced wholesale and retail mark-ups but did not guarantee low prices. Most countries had removed import duties (Ghana, India, Indonesia, Uganda), but additional tariffs of 3.5% were still applied in Ghana. Value-added tax in the private sector ranged from 5% to 20% across the countries. CONCLUSION: There are no clear trends in the mark-ups applied to insulin or specific differences in the price structure. A uniform approach to improving insulin access through regulating price components is unlikely to be successful, but elimination of duties and taxes, price regulation and greater price transparency could help influence prices and hence affordability. |
format | Online Article Text |
id | pubmed-6747921 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-67479212019-09-27 Insulin price components: case studies in six low/middle-income countries Ball, Douglas Ewen, Margaret Laing, Richard Beran, David BMJ Glob Health Research INTRODUCTION: Understanding price components for insulin products can help design interventions to improve insulin affordability in low/middle-income countries. METHODS: An adapted WHO/Health Action International standardised methodology was used in Brazil (Rio de Janeiro), China (Hubei and Shaanxi Provinces), Ghana, India (Haryana State), Indonesia and Uganda. Selected insulin products had their prices traced backwards through the supply chain from public and private sector retail outlets in the capital city and a district town, supplemented with key informant interviews. RESULTS: Cumulative mark-ups ranged from 8.7% to 565.8% but the magnitude of mark-ups was country specific and variable within and across sectors and regions. The proportion of the patient price attributed to the manufacturer’s selling price varied from 15.0% to 92.0%. Pricing regulations in China, India and Indonesia reduced wholesale and retail mark-ups but did not guarantee low prices. Most countries had removed import duties (Ghana, India, Indonesia, Uganda), but additional tariffs of 3.5% were still applied in Ghana. Value-added tax in the private sector ranged from 5% to 20% across the countries. CONCLUSION: There are no clear trends in the mark-ups applied to insulin or specific differences in the price structure. A uniform approach to improving insulin access through regulating price components is unlikely to be successful, but elimination of duties and taxes, price regulation and greater price transparency could help influence prices and hence affordability. BMJ Publishing Group 2019-09-11 /pmc/articles/PMC6747921/ /pubmed/31565414 http://dx.doi.org/10.1136/bmjgh-2019-001705 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Research Ball, Douglas Ewen, Margaret Laing, Richard Beran, David Insulin price components: case studies in six low/middle-income countries |
title | Insulin price components: case studies in six low/middle-income countries |
title_full | Insulin price components: case studies in six low/middle-income countries |
title_fullStr | Insulin price components: case studies in six low/middle-income countries |
title_full_unstemmed | Insulin price components: case studies in six low/middle-income countries |
title_short | Insulin price components: case studies in six low/middle-income countries |
title_sort | insulin price components: case studies in six low/middle-income countries |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747921/ https://www.ncbi.nlm.nih.gov/pubmed/31565414 http://dx.doi.org/10.1136/bmjgh-2019-001705 |
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