Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis
Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis
复制标题
DOI：
10.1016/s0140-6736(08)61762-6
复制
发表时间：
2009-01-17
期刊：
影响因子：
168.9
通讯作者：
Laing, R.
中科院分区：
文献类型：
--
作者：
Cameron, A.;Ewen, M.;Laing, R.
世卫组织和国际卫生行动制定了一种标准化方法，用于调查低收入和中等收入国家的药品价格、可获得性、可负担性和价格构成部分。在此，我们对使用世卫组织/国际卫生组织方法进行的45项国家和地方调查的药物可获得性进行了二次分析。方法对36个国家的45项WHO/HAI调查数据进行通货膨胀或通货紧缩和购买力平价调整。非专利产品公开国际采购的国际参考价格被用作比较标准。报告提供了至少80%调查中包括的15种药物和4种单独药物的结果。世卫组织各区域公共部门仿制药的平均可得性从29.4%到54.4%不等。15种仿制药的政府采购价格中位数是相应国际参考价格的1.11倍，尽管采购效率从0到0不等。9点到5点。37倍国际参考价格。低采购价格并不总是转化为低患者价格。在世卫组织各区域，私营部门患者为最低价非专利产品支付的费用是国际参考价格的9-25倍，为原产产品支付的费用是国际参考价格的20倍以上。在许多国家，急性和慢性疾病的治疗基本上是负担不起的。在私营部门，批发加价率从2%到380%不等，而零售加价率从10%到552%不等。在对药品征收增值税的国家，征收的金额从4%到15%不等。总体而言，公共和私营部门原药和非专利药的价格大大高于在采购和分销有效且加价合理的情况下的预期价格。需要促进仿制药和替代融资机制等政策选择来增加可得性、降低价格和提高可负担性。资金没有。
Background WHO and Health Action International (HAI) have developed a standardised method for surveying medicine prices, availability, affordability, and price components in low-income and middle-income countries. Here, we present a secondary analysis of medicine availability in 45 national and subnational surveys done using the WHO/HAI methodology.Methods Data from 45 WHO/HAI surveys in 36 countries were adjusted for inflation or deflation and purchasing power parity. international reference prices from open international procurements for generic products were used as comparators. Results are presented for 15 medicines included in at least 80% of surveys and four individual medicines.Findings Average public sector availability of generic medicines ranged from 29.4% to 54.4% across WHO regions. Median government procurement prices for 15 generic medicines were 1.11 times corresponding international reference prices, although purchasing efficiency ranged from 0 . 09 to 5 . 37 times international reference prices. Low procurement prices did not always translate into low patient prices. Private sector patients paid 9-25 times international reference prices for lowest-priced generic products and over 20 times international reference prices for originator products across WHO regions. Treatments for acute and chronic illness were largely unaffordable in many countries. In the private sector, wholesale mark-ups ranged from 2% to 380%, whereas retail mark-ups ranged from 10% to 552%. In countries where value added tax was applied to medicines, the amount charged varied from 4% to 15%.Interpretation Overall, public and private sector prices for originator and generic medicines were substantially higher than would be expected if purchasing and distribution were efficient and mark-ups were reasonable. Policy options such as promoting generic medicines and alternative financing mechanisms are needed to increase availability reduce prices, and improve affordability.Funding None.