By Eva Belmonte and Miguel Á. Gavilanes
The same pill costs around $1000 in the United States, $320 in Spain and $554 in France. Price differences are much more striking among patented medicines like the famous Sovaldi, the new treatment against Hepatitis C, but even for generics, whose patents expired years ago, the cost disparities in different countries are remarkable. Knowing about these differences is essential to develop evidence-based policies (like Indonesia, Lebanon, Nigeria and Tajikistan have done already) and to provide data and arguments to governments and organisations for their negotiations with pharmaceutical companies. Because of this, the not-for-profit Health Action International (HAI) and the World Health Organization (WHO) have been working since 2003 on a standard methodology to collect and compare the prices, accessibility and cost structure of 14 essential drugs. None of them are patented, but that does not prevent the differences in retail prices across countries from being dramatic, especially when considering the price to income ratio in each of them.
The reports made following HAI’s methodology, the result of months of rigorous work, include the total cost breakdown (i.e. which amount goes to the manufacturer, to pay taxes or fees, to pay for transport and distribution…), its availability in pharmacies (because sometimes the access problem is not just caused by prices) and the price of both brand name drugs and generics. From this valuable set of reports we’ve extracted data for 56 countries. In order to to make comparisons between different studies, despite them having been made in different years, we look at two relative values: the ratio between the retail cost and an international reference price and, even more importantly, the hours of work needed by the citizens of each country to buy the full treatment. All calculations are based on the cheapest generic.
A citizen of a developing country has to work much longer to afford the same treatment.
To these 56 developing countries analysed by HAI we have added data about Argentina, Italy, Spain and Germany, which enables us to compare with a very different country profile. And the first conclusion is clear: a citizen of a developing country has to work much longer to afford a treatment. An example: in Nigeria or Congo, a treatment with omeprazole (30 pills) can cost almost 13 working days. In Spain, Italy and Germany, the same treatment is paid with between one or two hours’ wages.
In this case, more than ever, information is power. Therefore, various regional organisations such as UNASUR are already creating shared databases and joint procurement. So does the European Union, which approved a procurement agreement, signed by 21 of its members, to buy medical countermeasures jointly in case of the outbreak of a serious cross-border threat to health. A mechanism which, for the time being, does not cover the purchase of new drugs against Hepatitis C.
Because price is one of the main barriers to access to medicines -although not the only one,- as it drains governments’ budgets and excludes the poorest people from treatment. According to the WHO, one third of the world’s population has trouble accessing the medicines they need while, at the same time, 15% of the population consumes 90% of the global spending on pharmaceutical products.
Antidepressant used for anxiety, also useful against migraine and headache.
Penicillin-like antibiotic, widely used against bacterial infections.
Used to control high blood pressure or heart diseases like angina pectoris.
Used to treat high blood pressure and protect the heart after a heart attack.
Antibiotic commonly used against meningitis, pneumonia or gonorrhea.
Antibiotic used for pneumonia, urinary tract infections or sexually transmitted diseases.
An antibiotic used against certain bacterial infections, such as pneumonia or bronchitis.
Anxiolytic used to relieve anxiety, muscle spasms and seizures.
Anti-inflammatory and analgesic, is used against mild or chronic pain, such as arthritis.
This is one of the most commonly used hypoglycemic drugs against type 2 diabetes.
Gastric protector used to prevent damage to the digestive system by gastroesophageal reflux.
One of the most common analgesics, routinely used against cold or flu symptoms.
Inhaler, used for asthma or obstructive respiratory diseases such as COPD.
Used to reduce blood cholesterol levels.
times the reference pricedays of work
This interactive chart shows the data that we have collected from HAI and from several official sources in Argentina, Italy, Spain and Germany. The final dataset can be downloaded here. If you want to include information about your country to the project, learn more about our methodology and the reasons why we have used these particular datasets, you can stop by here.
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