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article imageGlobal health procurement: Low-income countries pay too much

By Tim Sandle     Jul 1, 2019 in Health
A sweeping study into global health procurement finds that some low-income countries are paying over twenty times more for generic drug products. Lifesaving medicines continue to remain out of reach for many of those who need them the most.
A new Center for Global Development report, looks into the area of global health procurement. The study represents one of the biggest ever inquires into this topic of how patients get hold of much needed medicines. The key finding is that some of the world’s poorest people face the highest prices for medicines.
The report examines the billions of dollars that are spent in developing countries. The research reveals that some poor countries are paying 20 to 30 times more for basic medicines than others.
The report also finds that in developing countries, prices for basic generic medicines can vary widely and far exceed wealthy-country prices. Some purchasers in low- and middle-income countries pay as much as 20 to 30 times more for basic generic medicines like omeprazole, used to treat heartburn, or acetaminophen (also known as paracetamol), a common pain reliever.
Furthermore, data suggests that low- and middle-income countries purchase more expensive branded generic drugs rather than unbranded quality-assured generics. In the US, most drugs are either on-patent medicines or unbranded generics, but in many developing countries more expensive brand-name generics are widely used, because people are concerned about unsafe or counterfeit drugs.
In the poorest countries, unbranded generics are only 5 percent of the pharmaceutical market by volume—in comparison to the U.S. where unbranded quality-assured generics are 85 percent of the market by volume.
Another important finding from the survey is that there is little competition in the supply of essential medicines in low- and middle-income countries. The largest seller of products like contraceptives, cancer medicines, and antiparasitics can account for upwards of 85 percent of all sales in some countries.
According to one of the study authors, Kalipso Chalkidou, this highlights the case for reform: “A robust market for generic drugs is a core part of an affordable health system. But in way too many countries, generic drug markets are broken and patients are paying the price.”
He adds that: “You need enough competition to keep prices low and quality assurance that consumers trust, or essential medicines are going to be much more expensive than they should be.”
The types of reforms required are the need to sustain and expand global cooperation for procurement and targeted innovation; reform guidance and policy to support modern and agile procurement policy and practice; to professionalize procurement by building capacity and driving strategic practice; and to support in-country procurement policy reform.
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