who medicines strategy - libdoc.who.int - World Health Organization
who medicines strategy - libdoc.who.int - World Health Organization who medicines strategy - libdoc.who.int - World Health Organization
WHO MEDICINES STRATEGY 2004-2007 | 66Figure 17:Medicine prices: local components of privatesector prices as percentage of landed import price VATretail mark-updistribution/wholesale mark-upimporter mark-upimport taxcustoms, fees, insurance, clearance EO 3.5Medicine pricing policies and priceinformation promoted to improveaffordability of essential medicinesRationaleIn the complex national and global marketsfor medicines, access to price information forcomparable medicines is often difficult andexpensive. Yet such market intelligence is essentialfor informed purchasing decisions. In 2001,the World Health Assembly, recognizing theimportance of timely and reliable information onmedicine prices, called on WHO to:“..explore the feasibility and effectivenessof implementing, in collaboration with nongovernmentalorganizations and other concernedpartners, systems for voluntary monitoring drugprices and reporting global drug prices...and toprovide support to Member States in that regard”[WHA54.11 operative para 2.(2)]ProgressWHO is working with others in the UN familyand development partners to maintain threeinternational price information services:> Management Sciences for Health (MSH)in collaboration with WHO: InternationalDrug Price Indicator Guide. Boston, MA,Management Sciences for Health. Publishedannually.> UNICEF, UNAIDS, WHO, Médecins SansFrontières : Sources and Prices of SelectedMedicines and Diagnostics for People LivingWith HIV/AIDS. Geneva, World HealthOrganization. Published annually.> International Trade Centre: PharmaceuticalStarting Materials/Essential Drugs Report.Geneva, International Trade Centre/UNCTAD/WTO. Published monthly.The Global TB Drug Facility (as part of the Stop TBPartnership) provides web-based price informationon anti-TB medicines for use in implementingthe Directly Observed Treatment Short Course(DOTS) strategy. In addition, European countriesare increasingly putting their national priceinformation on the web.WHO also maintains regional price informationservices, including the AFRO Essential Drugs PriceIndicator, which compares national tender pricesfor essential medicines; and the Pan American
COMPONENTS OF THE STRATEGY | 67Figure 18: Variations in the price of ciprofloxacin:originator brand and genericsThe manual and accompanying workbookresulted from discussions in the regular WHO-Public Interest NGO Round Table. A revisededition, following extensive field testing andreview, is scheduled for 2005.OriginatorBrandGenericArmenia Brazil Peru Sri LankaSource: www.haiweb.org/medicinepricesHealth Organization (PAHO) website on ARVs inLatin America and the Caribbean, which providesinformation on prices, uses, and access policiesfor ARVs. The WHO website now provides linksto electronic sources of public information onmedicine prices in several languages 29 .In 2003, a new manual on the compilation andanalysis of medicine prices, Medicine Prices:a new approach to measurement 30 , was jointlydeveloped and published by HAI and WHO. Itis intended to be of use to a range of differentorganizations involved in efforts to achieve moreaffordable medicine prices in low- and middleincomecountries. It provides guidance oncollecting retail price information for selected keymedicines through surveys of health facilities indifferent sectors, and on comparing local priceswith international reference prices. Analysis isalso encouraged of the different componentsof retail price (Figures 17 and 18), and of theaffordability of treatment for selected commonconditions. The HAI (Europe) website has a publicdatabase of results from the nine pilot surveyscarried out in the development of these materials,and this will grow as more studies are undertaken.OUTCOME INDICATORS1999 2003 2007No. of countries with a pricing policy for maximum retailmark-up in the private sectorBig variations in medicine prices for the same orsimilar products, especially the newer essentialmedicines, remain the norm, both withinand between countries. Informed purchasingis therefore difficult for many individual orinstitutional purchasers, and price transparencyremains a distant goal.Meeting the challenges 2004-2007Over the next four years WHO will:> continue and, where possible, expand priceinformation in collaboration with other UNagencies and development partners.> issue an annual publication on the sourcesand prices of antimalarial medicines in2004, following the success of the annualpublication on HIV/AIDS-related medicines.> in collaboration with HAI, continue to supportworkshops in several regions for government,academic, and NGO personnel on how toundertake a survey on medicine prices.> carry out in-depth studies of HIV/AIDS andmalaria medicine prices to monitor pricechanges over time and to explore policyoptions in different national settings.> further develop information materials onprices and pricing policy guidelines to enablecountries to consider different options andstrategies for pricing mechanisms to ensureaffordable prices for essential medicines.#REPORTING % TARGET#REPORTING % TARGETna na na 36/75 48% 55%
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COMPONENTS OF THE STRATEGY | 67Figure 18: Variations in the price of ciprofloxacin:originator brand and genericsThe manual and accompanying workbookresulted from discussions in the regular WHO-Public Interest NGO Round Table. A revisededition, following extensive field testing andreview, is scheduled for 2005.OriginatorBrandGenericArmenia Brazil Peru Sri LankaSource: www.haiweb.org/medicineprices<strong>Health</strong> <strong>Organization</strong> (PAHO) website on ARVs inLatin America and the Caribbean, which providesinformation on prices, uses, and access policiesfor ARVs. The WHO website now provides linksto electronic sources of public information onmedicine prices in several languages 29 .In 2003, a new manual on the compilation andanalysis of medicine prices, Medicine Prices:a new approach to measurement 30 , was jo<strong>int</strong>lydeveloped and published by HAI and WHO. Itis <strong>int</strong>ended to be of use to a range of differentorganizations involved in efforts to achieve moreaffordable medicine prices in low- and middleincomecountries. It provides guidance oncollecting retail price information for selected key<strong>medicines</strong> through surveys of health facilities indifferent sectors, and on comparing local priceswith <strong>int</strong>ernational reference prices. Analysis isalso encouraged of the different componentsof retail price (Figures 17 and 18), and of theaffordability of treatment for selected commonconditions. The HAI (Europe) website has a publicdatabase of results from the nine pilot surveyscarried out in the development of these materials,and this will grow as more studies are undertaken.OUTCOME INDICATORS1999 2003 2007No. of countries with a pricing policy for maximum retailmark-up in the private sectorBig variations in medicine prices for the same orsimilar products, especially the newer essential<strong>medicines</strong>, remain the norm, both withinand between countries. Informed purchasingis therefore difficult for many individual orinstitutional purchasers, and price transparencyremains a distant goal.Meeting the challenges 2004-2007Over the next four years WHO will:> continue and, where possible, expand priceinformation in collaboration with other UNagencies and development partners.> issue an annual publication on the sourcesand prices of antimalarial <strong>medicines</strong> in2004, following the success of the annualpublication on HIV/AIDS-related <strong>medicines</strong>.> in collaboration with HAI, continue to supportworkshops in several regions for government,academic, and NGO personnel on how toundertake a survey on medicine prices.> carry out in-depth studies of HIV/AIDS andmalaria medicine prices to monitor pricechanges over time and to explore policyoptions in different national settings.> further develop information materials onprices and pricing policy guidelines to enablecountries to consider different options andstrategies for pricing mechanisms to ensureaffordable prices for essential <strong>medicines</strong>.#REPORTING % TARGET#REPORTING % TARGETna na na 36/75 48% 55%