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Comparing Medicine Prices Among Countries

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Comparing Medicine Prices Among Countries. Why compare across countries? ... What can we compare? Single drug comparisons, e.g. ... – PowerPoint PPT presentation

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Title: Comparing Medicine Prices Among Countries


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(No Transcript)
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Comparing Medicine Prices Among Countries
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Why compare across countries?
  • Principal investigators want to know how their
    results differ from other countries results
  • WHO/HAI and external users want to
  • describe world drug markets from consumer
    perspective
  • inform global drug policy discussions
  • examine variations in results in light of
    differences in local policy environments

4
What can we compare?
  • Single drug comparisons, e.g.
  • MPR ratio of median price found to
    international reference price, in USD
  • affordability days wages for std. tx.
  • Summary statistics across many drugs in each
    country, e.g.
  • median MPR for all innovators at retail
  • interquartile range of MPRs

5
Median Price Ratios for Nifedipine (Retail)
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Days Wages for Nifedipine Tx (Retail)
7
Summary stats Retail MPR medians IQRs, ?
Innovator Brand Most Sold Generic
8
Challenges of cross-country comparisons
Single-drug comparisons
  • WHO/HAI core list of 30 drugs ?
  • Opportunities for 1-drug comparisons
  • However
  • local epidemiological profiles differ
  • local treatment approaches differ
  • national registration patent status differ
  • ? market share role for drug differ

9
  • Economic vagaries
  • currency exchange rate, currency values
  • purchasing power
  • generosity of min. government wage
  • Name-brand drugs
  • source country of origin vary
  • quality may vary?
  • Lowest priced generics
  • names not specified
  • names vary within, between countries
  • quality varies how much?

10
Challenges of cross-country comparisons
Summary stats over many drugs
  • Variations in lists of drugs surveyed
  • core substance or strength not available
  • local supplementary drugs
  • To keep in mind
  • multi-drug summary statistics are crude indices
    only
  • nevertheless, orders of magnitude are probably
    meaningful

11
Median Price Ratios for omeprazole
Most Sold Generic
Innovator Brand
12
Days wages for omeprazole treatment
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Caveats for making cross-country comparisons
  • Single-drug comparisons
  • good validity
  • but still not perfect
  • Multi-drug comparisons
  • less valid when lists differ
  • matched drugs ? always more valid
  • but matching drugs ? smaller sample (less
    reliable)

14
Caveats for making cross-country comparisons
  • Give typical values, not extremes
  • Large differences more likely real than small
    differences
  • Be as transparent as possible
  • append details underlying analyses
  • post drug names origins on HAI web
  • Use cautious language
  • Starting point only ? keep digging

15
WHO/HAI survey in Rajasthan, IndiaWeb-based
pharmacies for US consumers, in US vs.
abroad(using LPG)
16
8 Pilot Surveys India US websitesMedians
and IQRs of MPRs(Private For-Profit)
17
Lowest Priced Generics Prices to PtsMedians
and IQRs of MPRs
Public Sector
Mission Sector
18
Public Procurement Prices for GenericsMedians
and IQRs of MPRs
pub. teaching hosps buying on local private
market
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