Evaluating drug prices, availability, affordability, and price components

Implications for access to drugs in Malaysia

Zaheer Ud Din Babar, Mohamed Izham Mohamed Ibrahim, Harpal Singh, Nadeem Irfan Bukahri, Andrew Creese

Research output: Contribution to journalArticle

113 Citations (Scopus)

Abstract

Background: Malaysia's stable health care system is facing challenges with increasing medicine costs. To investigate these issues a survey was carried out to evaluate medicine prices, availability, affordability, and the structure of price components. Methods and Findings: The methodology developed by the World Health Organization (WHO) and Health Action International (HAI) was used. Price and availability data for 48 medicines was collected from 20 public sector facilities, 32 private sector retail pharmacies and 20 dispensing doctors in four geographical regions of West Malaysia. Medicine prices were compared with international reference prices (IRPs) to obtain a median price ratio. The daily wage of the lowest paid unskilled government worker was used to gauge the affordability of medicines. Price component data were collected throughout the supply chain, and markups, taxes, and other distribution costs were identified. In private pharmacies, innovator brand (IB) prices were 16 times higher than the IRPs, while generics were 6.6 times higher. In dispensing doctor clinics, the figures were 15 times higher for innovator brands and 7.5 for generics. Dispensing doctors applied high markups of 50%-76% for IBs, and up to 316% for generics. Retail pharmacy markups were also high-25%-38% and 100%-140% for IBs and generics, respectively. In the public sector, where medicines are free, availability was low even for medicines on the National Essential Drugs List. For a month's treatment for peptic ulcer disease and hypertension people have to pay about a week's wages in the private sector. Conclusions: The free market by definition does not control medicine prices, necessitating price monitoring and control mechanisms. Markups for generic products are greater than for IBs. Reducing the base price without controlling markups may increase profits for retailers and dispensing doctors without reducing the price paid by end users. To increase access and affordability, promotion of generic medicines and improved availability of medicines in the public sector are required.

Original languageEnglish
Pages (from-to)466-475
Number of pages10
JournalPLoS Medicine
Volume4
Issue number3
DOIs
Publication statusPublished - 27 Mar 2007
Externally publishedYes

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Malaysia
Pharmaceutical Preparations
Public Sector
Medicine
Private Sector
Pharmacies
Salaries and Fringe Benefits
Public Facilities
Essential Drugs
Costs and Cost Analysis
Taxes
Peptic Ulcer

Cite this

Babar, Zaheer Ud Din ; Ibrahim, Mohamed Izham Mohamed ; Singh, Harpal ; Bukahri, Nadeem Irfan ; Creese, Andrew. / Evaluating drug prices, availability, affordability, and price components : Implications for access to drugs in Malaysia. In: PLoS Medicine. 2007 ; Vol. 4, No. 3. pp. 466-475.
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Evaluating drug prices, availability, affordability, and price components : Implications for access to drugs in Malaysia. / Babar, Zaheer Ud Din; Ibrahim, Mohamed Izham Mohamed; Singh, Harpal; Bukahri, Nadeem Irfan; Creese, Andrew.

In: PLoS Medicine, Vol. 4, No. 3, 27.03.2007, p. 466-475.

Research output: Contribution to journalArticle

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