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[e-drug] Price and availability of common medicines in India

E-DRUG: Price and availability of common medicines in India
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[Interesting conclusion: very low procurement price, but still very little 
access! WB]

This is a synthesis paper of data from surveys in six Indian States using the 
WHO/HAI methodology on medicine prices, see 
www.haiweb.org/medicineprices.

The full text is available at:
http://www.icmr.nic.in/ijmr/2007/may/0506.pdf

Kotwani A, Ewen M, Dey D, Iyer S, Lakshmi PK, Patel A, Raman K, Singhal
GL, Thawani V, Tripathi S, Laing R. Prices & availability of common medicines 
at six sites in India using a standard methodology. Indian J Med Res 2007 
May;125(5):645-54.

Department of Pharmacology, Vallabhbhai Patel Chest Institute, University of 
Delhi, India.

BACKGROUND & OBJECTIVE: The price and availability of medicines are key 
components in determining access to effective treatment. Data on prices and 
availability of common medicines in public and private sector in different 
States of India are scarce. Hence, surveys were undertaken in different States 
of India to evaluate these metrics. 

METHODS: During October 2004 to January 2005, six surveys were undertaken 
simultaneously in five States of India to assess medicine prices and 
availability of essential medicines (n = 21-28) using the World Health 
Organization and Health Action International methodology. Surveys were 
conducted at Chennai, Haryana, Karnataka, West Bengal, and at two sites in 
Maharashtra. For each medicine, data were collected for the Innovator Brand 
(IB), Most Sold Generic (MSG), and Lowest Priced Generic (LPG) at randomly 
selected public and private facilities in each site surveyed. Prices were 
compared to an international reference benchmark (expressed as median price 
ratio - MPR). 

RESULTS: The procurement price of medicines in the public sector was 0.27 to 
0.48 times the international reference price. However, these medicines were 
inadequately available and the median availability in the public sector ranged 
from 0 to 30 per cent. The median prices of medicines in the private sector 
were less than twice the IRP, although a few innovator brands were more 
expensive. No difference was observed between the prices of the most sold 
generic (MSG) and the lowest priced generic (LPG) available at the facilities. 
Interestingly, price variation was observed among different generic equivalents 
of ciprofloxacin in each region. The price of LPG diazepam in the private 
sector was thirty three times its procurement price in the public sector. 

INTERPRETATION & CONCLUSION: The survey revealed low procurement prices and 
poor availability in the public sector. Thus, the majority of the population 
purchased medicines from private pharmacies, where generics were usually 
available although prices of certain medicines were high. Various policy 
measures could increase the availability and accessibility of medicines for the 
population.  

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