Healthy Skepticism Library item: 16502

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Publication type: news

Sukkar E
Thailand FDA survey finds high drug prices
Scrip 2009 Sep 4
http://www.scripnews.com/policyregulation/Thailand-FDA-survey-finds-high-drug-prices-175764?autnID=/contentstore/scripnews/codex/7a975c47-987c-11de-97a4-f599b5abdca1.xml

Full text:

Officials from Thailand’s food and drug administration (FDA) say there
is a need to improve the country’s drug pricing system, after a survey
of medicine outlets found no logic to the prices of drugs.

“There is no national pricing policy in Thailand to regulate medicine
prices. Different prices for the same medicine were found, also high
prices were observed for the innovator brand medicines,” says a new
study, written by researchers at Thailand’s Mahidol University and
officials from the FDA (Southern Med Review, vol 2, issue 2, September
2009).

The study’s authors say the government should employ appropriate pricing
strategies and implement a price regulation scheme at every level of the
supply chain. “Price regulations, such as maximum selling prices or
maximum wholesale/retail mark-ups, should be implemented and enforced.
There should be an organisation to set and monitor medicine prices.”

The team surveyed the prices of 43 medicines in 41 medicines outlets (20
hospitals and 21 pharmacies) in Bangkok and three randomly selected
districts. The study was funded by the FDA.

Medicine prices were expressed as medicine price ratios (MPR) relative
to a standard set of international reference prices; an MPR of 2 would
mean that the medicine price is twice that of the international
reference price.

In terms of public sector procurement prices, the survey found that
overall the MPR was 1.46 for public sector generics and 3.3 for
innovator brands. Some innovator brands were being procured at very high
prices, such as captopril (MPR 12.10), phenytoin (MPR11.08) and
azithromycin (MPR 6.54). Some generics were also being procured at high
prices, such as azithromycin (MPR 3.07), captopril (MPR 2.88) and
nifedipine retard (MPR 2.6).

As a result of no direct medicine pricing policy, the study found that
different public hospitals bought the same product at different prices.
The study also found that among different public hospitals, the same
products were sold to patients at different prices.

The study also compared the public sector patient prices with public
sector procurement prices. For eight branded medicines, patients paid
32% more than the government procurement price; for 31 generics,
patients paid up to 75% more.

Private sector prices. In the private sector, the study found that the
lowest-priced generic equivalents were bought at an MPR of 1.48,
compared with the very high ratio of 9.67 for branded medicines. In
terms of what patients paid in the private sector, the lowest price
generic equivalent was sold to patients at an MPR of 3.31 and innovator
brands at 11.6.

Overall, for 17 innovator brands, patients were charged about 20% more
than the procurement price, while across 22 lowest-priced generics, the
mark-up was 124%.

The procurement prices in the public sectors were lower than the private
sectors for branded drugs and generics. This was due to public hospitals
buying medicines through group purchasing mechanisms. The survey used
the World Health Organization/Health Action International medicine price
methodology.