Search

Background: South Africa has proposed the implementation of a maximum logistics fee paid by pharmaceutical manufacturers to wholesalers and distributors. However very little knowledge exists of the effects, unintended or otherwise, of the implementation of these proposed regulations, which are required to guide further policy development and implementation. The objectives of this study was to therefore evaluate the effects of the proposed logistics fee cap on different pharmaceuticals and different dosage forms, as well as to observe the logistics fee contribution to the Single Exit Price.Methods: Private sector medicine prices were sourced from the South African Medicine Price Registry as at 20 December 2013. For each medicine the maximum logistics fee was calculated based on the 2012 proposed government guidelines. The logistics fee as a percentage of the final Single Exit Price was calculated, as part of the analysis of results.Results: Out of the 47 medicines in the overall sample from the current study, only 16 medicines showed a decrease in the Single Exit Price with the application of the maximum logistics fee cap.Conclusion: This study reveals the need for greater transparency of the mark ups along the distribution chain as well as further research with regards to the costing of logistics fees of similar pharmaceuticals. [ABSTRACT FROM AUTHOR]

Objectives: The main goal of this study was to document the situation of medicine prices in public and private health sectors for policy recommendation. Methods: A field study to measure prices of selected medicines was undertaken in Thailand using a standardized methodology developed by the World Health Organization (WHO) and Health Action International (HAI). Prices of 43 medicines were measured in health facilities and pharmacies in the capital city and three districts in different parts of Thailand. Medicine prices were expressed as the ratios relative to a standard set of international reference prices (median price ratio or MPR). Results: The public sector procured generics and innovator brands at 1.46 and 3.3 MPR while patients paid 2.55 and 4.36 MPR, respectively. Private pharmacies procured lowest price generics at 1.48 MPR and innovator brands at 9.67 MPR. Because of no medicine pricing policy in Thailand, it was found that between public and private sectors, among different public hospitals, and among different private pharmacies, the same generic products were procured and sold to patients at different prices. The median mark-up for innovator brands were 31% in the public sector and 22% in the private sector. For lowest priced generics, the median mark-up were 80% in the public sector and 96% in the private sector. Different prices for the identical product were problems to the health insurance organizations in terms of reimbursement, and to patients in terms of fairness. Conclusion: The results highlight priority areas for action by the Ministry of Public Health and others in improving the drug pricing systems. The price regulation system should be implemented at every level of drug supply chain and appropriate pricing strategies should be employed. [ABSTRACT FROM AUTHOR]

All countries face the challenge of finite health resources, and therefore the need to limit expenditure on medicines. Post-apartheid South Africa developed a National Drug Policy in 1996, which signaled a multi-faceted series of interventions to reduce medicines prices and also improve prescribing and dispensing practices. Implementing this policy has not been without challenges, including legal challenges by the pharmaceutical manufacturers, medical practitioners and pharmacists. While a policy of mandatory offer of generic substitution has been implemented successfully, improving the quality of medicines use in the private sector has not been as easily addressed. A single exit price mechanism for all medicines in the private sector has been introduced, with regulated maximal annual increases. However, the greatest difficulty has been encountered in determining a reasonable and enforceable dispensing fee. This element of the pricing intervention remains highly contested. South Africa's experience has also highlighted the need for clear legal drafting when attempting medicine pricing interventions. Other elements which still need addressing are the selection of medicines in the private sector, an enforceable code of marketing practice, and a more transparent way of indicating which medicines can be substituted, based on suitable bioequivalence and other data. South Africa's National Drug Policy is expected to be reviewed in the near future, and these issues will need urgent attention if the country is to realize its goal of introducing a National Health Insurance system. [ABSTRACT FROM AUTHOR]