Major study of drug prices in 36 developing and middle-income countries

The prices charged to patients for 15 generic drugs are "substantially higher than would be expected if purchasing and distribution were efficient and mark-ups were reasonable," according to a new study based on secondary analysis of 45 surveys carried out by the World Health Organization and the Netherlands-based Health Action International advocacy group. The results, published in The Lancet, examined drug prices, availability and affordability in 36 developing or middle-income countries, and was carried out by researchers from the WHO, the HAI and Harvard University, USA.

Drug retail markup as much as 552%

The WHO and HAI developed a standard survey methodology which takes into account national variations in purchasing power. International reference prices were used from open international procurements. Across the WHO's global regions, the average public sector availability of generics ranged from 29.4% to 54.4%, with purchasing efficiency varying from 0.09 to 5.37 times the reference levels, the report's authors said. Even where initial procurement was at a low price, other factors contributed to a high cost for patients. In the private sector, wholesale markups were in the 2%-380% range, with retailers adding another 10%-552%. Valued-added tax could also contribute a further 4%-15% to the final price of a drug, depending on the country.