International Pharma Pricing: All smoke & mirrors

Inspired by a recent post on the very fine Pharmagossip regarding the high price of medicines, Pharmalyst set out to to compile some prices for various brand name medicines in the US and Thailand (Thailand being in the news re compulsory licensing of Abbott's Kaletra etc due to high prices). In a previous post Pharmalyst had noted that Kaletra in Thailand was priced at 30% of their per capita GDP compared to the US price of 18% (of US per capita GDP) .

Well, Pharmalyst is sorry to report that finding international prices of pharmaceuticals outside the US & Western Europe has been really hard. Pharmalyst knows that some of the readers of this blog are in Asia. Pharmalyst appeals to you to e-mail prices from your markets. Pharmalyst's research indicates that drug companies like to keep drug prices opaque; they then seem to exploit this information asymmetry to overcharge those countries that do not drive a hard bargain. Towards this point, Pharmalyst refers readers to Health Action International. Together with the WHO, they have a project to compile world medicine prices so that consumers and govts can negotiate the best prices from pharma companies. To quote from their brochure on medicine prices:

"if you have a peptic ulcer and require a month’s treatment, the originator brand version of ranitidine will cost you the equivalent of 50 days wages in Cameroon, almost 19 days of pay in Armenia and 13 days in the Philippines…That is almost two month’s pay for one month of treatment. If a partner and children get sick, then the medicine bill will rapidly devastate a household income. Of course, the medicine may be available at lower prices. Generic equivalents from public sector sources can be half of the price of the originator brand. But in some countries – e.g. Cameroon and Philippines – generic ranitidine was not found. People either pay the
full price of the originator brand of ranitidine or go without. Medicine prices vary to an extraordinary degree. The same medicine may have a different price tag in its originator or generic form, from a public clinic, a charitable agency or from a private pharmacy, in an urban or rural area. This makes it impossible for people to know what is the ‘best buy’ and where to find it."

Another interesting find for Pharmalyst was how the drug companies use free trade agreements to prevent countries (including some not very wealthy ones like Morocco) from supporting medicine reimportation. A good summary of this can be found here at the American University's website for the Project on Information Justice and Intellectual Property. It appears that these free trade agreements are anything but free trade. They probably should be called special interest agreements.