WHO-Health Action International project on drug price comparisons A technical project of the WHO-Public interest NGO round table on access to medicines

WHO - EDM 2 Background n Evidence from small-scale studies that retail price for some drugs is higher in low income countries than in high income settings n Practical difficulty of obtaining reliable, up-to-date information on drug prices particularly in low income countries n Methodological difficulty of making international price comparisons n Approach to improve price transparency and empower actors concerned with health and medicines policy n WHO-Public Interest NGO Roundtable an opportunity to launch such an initiative

WHO - EDM 3 Objectives

WHO - EDM 4 Sources of financial support n Netherlands government n Rockefeller Foundation n WHO n GTZ (cameroon pilot study)

WHO - EDM 5 Elements covered n “Core list” of 30 important drugs n “Supplementary lists” adapted to local needs encouraged n Retail prices at health facilities in public, private and not- for-profit sectors - NGOs -(where all three exist) n Prices of branded drug, best selling generic drug, and lowest price generic drug to be collected n “Affordability” assessments for 9 conditions built into worksheet (use STGs, local prices, local minimum wage) n Links in price chain (Price components) from manufacturer to retailer to be identified

WHO - EDM 6 Core list of drugs for price comparison

WHO - EDM 7 Data collection n Self-contained Manual/Excel worksheet to guide surveys n Detailed guidance given on choosing a national or regional representative sample (25-50 facilities) based on largest urban area plus three other areas with randomly selected public, private and (where applicable) NGO facilities n Core list of 30 drugs, 3 sectors, 3 prices

WHO - EDM 8

9 Country studies n Armenia, Kenya, South Africa, Brazil, Sri Lanka first pilots, then modification to methodology n Ongoing second round studies Cameroon, Philippines, Peru, Pakistan, India, Ghana n Cost to project per country study between $0 and $8000 n Overall project cost: < $300,000 n Project finishes end 2002

WHO - EDM 10 Data analysis & availability n Recommended minimum analysis at country level built into Manual n HAI web site being developed as repository for data, allowing comparisons within and between countries for individual drug prices and their make-up.

WHO - EDM 11 Project management - advisory board

WHO - EDM 12 Project management - steering group n Margaret Ewen, HAI (co-ordinator) n Andrew Creese, WHO (co-ordinator) n Harry Van Schooten, Netherlands Government n Anthony So, Rockefeller Foundation n Carmen Perez Casas, MSF n Mogha Smith, Oxfam