1. Indicators for tracking the effect of the economic crisis on pharmaceutical consumption

2. 2 The Asian Financial Crisis in 1997/8 demonstrates the potential impact on access to medicines Thailand Indonesia Korea # of Quarters Q 0 = Q2 ’97 0.0 1.0 1.1 1.2 1.3 1.4 0.9 Thailand Indonesia Korea # of Quarters Q 0 = Q2 ’97 0.0 1.0 1.1 1.2 1.3 1.4 0.8 0.9 Real GDP (LCU) (Q2 ’97=1) Drug Consumption (SU) (Q2 ’97=1) Source: ????Source: IMS Midas

3. 3 The WHO, in collaboration with IMS, has established a programme to monitor the current impact 83 countries, approximately 81% of global population, quarterly reports Impact on expenditure (Leading indicators) −Total expenditure −Average price per unit of volume Impact on consumption (Lagging indicator) −Total volume −Volume of acute and chronic medicines −Movement to or from original and licensed branded medicines

4. 4 Earliest indicators suggest first signs of economic impact Note: Canada, Puerto Rica, USA, Uruguay (Public) Netherlands, Australia and New Zealand have all had price declines in at least three quarters since start of 2008 until end of Q1 2009 when compared to the same quarter a year previously.

5. 5 Volume indicators also beginning to show signs of worsening

6. 6 Conclusions No firm evidence of a negative impact except perhaps in Estonia and the private sector in Russia So far countries seem to have absorbed the moderate price increases without a loss in medicine consumption Confident that the data collection methods and the analytic tools available will enable us to detect significant changes as soon as they occur When such changes are detected, governments have a range of policy instruments to alleviate the situation