Poor countries pay up to 30 times more for medicines, study shows

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The world’s poorest countries are paying some of the highest drug prices, with everyday medicines costing up to 30 times more than in rich nations, according to a study.

The Washington-based Center for Global Development examined billions of dollars in spending by developing countries, concluding that low- and middle-income countries were paying 20 or 30 times more for medicines such as omeprazole, for heartburn, or paracetamol, a common pain reliever.

Pharmaceutical and healthcare markets “don’t work for the poorest countries, especially in South Asia and Africa”, said Kalipso Chalkidou, one of the report’s authors.

The study uncovered a stark disparity in the proportion of poorer countries’ use of unbranded generic drugs, usually the least expensive option.

In the poorest nations, branded generics — which command a price premium — make up about two-thirds of the market by volume and value.

Unbranded generics are “a tiny sliver”, said the researchers, making up just 5 per cent of the market by volume and 3 per cent by value.

By contrast, in the US and the UK, unbranded quality-assured generics account for 85 per cent of the pharmaceutical market by volume, but only about a third by cost.

Nor was there much competition in the supply of essential medicines in low- and middle-income countries, the report said.

These markets tended to be dominated by a single, or small number, of suppliers, directly affecting the prices paid by public bodies or consumers.

In some low- and middle-income countries, the largest seller of certain medicines “accounts for upwards of 85 per cent of all sales, such as contraceptives in Zambia, the Philippines, Senegal, and Kerala; cancer medicines in Zambia and Kerala; diabetes medicines in Zambia; and antiparasitics in the Philippines, Zambia, Tunisia, and South Africa”, the researchers found.

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