Wednesday, July 1, 2009

Why are essential drugs so expensive in poor countries?

One of the issue I face as a doctor in private practice is the high price of drugs or medications. While I recognize that the pharmaceutical companies need to recoup their R & D costs, yet somehow I feel that it has become a convenient excuse to price their medications high. Why are propriety medications so expensive in poor countries? In this interesting article by Brook Baker in the magazine Virtual Mentor (American Medical Association Journal of Ehics), July 2009 offers some perspectives on the issue Medicines in Developing Countries

Of the 12 million people living with HIV/AIDS in developing countries who will die within 3 years without immediate access to affordable antiretroviral medicines, only 4 million were receiving treatment at the end of 2008. Access to a much broader list of essential medicines (those defined as essential for health by national governments or the World Health Organization, or WHO) is equally dismal. Recent WHO studies found that public pharmacies in developing countries had only one-third of essential medicines available onsite, and the private pharmacies had only two-thirds of medicines available. End prices were 2.5 and 6.5 times international reference prices at public and private pharmacies, respectively

he continues,

Many factors contribute to a lack of access to existing medicines in developing countries: tattered health systems, insufficient numbers of health workers, weak regulatory regimes, and poor procurement and distribution systems. Other conditions—import duties and taxes, mark-ups throughout the distribution chain, and even corruption and product diversion—coalesce to produce high drug prices. Weak research and development (R&D) capacity and limited investment in R&D combine to restrict research on neglected diseases in developing countries. But clearly one of the factors most implicated in unavailability (and unaffordability) of medicines in developing countries is the current intellectual property regime—a regime that allows proprietary drug companies with intellectual property monopolies to charge high prices and maximize profit by the sale of medicines that only rich and well-insured people can afford while simultaneously deprioritizing R&D into products that poor people need.

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Is there anything we who live the the poorer countries can do? Any help from those living in developed countries?

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