Some Low-Income Countries ‘Pay 30 Times More’ For Medicines

Poor countries tended to purchase the most expensive drugs rather than generics.

KUALA LUMPUR, June 24 — A health expert from the Centre for Global Development recently highlighted in a report that in some African countries, ordinary medicines such as paracetamol could cost up to 30 times more than those in the US and UK.

Countries such as Tunisia, Senegal and Zambia, with small to medium-sized economies are particularly affected, resulting in patients paying for less effective drugs.

Kalipso Chalkidou, director of global health policy at the centre, told the BBC recently that drug markets in poorer countries “just don’t work” and that “competition is broken” due to a “concentrated supply chain”.

Her recent report on drug procurement found that such countries would purchase a smaller range of medicines. This would lead to weaker competition, regulation and quality.

They would also tended to procure the most expensive medicines, rather than the cheaper, unbranded generic pharmaceuticals.

The very poorest countries, interestingly, were largely not affected as international donors purchased drugs on their behalf, ensuring that over-the-counter medicines remain available at low cost to the public.

“In the middle it’s very problematic,” Chalkidou said.

Low- to middle-income countries “have little ability to negotiate prices down and quality assure products”. There were a lot of mark-ups, often due to corruption and duties.

The report recommends greater global co-operation and reforming World Health Organisation policy. It also recommends reforming procurement policies in targeted countries to improve practices.

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