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Medicine Availability, Prices and Affordability in West Bengal, India (2004) DALIA DEY CUTS & CDMU. Geographic Regions Surveyed. indicates surveyed districts. Population of West Bengal: 80 million Source: 2001 Census Report. Survey Details. Sectors Surveyed Public Sector - PowerPoint PPT Presentation
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Medicine Availability, Prices and Medicine Availability, Prices and Affordability Affordability
inin West Bengal, IndiaWest Bengal, India
(2004)(2004)
DALIA DEYDALIA DEY
CUTS & CDMUCUTS & CDMU
22
indicates surveyed districts
Geographic Regions SurveyedGeographic Regions Surveyed
Population of West Bengal: 80 millionSource: 2001 Census Report
33
Survey Details Survey Details
Sectors SurveyedSectors Surveyed Public SectorPublic Sector Private retail sectorPrivate retail sector
Products Selected (Core & Supplementary)Products Selected (Core & Supplementary) Originator BrandOriginator Brand Most sold genericsMost sold generics Lowest priced genericsLowest priced generics
AnalysedAnalysed PricesPrices AvailabilityAvailability AffordabilityAffordability
44
Daily salary of lowest paid unskilled Daily salary of lowest paid unskilled government workergovernment worker = INR 131.73 = INR 131.73 ($2.86US)($2.86US)
Estimated proportion of population on Estimated proportion of population on less than this salaryless than this salary11 = 79.9% live on less = 79.9% live on less than $2US per day.than $2US per day.
1 Source = WB Development Report, 2004
Affordability BaselineAffordability Baseline
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Public Sector Procurement Prices Public Sector Procurement Prices (measured as Median Price Ratios)(measured as Median Price Ratios)Public Sector Procurement Prices Public Sector Procurement Prices
(measured as Median Price Ratios)(measured as Median Price Ratios)
----
----
----
----
IBIB
0.090.09 MPR for OmeprazoleMPR for Omeprazole
0.160.16 MPR for CeftriaxoneMPR for Ceftriaxone
0.930.93 MPR for AmoxicillinMPR for Amoxicillin
0.750.75Median MPR for all 32 Median MPR for all 32 medicinesmedicines
LPGLPG
---- 1.441.44 MPR for DoxycyclineMPR for Doxycycline
66
Availability: Availability: Public vs. Private Retail SectorsPublic vs. Private Retail SectorsMedian Median
Availability (%)Availability (%)Public Public SectorSector
Private Private Retail Retail SectorSector
IBIB LPGLPG IBIB LPGLPG
AciclovirAciclovir ---- 0.0%0.0% 68.6%68.6% 31.4%31.4%
AmoxicillinAmoxicillin ---- 96.2%96.2% 5.7%5.7% 94.3%94.3%
Ceftriaxone InjCeftriaxone Inj ---- 19.2%19.2% 0.0%0.0% 85.7%85.7%
Salbutamol InhSalbutamol Inh ---- 0.0%0.0% 60.0%60.0% 85.7%85.7%
PhenytoinPhenytoin ---- 0.0%0.0% 0.0%0.0% 91.4%91.4%
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Median Price Ratios in the Private Retail Median Price Ratios in the Private Retail Pharmacy SectorPharmacy Sector
Median Price Ratios in the Private Retail Median Price Ratios in the Private Retail Pharmacy SectorPharmacy Sector
0 5 10 15 20
Doxycycline
Atenolol
Diazepam
Ciprofloxacin
All Medicines (32)
MPR
Lowest Priced Generic Originator Brand
88
Affordability in the Private Retail Affordability in the Private Retail Pharmacy SectorPharmacy Sector
0 0.2 0.4 0.6 0.8 1
Hypertension(Atenolol)
Antibacterial(Doxycycline)
Peptic ulcer(Ranitidine)
Days Wages
Lowest Priced Generic Originator Brand
99
Availability and Affordability of Lowest Price Generics – Availability and Affordability of Lowest Price Generics – Acute and Chronic ConditionsAcute and Chronic Conditions
0.10.1
1.31.3
0.50.5
0.30.3
0.30.3
Affordability Affordability in Private in Private
Sector Sector (# days (# days work for unskilled work for unskilled
government worker)government worker)
1 / 26 1 / 26 (3.8%)(3.8%)
Co-trimoxazole Co-trimoxazole suspensionsuspension
Pediatric ARIPediatric ARI
25 / 26 25 / 26 (96.2%)(96.2%)
AmoxicillinAmoxicillinAdult ARIAdult ARI
4 / 26 4 / 26 (15.4%)(15.4%)
AtenololAtenololHypertensioHypertensionn
0 / 260 / 26HydrochloroHydrochloro-thiazide-thiazide
HypertensioHypertensionn
1 / 26 1 / 26 (3.8%)(3.8%)
GlibenclamiGlibenclamidede
DiabetesDiabetes
Availability Availability in Public in Public SectorSector(no. of facilities out (no. of facilities out
of 26 surveyed)of 26 surveyed)
MedicineMedicineConditionCondition
1010
Conclusions - 1Conclusions - 1
1.1. Availability situation in the public sector is far from Availability situation in the public sector is far from satisfactory, with 19 of the 32 medicines (59.4%) satisfactory, with 19 of the 32 medicines (59.4%) not not being availablebeing available
2.2. Procurement in the public sector is quite efficient with Procurement in the public sector is quite efficient with the median MPR (in comparison with MSH 2003 the median MPR (in comparison with MSH 2003 median prices) for all medicines being 0.75median prices) for all medicines being 0.75
3. 3. Availability is better in the private retail sector, with Availability is better in the private retail sector, with the median availability of all the 32 medicines being the median availability of all the 32 medicines being 77.1% for generic products77.1% for generic products
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Conclusions - 2Conclusions - 2
4. The median MPR of generics (2.17 for all 32 4. The median MPR of generics (2.17 for all 32 medicines) in the private sector indicate that medicines) in the private sector indicate that medicines are costlier than the international medicines are costlier than the international reference pricesreference prices
5. Most standard treatments are likely to be affordable to 5. Most standard treatments are likely to be affordable to individuals who draw at least the minimum daily individuals who draw at least the minimum daily wageswages
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Policy ImplicationsPolicy Implications
With the government committed to providing universal With the government committed to providing universal access to essential medicines, serious investigation access to essential medicines, serious investigation is needed into the causes of the is needed into the causes of the low availabilitylow availability in the in the public sector.public sector.
Government of West Bengal should Government of West Bengal should establish a establish a monitoring authority to continuously monitor prices, monitoring authority to continuously monitor prices, availability and affordability of medicines, with availability and affordability of medicines, with transparent publicationtransparent publication to their citizens, and to their citizens, and act act when prices are high, availability low and treatment when prices are high, availability low and treatment affordability poor.affordability poor.
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Policy AdvocacyPolicy Advocacy The medicine pricing survey report The medicine pricing survey report “Medicine “Medicine
Prices and Affordability in West Bengal” was Prices and Affordability in West Bengal” was released by Dr. Jayashree Mitra, Director of released by Dr. Jayashree Mitra, Director of Medical Education, Government of West Bengal Medical Education, Government of West Bengal on October 1, 2005. on October 1, 2005.
The report has already been shared with the The report has already been shared with the Department of Health and Family Welfare, Department of Health and Family Welfare, Government of West Bengal and tried to draw their Government of West Bengal and tried to draw their attention on the concerns.attention on the concerns.
CUTS is going to hold an advocacy workshop CUTS is going to hold an advocacy workshop involving relevant state government officials to take involving relevant state government officials to take action to improve medicine availability.action to improve medicine availability.
Both national and local newspapers highlighted the Both national and local newspapers highlighted the abysmal availability situation of medicines in the abysmal availability situation of medicines in the public sector and insisted that the state government public sector and insisted that the state government should find out the exact reason and improve the should find out the exact reason and improve the system.system.
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Press Coverage SurveyPress Coverage Survey
1515
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