[Ip-health] UK leads initiative to drive down cost of drugs in poor countries

[Joana Ramos]

URL for Medicines Transparency Alliance:
http://www.dfidhealthrc.org/MeTA/index.html

http://www.bmj.com/cgi/content/full/334/7599/870-a

BMJ  2007;334:870 (28 April), doi:10.1136/bmj.39195.388356.DB


    News


      UK leads initiative to drive down cost of drugs in poor countries

*Robert Short*

London

A new organisation is being set up to increase transparency^ in the
regulation, procurement, distribution, and sales of drugs^ in developing
countries. Its objective is to drive the cost^ of drugs down to levels
that patients can afford.^

The UK led initiative, called the Medicines Transparency Alliance,^ has
just had its first stakeholder meeting and will be launched^ in the
coming months. It will run pilot projects in up to nine^ countries. Its
aim is to publish information on the amount,^ quality, and price of
drugs in poor countries; to allow patients^ to see what they should pay
and give them confidence in the^ quality and safety of the drugs; and to
create a forum in each^ pilot country that will bring together patients,
doctors, non-governmental^ organisations, and those involved in
supplying drugs.^

Hilary Benn, secretary of state for international development,^ said at
the stakeholder meeting: "One third of the world's population^ has no
access to the drugs they need to help them fight disease,^ and up to 30%
of drugs available in the poorest countries are^ fake or substandard.
Even when the right medicines are available^ they are unaffordable for
the majority of people in developing^ countries, with mark-ups of up to
500% by some pharmacists."^

The UK Department for International Development is also creating^ an
international advisory body to inform it of new developments^ and to
identify ways to obtain and deliver drugs at sensible^ prices to the
developing world. At an international conference^ on access to drugs,
hosted jointly by the department and the/^ Lancet/, the department's
undersecretary of state, Gareth Thomas,^ challenged the drug industry,
non-governmental organisations,^ and governments to find new ways to
ensure that drugs reached^ people in developing countries at affordable
prices. He invited^ participants at the conference to contribute to
further debate^ at the department and to put themselves forward to join
the^ advisory body.^

"Finding new, innovative solutions-through new partnerships^ and
networks, bringing down costs, accelerating research, [and]^ jumping
over legal hurdles-is vital if we are to get serious^ about improving
access to medicines for the poorest people of^ the world," said Mr Thomas.^

Presentations at the conference showed that success in reducing^ the
cost of drugs in developing countries is not just about^ obtaining
discounts from the industry and engineering flexibility^ in patent
rights-the subjects of media attention. Access^ to drugs is affected by
every aspect of the supply process,^ delegates heard. Relevant factors
included research into and^ development of treatments for neglected
diseases; patent control^ over the manufacture and sale of drugs;
competition with generic^ drugs; the supply chain by which the drugs are
delivered; unethical^ local incentives to supply specific drugs;
government support^ of health priorities; and the means by which
hospitals and clinics^ are able to get payment for services to patients.^

Jonathan T Mwiindi, from the Ecumenical Pharmaceutical Network,^ Kenya,
commented on the difficulty of dealing with the unethical^ and often
invisible practices of intermediaries in the supply^ chain. For
instance, retailers may receive incentives (such^ as a television) for
stocking certain products; and prescribing^ patterns may be sold to
agents, who then put pressure on individual^ doctors. He believes that
there has been a shift from a culture^ of medical representatives
offering information on the best^ use of drugs to one of sales
representatives who are paid incentives^ to maximise volume generated
from prescribers.^

Trevor Jones, former head of the Association of the British^
Pharmaceutical Industry, suggested a naming and shaming mechanism^ to
counter bad practices. However, one of the conference participants^
pointed out that such a procedure might endanger the lives of^ the
whistleblowers and the perpetrators in some countries.^

It was also pointed out that the local mark-up of drug prices^ is not
always caused by corruption. In many hospitals most patients^ are
unwilling to pay for "non-tangibles," such as a consultation^ that
results in no drug being prescribed. So the mark-up is^ sometimes the
main way by which hospitals can cover their consultation^ and other
costs, and it is the cheapest drugs that are most^ often heavily marked
up.^


    Rapid Responses:

Read all _Rapid Responses_ <http://www.bmj.com/cgi/eletters/334/7599/870-a>

*Economic value relative to clinical outcome should be the U.K.'s
objective.*
    Jeremiah Norris
    bmj.com, 28 Apr 2007 _[Full text]:
    http://www.bmj.com/cgi/eletters/334/7599/870-a#164510_
    <http://www.bmj.com/cgi/eletters/334/7599/870-a#164510>



--
Joana Ramos, MSW
Cancer Resources & Advocacy
Seattle WA USA
Tel. +1-206-229-2420
http://ramoslink.info/
www.cancersurvivorsproject.org
www.healthyskepticism.org