Availability and Prices of Generic Medicines in the...
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Department of Research and Health Technology Assessment Availability and Prices of Generic Medicines in the Private Sector. Panama. 2012 Beatriz Gómez 1 , Carlos Gordón 1 , Zila Samaniego 2 , Diosa Barahona 3 , Eric Conte 2 , Reina Roa 2 1 Gorgas Memorial Institute of Health Studies, 2 Ministry of Health, 3 Consumer Protection and Competition Authority Source: Database of the National Direction of Pharmacy and Drugs Population: 3,787,511 Area: 75,510 km2 GDP: 23 mil 253.6 millions USD GDP per capita: 9,534 USD Urban Population: 2,514,412 Rural Population: 1,039,111 Indigenous Territories Population: 233,998 Age Structure (%) 0- 14 years: 29.2 15- 64 years: 63.4 64 years and over: 7.4 Life Expectancy at birth Population: 78.1 years Males: 75.35 years Females: 81.0 years Mortality Crude Rate: 4.5/ 1,000 inhabs. Infant Mortality: 12.2/1,000 inhabs. Growth Annual GDP: 10.7% Health Expendure per capita 611 USD Public expenditure in medication 2007- 2011: 672, 951,707 USD Social Security Covered Population: 2.9 millions USD Poverty Population: 40.4% Economic, Social, and Health Indicators of the Republic of Panama. 2012. ICGES Panama, Ave. Justo Arosemena y calle 35. Tel.: (507) 507 - 5926 Fax: (507) 527 - 4889 ZIP Code: Nº 0816 – 02593. email: [email protected] Panama, Republic of Panama http://www.gorgas.gob.pa/SIGMED/Home1.htm BIBLIOGRAPHY World Health Organization and Health Action International. Manual Measuring, Medicine Prices, Availability, Affordability and Price Components. 2008 64 73 93 78 8 78 90 60 71 51 44 72 88 35 82 75 75 87 44 19 69 67 23 49 89 30 ALIMENTARY TRACT AND METABOLISM RESPIRATORY SYSTEM CENTRAL NERVOUS SYSTEM MUSCULOSKELETAL SYSTEM GENITOURINARY SYSTEM CARDIOVASCULAR SYSTEM BLOOD AND BLOOD DERIVATIVES DERMATOLOGIC PRODUCTS ANTIPARASITICS ORGANS OF SENSES MENTAL HEALTH SYSTEMIC HORMONES GENERAL SYSTEMIC ANTIBIOTICS Average Availability of Original and Generic Medicines by Pharmacological Groups. Panama. Year: 2012 Basic Basket of Medicines 0 20 40 60 80 100 120 2006 2007 2008 2009 2010 2011 2012 24 101 65 64 55 91 73 Interchangeability Certificates issued by Generic Medicines.Years: 2006-2012 0.00 5.00 10.00 15.00 20.00 25.00 30.00 BLOOD AND BLOOD DERIVATIVES SYSTEMIC HORMONES MENTAL HEALTH CARDIOVASCULAR SYSTEM GENITOURINARY SYSTEM MUSCULOSKELETAL SYSTEM CENTRAL NERVOUS SYSTEM ANTIPARASITICS DERMATOLOGIC PRODUCTS RESPIRATORY SYSTEM GENERAL SYSTEMIC ANTIBIOTICS ORGANS OF SENSES ALIMENTARY TRACT AND METABOLISM BLOOD AND BLOOD DERIVATIVES SYSTEMIC HORMONES MENTAL HEALTH CARDIOVASCULAR SYSTEM GENITOURINARY SYSTEM MUSCULOSKELETAL SYSTEM CENTRAL NERVOUS SYSTEM ANTIPARASITICS DERMATOLOGIC PRODUCTS RESPIRATORY SYSTEM GENERAL SYSTEMIC ANTIBIOTICS ORGANS OF SENSES ALIMENTARY TRACT AND METABOLISM GENERIC 0.11 0.27 0.52 0.42 0.53 2.48 1.62 2.86 6.87 4.50 5.99 11.02 5.50 ORIGINAL 0.13 0.50 1.00 1.16 1.30 3.48 4.18 4.87 8.90 9.32 12.89 15.99 21.64 Average Price of Original and Generic Medicines by Pharmacological Groups. Panama. Year: 2012 USD N= 473 Source: Database of the National Direction of Pharmacy and Drugs Source: Database of the National Direction of Pharmacy and Drugs Source: Database of the National Direction of Pharmacy and Drugs INTRODUCTION Generic medicines are considered a cheaper alternative but of lower quality compared to the original medicines. The lower price of generic medicines may be related to the limited investment in clinical trials and marketing, or information to follow them up in the market. AIM Develop an information system to identify the price and availability of medicines in private pharmacies in Panama. METHODS We used the model proposed by the World Health Organization and Health Action International. Eighty four (84) private pharmacies were randomly selected in the country from the Pharmacy and Drugs National Direction database available at the Ministry of Health. The survey was conducted by staff from the Consumer Protection and Competition Authority, Ministry of Health, and the Gorgas Institute. It contained a list of 60 medicines: 14 global for comparison with international prices; 16, for regional comparison; and 30, for their local importance within the country. We verified their inclusion in the local interchangeability list. Geographic and web map based information technologies were used to visualize the data. RESULTS The average availability of medicines in private pharmacies in Panama was 67% for generics and 57% for the originals. Generic medicines recorded an average price 48% less than that of original medicines. In rural and indigenous areas the availability was lower, but the prices were higher. From the list of 60 medicines, 23 required interchangeability and only 8 were available in all 9 provinces. However, in the indigenous territories, private pharmacies are inexistent. CONCLUSIONS The challenge facing the medicine market is the limited information on generic medicines. The information system that we developed has allowed (1) the implementation of a systematic price monitoring by Consumer Protection and Competition Authority regularly and (2) the creation of the “Basic Basket of Medicines" (CABAMED), whose goal is to provides price information of a generic medicine group in the market available for pharmacological treatment. Likewise, CABAMED offers interchangeable product information and therapeutic equivalence of the generic medicines efficacy, becoming a mechanism for improving market price, availability and affordability. 0 0 1 4 19 32 35 42 43 49 113 500 0 100 200 300 400 500 600 COMARCA EMBERA COMARCA NGABE BUGLE COMARCA GUNA YALA DARIEN BOCAS DEL TORO HERRERA LOS SANTOS VERAGUAS COLON COCLE CHIRIQUI PANAMA # Pharmacies Provinces Public and Private Pharmacies Distributed by Province. Panama. Year: 2012 N= 838 0 0 0 1 8 9 10 11 11 11 22 59 0 10 20 30 40 50 60 70 DARIEN COMARCA EMBERA COMARCA NGABE BUGLE COMARCA GUNA YALA BOCAS DEL TORO HERRERA COCLE COLON LOS SANTOS VERAGUAS CHIRIQUI PANAMA # Pharmacies Provinces Public Pharmacies Distributed by Province. Panama. Year: 2012 N= 142 0 0 0 4 11 23 24 31 32 39 91 441 0 100 200 300 400 500 COMARCA GUNA YALA COMARCA EMBERA COMARCA NGABE BUGLE DARIEN BOCAS DEL TORO HERRERA LOS SANTOS VERAGUAS COLON COCLE CHIRIQUI PANAMA # Pharmacies Provinces Private Pharmacies Distributed by Province. Panama. Year: 2012 N= 696 % GENERICS % ORIGINALS 71 58 47 27 0 10 20 30 40 50 60 70 80 URBAN ZONE RURAL ZONE Average Availability of Original and Generic Medicines by Urban and Rural Zone, as Pharmacological Groups. Panama. Year: 2012 % GENERICS % ORIGINALS
Transcript of Availability and Prices of Generic Medicines in the...
Department of Research and Health Technology Assessment
Availability and Prices of Generic Medicines in the Private Sector.
Panama. 2012
Beatriz Gómez1, Carlos Gordón1, Zila Samaniego2, Diosa Barahona3 , Eric Conte2, Reina Roa2
1Gorgas Memorial Institute of Health Studies, 2Ministry of Health, 3 Consumer Protection and Competition Authority
Source: Database of the National Direction of Pharmacy and Drugs
Population: 3,787,511
Area: 75,510 km2
GDP: 23 mil 253.6 millions
USD
GDP per capita: 9,534 USD
%
Urban Population:
2,514,412
Rural Population:
1,039,111
Indigenous Territories
Population:
233,998
Age Structure (%)
0- 14 years: 29.2
15- 64 years: 63.4
64 years and over: 7.4
Life Expectancy at birth
Population: 78.1 years
Males: 75.35 years
Females: 81.0 years
Mortality Crude Rate: 4.5/ 1,000 inhabs.
Infant Mortality: 12.2/1,000 inhabs.
Growth Annual GDP: 10.7%
Health Expendure per capita
611 USD
Public expenditure in
medication 2007- 2011:
672, 951,707 USD
Social Security Covered
Population: 2.9 millions USD
Poverty Population: 40.4%
Economic, Social, and Health Indicators of the
Republic of Panama. 2012.
ICGES Panama, Ave. Justo Arosemena y calle 35. Tel.: (507) 507 - 5926 Fax: (507) 527 - 4889
ZIP Code: Nº 0816 – 02593. email: [email protected] Panama, Republic of Panama
http://www.gorgas.gob.pa/SIGMED/Home1.htm
BIBLIOGRAPHY World Health Organization and Health Action International. Manual Measuring, Medicine Prices,
Availability, Affordability and Price Components. 2008
64
73
93
78
8
78
90
60
71
51
44
72
88
35
82
75
75
87
44
19
69
67
23
49
89
30
ALIMENTARY TRACT AND METABOLISM
RESPIRATORY SYSTEM
CENTRAL NERVOUS SYSTEM
MUSCULOSKELETAL SYSTEM
GENITOURINARY SYSTEM
CARDIOVASCULAR SYSTEM
BLOOD AND BLOOD DERIVATIVES
DERMATOLOGIC PRODUCTS
ANTIPARASITICS
ORGANS OF SENSES
MENTAL HEALTH
SYSTEMIC HORMONES
GENERAL SYSTEMIC ANTIBIOTICS
Average Availability of Original and Generic Medicines by Pharmacological Groups.
Panama. Year: 2012
Basic Basket of Medicines
0
20
40
60
80
100
120
2006 2007 2008 2009 2010 2011 2012
24
101
65 64
55
91
73
Interchangeability Certificates issued by Generic Medicines.Years: 2006-2012
0.00 5.00 10.00 15.00 20.00 25.00 30.00
BLOOD AND BLOOD DERIVATIVES
SYSTEMIC HORMONES
MENTAL HEALTH
CARDIOVASCULAR SYSTEM
GENITOURINARY SYSTEM
MUSCULOSKELETAL SYSTEM
CENTRAL NERVOUS SYSTEM
ANTIPARASITICS
DERMATOLOGIC PRODUCTS
RESPIRATORY SYSTEM
GENERAL SYSTEMIC ANTIBIOTICS
ORGANS OF SENSES
ALIMENTARY TRACT AND METABOLISM
BLOOD ANDBLOOD
DERIVATIVES
SYSTEMICHORMONES
MENTAL HEALTHCARDIOVASCULAR
SYSTEMGENITOURINARY
SYSTEMMUSCULOSKELETAL
SYSTEMCENTRAL NERVOUS
SYSTEMANTIPARASITICS
DERMATOLOGICPRODUCTS
RESPIRATORYSYSTEM
GENERAL SYSTEMICANTIBIOTICS
ORGANS OF SENSESALIMENTARYTRACT AND
METABOLISM
GENERIC 0.11 0.27 0.52 0.42 0.53 2.48 1.62 2.86 6.87 4.50 5.99 11.02 5.50
ORIGINAL 0.13 0.50 1.00 1.16 1.30 3.48 4.18 4.87 8.90 9.32 12.89 15.99 21.64
Average Price of Original and Generic Medicines by Pharmacological Groups. Panama. Year: 2012
USD
N= 473
Source: Database of the National Direction of Pharmacy and Drugs
Source: Database of the National Direction of Pharmacy and Drugs Source: Database of the National Direction of Pharmacy and Drugs
INTRODUCTION
Generic medicines are considered a cheaper
alternative but of lower quality compared to the
original medicines. The lower price of generic
medicines may be related to the limited
investment in clinical trials and marketing, or
information to follow them up in the market.
AIM
Develop an information system to identify the
price and availability of medicines in private
pharmacies in Panama.
METHODS
We used the model proposed by the World
Health Organization and Health Action
International. Eighty four (84) private pharmacies
were randomly selected in the country from the
Pharmacy and Drugs National Direction
database available at the Ministry of Health. The
survey was conducted by staff from the
Consumer Protection and Competition Authority,
Ministry of Health, and the Gorgas Institute. It
contained a list of 60 medicines: 14 global for
comparison with international prices; 16, for
regional comparison; and 30, for their local
importance within the country. We verified their
inclusion in the local interchangeability list.
Geographic and web map based information
technologies were used to visualize the data.
RESULTS
The average availability of medicines in private
pharmacies in Panama was 67% for generics
and 57% for the originals. Generic medicines
recorded an average price 48% less than that of
original medicines. In rural and indigenous areas
the availability was lower, but the prices were
higher. From the list of 60 medicines, 23 required
interchangeability and only 8 were available in all
9 provinces. However, in the indigenous
territories, private pharmacies are inexistent.
CONCLUSIONS
The challenge facing the medicine market is the
limited information on generic medicines. The
information system that we developed has
allowed (1) the implementation of a systematic
price monitoring by Consumer Protection and
Competition Authority regularly and (2) the
creation of the “Basic Basket of Medicines"
(CABAMED), whose goal is to provides price
information of a generic medicine group in the
market available for pharmacological treatment.
Likewise, CABAMED offers interchangeable
product information and therapeutic equivalence
of the generic medicines efficacy, becoming a
mechanism for improving market price,
availability and affordability.
0 0 1 4 19 32 35 42 43 49 113
500
0
100
200
300
400
500
600
COMARCAEMBERA
COMARCANGABEBUGLE
COMARCAGUNA YALA
DARIEN BOCAS DELTORO
HERRERA LOS SANTOS VERAGUAS COLON COCLE CHIRIQUI PANAMA
# P
ha
rma
cie
s
Provinces
Public and Private Pharmacies Distributed by Province. Panama. Year: 2012
N= 838
0 0 0 1 8 9 10 11 11 11
22
59
0
10
20
30
40
50
60
70
DARIEN COMARCAEMBERA
COMARCANGABEBUGLE
COMARCAGUNAYALA
BOCAS DELTORO
HERRERA COCLE COLON LOSSANTOS
VERAGUAS CHIRIQUI PANAMA
# P
har
mac
ies
Provinces
Public Pharmacies Distributed by Province. Panama. Year: 2012
N= 142
0 0 0 4 11 23 24 31 32 39 91
441
0
100
200
300
400
500
COMARCAGUNA YALA
COMARCAEMBERA
COMARCANGABEBUGLE
DARIEN BOCAS DELTORO
HERRERA LOS SANTOS VERAGUAS COLON COCLE CHIRIQUI PANAMA
# P
harm
acie
s
Provinces
Private Pharmacies Distributed by Province. Panama. Year: 2012
N= 696
% GENERICS
% ORIGINALS
71
58
47
27
0
10
20
30
40
50
60
70
80
URBAN ZONE RURAL ZONE
Average Availability of Original and Generic Medicines by Urban and Rural
Zone, as Pharmacological Groups. Panama. Year: 2012
% GENERICS
% ORIGINALS
