PCN231 - PRICING, AVAILABILITY, AFFORDABILITY, PRICE COMPONENTS OF ESSENTIAL ANTICANCER MEDICINES IN ADDIS ABABA, ETHIOPIA

Abstract

To investigate the price, availability, affordability and price components of essential anticancer medicines in Addis Ababa, Ethiopia. The survey assessed the pricing, availability, affordability and price components of essential anticancer medicines using the standardized WHO/HAI methodology. Data on the availability and patient prices of 17 anticancer medicines for both lowest priced generics (LPGs) and innovator brands (IBs) –15 from the global core list, and 2 supplementary anticancer medicines were collected from 2 national oncology Centers and 5 private pharmacies. Government procurement prices were collected from public procurement agency. Price component survey was conducted to identify various components contributing to the final patient medicine price. Median Price Ratios (MPR) were computed and the daily wage of lowest unskilled government worker used to assess affordability of the medicines. Cross sector and cross country comparison of prices and affordability was performed to reflect situations. The Mean availability of LPG anticancer medicines were fairly high (56.9%) in public but low (18.8%) in private sector. Generics were the only product type available in both sectors. The MPR, the public sector procuring LPGs, was 1.10 times the international reference prices. LPG anticancer medicines were sold at 1.29 and 2.62 times the international reference prices in the public and private sector respectively. Patient prices were increased by 45.3 % as a result of add-on costs in public sector and manufacturer selling price was the top contributor. However, these patient prices were 94.5% lower compared to private. The lowest price generics in both sectors were not affordable. International Comparison indicated better availability, higher prices, and worse affordability of anticancer medicines in Ethiopia than most of the other countries included in the analysis. Mixes of policies need to be implemented to make essential anticancer medicines more available and affordable particularly for the low income group of the population.