Medicine prices in 2017 and 2018 as a reflection of the effectiveness of government measures to ­ensure access to medicines

Abstract

Aim. To conduct a comparative analysis of medicine prices in 2017 and 2018 years in Kazan (The Republic of Tatarstan, The Russian Federation) to assess the effectiveness of government measures to ensure the accessibility of medicines.

Methods. We conducted a comparative analysis of medicine prices according to methodology developed by Health Action International and World Health Organization (WHO/HAI). The analysis included 30 medicines at a preselected dosage form. We studied the accessibility and prices of original brands and lowest priced generic of each medicine in the public and private pharmacies of Kazan in 2017 and 2018, and analyzed the procurement prices of the same medicines in inpatient hospitals. Medicine prices were compared with international reference prices (The Management Sciences for Health (MSH) reference prices) and expressed as median price ratio (MPR).

Results. Prices for originator and generic medicines in the public and private sectors tended to decrease in 2018 compared to 2017, but statistically significant price reduction occurred only for generic medicines in the private sector. For example, the median price ratio for originator products changed from 6.86 to 2.97 in the public sector and from 11.1 to 5.36 in the private sector in 2018 compared to 2017, but the changes were not statistically significant (p >0.05). Prices for generics medicines in the public sector did not change in the studied years and remained at the level of international reference prices (the median price ratio were 1.3 in 2017 and 1.27 in 2018). In the private sector, we found a twofold decrease in the prices of generics medicines in 2018 compared to 2017 [the median price ratio decreased from 3.25 to 1.44 (p <0.05)]. Procurement prices for generics medicines in public hospitals in 2017 and 2018 years did not show statistically significant changes with the median price ratio equal to 1.34 and 0.8, respectively.

Conclusion. Government price control measures of medicines contributed to maintaining the price of generic medicines at the reference prices level in the public sector and to halving the price of generic medicines in the private sector in 2018 compared to 2017.

Keywords

medicine prices / Accessibility of Medicines / procurement prices / pharmacy / WHO/HAI

References

[1] Government of the Netherlands. Keeping medicines affordable. https://www.government.nl/topics/medicines/keeping-medicines-affordable (access date: 28.01.2020).

[2] Health Action International. Pricing & related poli­cies. https://haiweb.org/what-we-do/price-availability-­affordability/resources-for-pricing-policies/ (access date: 28.01.2020).

[3] Health Action International. New and affordable me­dicines in the Netherlands: Tracing the Dutch Go­vernment’s Policy Commitments and Actions. https://haiweb.org/wp-content/uploads/2019/06/NL-Government-­Commitments-on-New-Affordable-Medicines-1.pdf (access date: 28.01.2020).

[4] Reso­lutions of the Government of the Russian Federation of October 29, 2010 No. 865 “State regulation of prices for drugs included in the list of vital and essential medicines”. (In Russ.)

[5] Постановление Правительства РФ от 29 октября 2010 г. №865 «О государственном регулировании цен на лекарственные препараты, включённые в перечень жизненно необходимых и важнейших лекарственных препаратов». https://www.rosminzdrav.ru/documents/7459-postanovlenie-pravitelstva-rf-865-ot-29-oktyabrya-2010-g (дата обращения: 28.01.2020).

[6] Razzakova Ch.M., Ziganshina L.E. Change in affordability of medications in Kazan in 2011 and 2015 as a reflection of state initiatives to regulate drug pri­ces. Kazan medical journal. 2017; (5): 822–826. (In Russ.) DOI: 10.17750/KMJ2017-822.

[7] Раззакова Ч.М., Зиганшина Л.Е. Изменение ценовой доступности лекарственных препаратов в Казани в 2010 и 2015 годах как отражение государственных мер по регулированию цен на лекарства. Казанский мед. ж. 2017; (5): 822–826. DOI: 10.17750/KMJ2017-822.

[8] Razzakova Ch.M., Ziganshina L.E. Cardiovascular medicine prices as an indicator of access to medicines and their rational use. Rational pharmacotherapy in cardiology. 2019; 15 (2): 215–223. (In Russ.) DOI: 10.20996/1819-6446-2019-15-2-215-223.

[9] Раззакова Ч.М., Зиганшина Л.Е. Цены на сердечно-сосудистые лекарственные препараты как показатель доступности лекарств для их рационального использования. Рационал. фармакотерап. в кардиол. 2019; 15 (2): 215–223. DOI: 10.20996/1819-6446-2019-15-2-215-223.

[10] Resolutions of the Government of the Russian Federation of February 3, 2016 No. 58 «On amendments to the Decree of the Government of the Russian Federation of October 29, 2010 No. 865 “On state regulation of prices for medi­cines included in the list of vital and essential medicines”». (In Russ.)

[11] Постановление правительства РФ от 3 февраля 2016 г. №58 «О внесении изменений в Постановление Правительства РФ от 29 октября 2010 г. №865 “О государственном регулировании цен на лекарственные препараты, включённые в перечень жизненно необходимых и важнейших лекарственных препаратов”».

[12] Health Action International. Measuring medicine prices, availability, affordability and price components. 2nd ed. https://haiweb.org/price-availability-affordability/collec­ting-evidence-on-medicine-prices-availability/ (access date: 28.01.2020).

[13] Management Sciences for Health. International drug price indicator guide. http://mshpriceguide.org/en/home/ (access date: 28.01.2020).

[14] Cameron A.М., Ewen M., Ross-Degnan D. et al. Medicine prices, availability, and affordability in 36 deve­loping and middle-income countries: a secondary analysis. Lancet. 2009; 373 (9659): 240–249. DOI: 10.1016/S0140-6736(08)61762-6.

[15] Babar Z.U., Ibrahim M.I., Singh H. et al. Evalua­ting drug prices, availability, affordability, and price components: Implications for access to drugs in Malaysia. PLoS Med. 2007; 4 (3): e82. DOI: 10.1371/journal.pmed.0040082.

[16] Khuluza F., Haefele-Abah C. The availability, pri­ces and affordability of essential medicines in Malawi: A cross-sectional study. PLoS ONE. 2019; 14 (2): e0212125. DOI: 10.1371/journal.pone.0212125.

[17] Dabare P., Wanigatunge C., Beneragama B. A national survey on availability, price and affordability of selected essential medicines for non communicable disea­ses in Sri Lanka. BMC Public Health. 2014; 14 (1): 817–831. DOI: 10.1186/1471-2458-14-817.

[18] Health Action International. Medicine prices, avai­lability, affordability & price components database. https://haiweb.org/survey-related-reports/ (access date: 28.01.2020).

[19] Imaeva A.E., Balanova Y.A., Kontsevaya A.V. et al. Availability and Affor­dability of Medicines for the Treatment of Cardiovascular Diseases in Pharmacies in Six Regions of the Russian Fe­deration. Rational Pharmacotherapy in Cardiology. 2018; 14 (6): 804–815. (In Russ.) DOI: 10.20996/1819-6446-2018-14-6-804-815.

[20] Имаева А.Э., Баланова Ю.А., Концевая А.В. и др. Наличие и доступность препаратов для лечения сердечно-сосудистых заболеваний в аптеках шести регионов Российской Федерации. Рационал. фармакотерап. в кардиол. 2018; 14 (6): 804–815. DOI: 10.20996/1819-6446-2018-14-6-804-815.

[21] Order Of the government of the Russian Federation of October 23, 2017 No. 23233-r “On approval of the list of vital and essential medicines for medical use for 2018”. (In Russ.)

[22] Распоряжение от 23 октября 2017 г. №­2323-р «Об утверждении перечня жизненно необходимых и важнейших лекарственных препаратов для медицинского применения на 2018 год». http://government.ru/docs/29758/ (дата обращения: 28.01.2020).

[23] Resolutions of the Government of the Russian Federation of November 28, 2013 No. 1086 “On approval of the Rules for the formation of the list of medicines, the purchase of which is carried out in accordance with their trade names”. (In Russ.)

[24] Постановление Правительства РФ от 28 ноября 2013 г. №1086 «Об утверждении Правил формирования перечня лекарственных средств, закупка которых осуществляется в соответствии с их торговыми наименованиями». http://minfin.tatarstan.ru/normativno-pravovie-dokumenti-v-sfere-zakupok.htm?page=2 (дата обращения: 28.01.2020).

[25] Resolutions of the Government of the Russian Federation of November 15, 2017 No. 1380 “On the specifics of the description of drugs for medical use, which are the subject of procurement to meet state and municipal needs”. (In Russ.)

[26] Постановление Правительства Российской Федерации от 15 ноября 2017 г. №1380 «Об особенностях описания лекарственных препаратов для медицинского применения, являющихся объектом закупки для обеспечения государственных и муниципальных нужд». http://government.ru/docs/30157/ (дата обращения: 28.01.2020).

[27] Order of the Ministry of Health of the Russian Federation of 10.26.2017 No. 871n “On appro­val of the Procedure for determining the initial (maximum) price of a contract, the price of a contract concluded with a single supplier (contractor) when purchasing medicines for medical use”. (In Russ.)

[28] Приказ Министерства здравоохранения Российской Федерации от 26.10.2017 №871н «Об утверждении Порядка определения начальной (максимальной) цены контракта, цены контракта, заключаемого с единственным поставщиком (подрядчиком, исполнителем), при осуществлении закупок лекарственных препаратов для медицинского применения». http://publication.pravo.gov.ru/Document/View/0001201711280009 (дата обращения: 28.01.2020).

[29] Federal Antimonopoly Service of the Russian Federation. “Report on the state of competition in the Russian Federation for 2017”. (In Russ.)

[30] Федеральная антимонопольная служба России. Доклад о состоянии конкуренции в Российской Федерации за 2017 г. https://fas.gov.ru/documents/658027 (дата обращения: 28.01.2020).

RIGHTS & PERMISSIONS

Razzakova C.M., Ziganshina L.E.