Relationship between pharmaceutical pricing strategies with price, availability, and affordability of cardiovascular disease medicines: surveys in Qatar and Lebanon

• Published in: BMC health services research Vol. 19; no. 1; p. 973
• Main Authors: Abdel Rida, N, Mohamed Ibrahim, M I, Babar, Z U D
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.12.2019; BioMed Central; BMC
• Subjects: Cardiovascular agents; Cardiovascular Agents - economics; Cardiovascular Agents - supply & distribution; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - drug therapy; Chronic illnesses; Commerce - statistics & numerical data; Costs and Cost Analysis - statistics & numerical data; Cross-Sectional Studies; Death; Disease prevention; Drug stores; Drugs; Drugs, Essential - economics; Drugs, Essential - supply & distribution; Drugs, Generic - economics; Drugs, Generic - supply & distribution; Economic indicators; Expenditures; Generic drugs; Generic medicine; Health; Health services; Humans; Lebanon; Medicine; Medicine access; Medicine policy; Medicines prices; Pharmaceutical industry; Pharmaceuticals; Pharmacy; Polls & surveys; Population density; Price cuts; Pricing policies; Primary care; Private Sector - statistics & numerical data; Public health; Public sector; Public Sector - statistics & numerical data; Purchasing; Purchasing power parity; Qatar; Supply chains; Surveys; Surveys and Questionnaires; Lebanon; Qatar; Saudi Arabia; Iran; Cardiovascular disease; Generic medicine; Medicine access; Medicines prices; Medicine policy
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-019-4828-0

Cardiovascular diseases are the leading cause of death in Lebanon and Qatar. When lifestyle modifications prove insufficient, medication becomes a cornerstone in controlling such diseases and saving lives. Price, availability, and affordability hinder the equitable access to medicines. The study aimed to assess prices, availability, and affordability of essential cardiovascular disease medicines in relation to pricing strategies in Qatar and Lebanon. A cross-sectional survey using a variant of the World Health Organization and Health Action International (WHO/HAI) methodology as outlined in "Measuring medicine prices, availability, affordability and price components" (2008), second edition, was adopted. Prices and availability of 27 cardiovascular medicines were collected from public and private dispensing outlets. For international comparison, prices were adjusted to purchasing power parity. Data was analyzed across multiple sectors, within and across countries. A total of 15 public and private outlets were surveyed in each country. Prices were more uniform in Qatar than in Lebanon. In the public sector, medicines were free-of-charge in Lebanon and priced lower than the international reference prices in Qatar. The ratio of medicine unit price to international reference price in the private sectors surveyed are significantly higher than the acceptable threshold of 4. This ratio of originator brands and lowest priced generics in Qatar were up to two and five times those in Lebanon, respectively, even after adjusting for purchasing power parity. However, prices of lowest priced generics in the private sector were at least 35% cheaper in Qatar and 65% cheaper in Lebanon than their comparative originator brands. Medicines were more available in the private sector in Lebanon than in Qatar, but only the originator brand availability in the public sector in Qatar exceeded the WHO target of more than 80%. While affordable in the public sector in Qatar, four out of thirteen medicines exceeded the threshold in all private sectors covered. Hence, only the public sector in Qatar had a satisfying level of availability and affordability. Except for the Qatari public sector, medicine prices, availability, and affordability are falling short from targets. Key policy decisions should be implemented to improve access to medicines.