Shocking drug price disparities

Source: Shocking drug price disparities | The Herald January 10, 2020

Shocking drug price disparitiesAviation Ground Services employees offload medical drugs that were bought by the Government at Robert Gabriel Mugabe International Airport in Harare yesterday

Paidamoyo Chipunza Senior Health Reporter
Patients seeking to buy medicines from the private sector need to shop around and compare prices first owing to huge disparities in the cost of similar products at different retail pharmacies.

Tech-savvy patients have since created social media groups where they advise each other on pharmacies that sell cheaper medicines.

A survey conducted by The Herald yesterday showed prices could be half in one pharmacy compared to another, mainly in over-the-counter (OTC) medicines.

This has triggered the call for the regulation of pharmaceutical products to protect patients from unscrupulous wholesalers and retailers.

In the absence of a law to control prices of pharmaceutical products, the Government can bring competition to the market through the capacitation and revival of local pharmaceutical manufacturers such as CAPS, Varichem and Natpham, which can procure cheaper medicines on a government-to-government arrangement.

The Government is also working towards assisting wholesalers in accessing foreign currency from the Reserve Bank of Zimbabwe (RBZ) and not the black market, to reduce the costs of imports.

In one pharmacy, 200ml of Benylin 4flu syrup was going for $224 while two other pharmacies charged $184 and $108. One week’s supply of Paracetamol tablets for adults costs around $110 in some pharmacies, yet others charge as low as $40.

In one pharmacy, a box of 100 Adco-dol tablets for headaches was sold at $356 against the lowest of $264 in a different pharmacy. The disparities are also seen on the pricing of Betadine, which is sold at $69 and $34.50 in different pharmacies.

Some wholesalers are also part of cartels in the sector with exclusive rights to certain products by particular manufacturers, hence determine pricing by retailers.

For a long time, these cartels have been getting cheaper medicines from manufacturers but put more than 100 percent mark-up when selling the same products locally.

Investigations carried out by The Herald last year revealed that one of the wholesalers has exclusive rights from most Indian manufacturers to provide at least 85 percent of these cheaper drugs to both the private and public health sectors.

While the pharmaceutical industry attributed the disparities to buying foreign currency from “sources”, resulting in many charging speculative prices, patients interviewed expressed concern over the disparities arguing that there was an element of profiteering.

In some instances, people are having to buy OTC medicines from neighbouring countries like South Africa and Zambia where prices are way cheaper, compared to local costs even when one factors in the parallel market exchange rate.

For example, the cost of 100 Adco-dol tablets for headache is around R100 in South African pharmacies, which is an equivalent of about $120 using the prevailing parallel market rate.

“Sometimes, one pharmacy can have selected pharmaceuticals cheaper compared to others. This means if you buy the whole prescription from one shop you might pay more than when you shop around first and buy separate items from different outlets,” said Mrs Zodia Marowa of Harare.

She said sometimes it makes sense to buy OTC medications in bulk for children beyond the borders where prices are cheaper.

Retail Pharmacists Association chairperson Mrs Jocelyn Chaibva said as an industry, their focus was largely on monitoring prices of medication for chronic diseases.

She said disparities call for industry to also monitor pricing of OTC medicines.

“Our focus had been on monitoring mark-up percentages of medication for chronic diseases such cancers, diabetes and high blood pressure, as well as anti-retroviral drugs.

“We have been negotiating with wholesalers and manufacturers to give us the medicines at reasonable costs and we have also been urging our members not to effect mark up costs of over 20 percent,” said Mrs Chaibva.

She said following concerns from patients on the disparities, the RPA will also consider looking into OTC medicines.

Pharmaceutical Wholesalers Association chairman Mr Kudakwashe Chapfika attributed the disparities to fluctuating rates of foreign currency, arguing that some people end up using speculative rates to cushion themselves against changing rates.

“Pricing is currently affected by different sources of accessing foreign currency and the rates at which one accesses the foreign currency.

“What it means is if one has access to cheaper foreign currency, their products are also likely to be cheaper. So it is the rate that determines pricing of medicines,” said Mr Chapfika.

Asked if they were not getting allocations at the interbank rate, Mr Chapfika said released funds were too insignificant to satisfy the actual needs.

Health and Child Care Minister Dr Obadiah Moyo said the Government will continue working to ensure that wholesalers access foreign currency at the interbank rate.

He said this will go a long way in bringing down the cost of medicines in private pharmacies.