Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-24T01:43:59.074Z Has data issue: false hasContentIssue false
  • English
  • Français

International price comparisons of Alzheimer's drugs: a way to close the affordability gap

Published online by Cambridge University Press:  08 September 2009

Guk-Hee Suh ,
Anders Wimo ,
Serge Gauthier ,
Daniel O'Connor ,
Manabu Ikeda ,
Akira Homma ,
Jacqueline Dominguez  and
Bong-Min Yang
Guk-Hee Suh*
Affiliation:
Department of Psychiatry, Hallym University College of Medicine, Seoul, Korea
Anders Wimo
Affiliation:
Alzheimer's disease research center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
Serge Gauthier
Affiliation:
McGill Center for Studies in Aging, Douglas Institute for Mental Health, Montreal, Quebec, Canada
Daniel O'Connor
Affiliation:
Department of Psychological Medicine, Monash University, Kingston Centre, Victoria, Australia
Manabu Ikeda
Affiliation:
Department of Psychiatry and Neuropsychiatry, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Akira Homma
Affiliation:
Dementia Interventional Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Jacqueline Dominguez
Affiliation:
Memory Clinic, Institute of Neuroscience, St. Luke's Medical Center, Quezon City, Phillippines
Bong-Min Yang
Affiliation:
School of Public Health, Seoul National University, Seoul, Korea
*
Correspondence should be addressed to: Professor Guk-Hee Suh, MD, PhD, Department of Psychiatry, Hallym University College of Medicine, Hangang Sacred Heart Hospital, 94–200 Yeongdeungpo-Dong, Seoul, 150-030Korea. Phone: +82-2-2639-5289; Fax: +82-2-2633-5910. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Alzheimer's drugs are believed to have limited availability and to be unaffordable in low- and middle-income countries compared to high-income countries. The price, availability and affordability of Alzheimer's drugs have not been reported before.

Methods: During 2007 an international survey was conducted in 21 countries in six continents (Argentina, Australia, Brazil, the Dominican Republic, France, India, Japan, Macedonia, Mexico, New Zealand, Nigeria, the Philippines, Portugal, Serbia, South Korea, Switzerland, Taiwan, Thailand, Uganda, the U.K. and the U.S.A.). Prices of Alzheimer's drugs were compared using the affordability index (the total number of units purchasable with one's daily income) derived from purchasing power parity (PPP) converted prices as well as raw prices.

Results: Donepezil is available in all 21 countries, whereas the newer drugs are less available. A 5 mg tablet of branded originator donepezil costs just US$0.26 in India and US$0.31 in Mexico, whereas it costs US$6.64 in the U.S.A. Pricing conditions of rivastigmine, galantamine and memantine appear to be similar to that of donepezil. The cheapest branded originators are from India and Mexico. However, in terms of PPP, Alzheimer's drugs in other low- and middle-income countries are much more expensive than in high-income countries. Most people in low- and middle-income countries cannot afford Alzheimer's drugs.

Conclusions: Alzheimer's drugs, albeit available, are often unaffordable for those who need them most. It is hoped that equitable differential pricing will be applied to Alzheimer's drugs.

Keywords

Alzheimer'sdrugpriceavailabilityaffordabilitydementia
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 6 , December 2009 , pp. 1116 - 1126
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Danzon, P. M. and Furukawa, M. F. (2006). Prices and availability of biopharmaceuticals: an international comparison. Health Affairs, 25, 1353–1362.CrossRefGoogle ScholarPubMed
Ferri, C. P. et al. (2005). Global prevalence of dementia: a Delphi consensus study. Lancet, 366, 2112–2117.CrossRefGoogle ScholarPubMed
International Monetary Fund (2008). World Economic and Financial Surveys. Available at http://www.imf.org/external/pubs/ft/weo/2007/02/weodata/index.aspx (last accessed 22 August 2008).Google Scholar
Jorm, A. F., Korten, A. E. and Henderson, A. S. (1987). The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatrica Scandinavica, 76, 465–479.CrossRefGoogle ScholarPubMed
Mendis, S. et al. (2007). The availability and affordability of selected essential medicines for chronic diseases in six low- and middle-income countries. Bulletin of the World Health Organization, 85, 279–289.CrossRefGoogle ScholarPubMed
Murray, C. J. L. and Lopez, A. D. (1996) Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Boston: Harvard University Press.Google Scholar
Steinbrook, R. (2007). Closing the affordability gap for drugs in low-income countries. New England Journal of Medicine, 357, 1996–1999.CrossRefGoogle ScholarPubMed
Wimo, A., Jönsson, L. and Winblad, B. (2007). An estimate of the total worldwide societal costs of dementia in 2005. Alzheimer's and Dementia, 3, 81–91.CrossRefGoogle ScholarPubMed
World Health Organization (2000). Core Indicators on Country Pharmaceutical Situation. Geneva: WHO Publications.Google Scholar
World Health Organization (2002). The World Health Report 2001 Mental Health: New Understanding, New Hope. Geneva: WHO Publications.Google Scholar
World Health Organization/World Trade Organization (2001). Background Paper for the WHO-WTO Secretariat Workshop on Differential Pricing and Financing of Essential Drugs. Available at http://www.wto.org/english/tratop_e/trips_e/hosbjor_presentations_e/28wilder_e.doc (last accessed 22 August 2008).Google Scholar
Yang, B. M., Bae, E. and Kim, J. (2008). Economic evaluation and pharmaceutical reimbursement reform in South Korea's national health insurance. Health Affairs, 27, 179–187.CrossRefGoogle ScholarPubMed