Cost of medicines in Ukraine is the lowest in Europe, and Ukrainians cannot afford them due to low income, according to experts of Spanish nongovernmental organization CivioFoundation.
The experts presented the global investigation into access to medicines around the world on Medicamentalia website. The study compares the prices, accessibility and cost structure of 14 essential drugs in 61 countries. The study was financed by the European Journalism Centre (EJC) and Bill & Melinda Gates Foundation.
CivioFoundation experts used and expanded the database drawn up by Health Action International (HAI) dedicated to strengthening medicines policy to improve public health. The database contained information on 14 essential drugs: diazepam, paracetamol, cotrimoxazole, atenolol, glibenclamide, diclofenac, ceftriaxone, captopril, amoxicillin, amitriptyline, ciprofloxacin, omeprazole, salbutamol and simvastatin. Information about prices was collected for drugs with the same content of active ingredient, dosage form and taking into account the package. The database contains information about prices of drugs for the period starting from 2001 through 2015, taking into account inflation and currency rates’ changes. The experts used the MPR (Median Price reference), the ratio of the drug price versus an international reference value set by the not-for-profit organization MSH.
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The second indicator the experts analyzed is affordability, i.e. the work time needed to pay for a full treatment in each country, using the net salary of the lowest-paid public servant. In both cases, the experts decided to do the analysis using the price of the cheapest generic and display both private (direct purchases in pharmacy counters or with prescription from private insurers) and public data (purchases subsidized partially or fully by public health systems).
For Europe data from Belgium, Germany, Italy, Moldova, Russia, Spain and Ukraine are compared. The experts have come to the conclusion that Ukraine has the lowest prices of almost all drugs, even compared to Moldova and Russia. Particularly, average price of amoxicillin is 4.38 times higher than MPR. Average price of amoxicillin in Russia exceeds MPR by 4.9 times, in Italy – almost 8.8 times and Germany – 25.6 times. Average price of atenolol in Ukraine is less than three-fold higher MPR, while in Moldova it is 5.44 times more than MPR and in Belgium – 15.3 times more.
The experts said that Ukraine has lower prices of ciprofloxacin, diazepam, diclofenac, glibenclamide and ceftriaxone. Only the price of captopril is higher in Ukraine than in Moldova and Russia, but it is cheaper than in the EU countries. The price of cotrimoxazole is higher than in Spain and omeprazole is more expensive than in Russia, but cheaper than in the EU countries.
The CivioFoundation experts said that low prices do not provide for affordability of drugs in Ukraine at the level of European countries, as in western countries the reimbursement systems decrease the price level to MPR and even lower. Europeans do not pay the whole price for drugs, and some drugs are provided free of charge. On the other hand, low prices of drugs in Ukraine in public procurement for medical institutions allow cutting average price compared to other European countries. If the drugs are compared not using absolute prices, but time citizens are to spend to earn money to buy drugs, Ukraine loses to western countries, being at the level of Russia. Ukrainian has to work for four hours to buy cotrimoxazole, while Belgians, Germans and Italians – less than one hour.
Ukrainians have to spend more time for work to buy drugs if they buy them directly in pharmacies compared to Belgians, Germans and Italians. The difference is not large thanks to lower prices of medicines in Ukraine. For some drugs Ukrainian even win not only from Moldova and Russia, but even Europeans. Ukrainians need to work four hours to buy amoxicillin, Russians – five hours, Germans – two hours and Italians – one hour.