Analysis of price discrepancies and its impact on rational use of medicines

ABSTRACT

The concept of rational use of medicines requires that patients receive quality efficacious medicines appropriate to their needs, in doses that meet their individual requirements, for the adequate period of time and at the lowest cost to them and to the community. The objectives of the study were to 1] Analyze drug price differences between brands included in Sudan Drug Index [2009], 2] compare current drug prices with prices available in the international market [WHO drug price guide 2010], 3] assess the impact of price discrepancy on rational drug use by prescribers, dispensers and patients. A descriptive, analytical, one time study was done in Khartoum capital, including 54 drugs selected via a pilot study. Questionnaire was designed to elect the perception, attitude, and behavior of prescribers and dispensers, toward price discrepancy and its impact on rational drug use. Information from patients was taken via a structured interview, using a probability value of 0.07; the sample size was 184 pharmacists, 196 doctors and 196 patients. The discrepancy level was very high in Diclofenac Na 75 mg/3 ml inj with an H/L ratio of 73.7. Drug price comparison with the international guide reveled 92.31% of drug prices included in the study were higher than the guide. The impact of price discrepancy on rational drug use by prescribers, dispensers and patients is confusing, indicating a high degree of irrationality. Price discrepancies haven't been explained neither by the national regulatory authority nor by the local agents. The state of confusion on prescribers, dispensers, and patients would be a source of irrational practice with all its implications on rational use of medicines particularly on the end user having the current scarce financial resources. To ensure availability, accessibility and affordability of medicines establishment of a new drug policy becomes of paramount importance