8/7/2019 Evidence of Drug Prices in Indonesia

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Evidences of Drug Prices in

Indonesia

Erni Widiastri and Hasbullah ThabranyCenter for Health Economics and Policy

Analysis, Universitas Indonesia

hasbullah.thabrany@ui.edu

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Drugs and Other Cossumables?

Other Consumables: VeryResponsive to Market

Much less information

asymetry

Free entry and exit ofsupply

Normal good

Price and income elastis

Consumers are rational

Consumers direct decision

to consume

Drugs

Huge asymetric ofinformation

Barrier to entry Essential product, life

threthening

Income and price inelastis

Consumers are much lessrational

Doctors decideconsumption

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The Size of Pharmacy Market in Indonesia

Year Pharma

Market (Bill

IDR)

US$

Estimate

(Bill US$)2005 23,629 2.5

2006 23,174 2.4

2007 25,700 2.72008 29,700 3.1

2009 32,900 3.2

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10.67

21.8

80.72

86.81

73.09

9.5

1.69

40.49 40.94

5.511.77 1.69

6.03 5.32 5.51

0

10

20

30

40

50

60

70

80

90

100

Amoxicillin 500mg,tab/cap

Captopril 25 mg, tab Ciprofloxacin 500mg, tab

Diazepam 5 mg, tab Glibenclamide 5 mgtab

MedianPriceRatio

Generic Name

Retail Prices in Public Hospitals inIndonesia

Brand

Most Sold

Lowest Price

Sumber: BPOM 2004

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Original ;

Ponstan 250 mg XV Rp 18.700

Ciproxin 500 mg X Rp 289.200

Immunos VII Rp 43.900

Max C 500 mg VII Rp 18.800

TOTAL Rp 370.600

AlternativeI ;Pondex 250 mg XV Rp 7.100

Baquinor 500 mg X Rp 128.700

Immunos VII Rp 43.900

Max C 500 mg VII Rp 198.500

. TOTAL Rp 107.700

Alternative2 ; As mefenamat 250 Rp 3.000

Ciprofloxasin 500 Rp 14.500

Immunos VII Rp 43.900

Max C 500 mg VII Rp 18.800

TOTAL Rp 81.100

Original;

Medrol 4 mg X Rp 31.300

Claritin VII Rp 41.850

Zantac XV Rp 106.300

Vantiz X Rp 30..200

TOTAL Rp 209.650

AlternativeI ;Lameson 4 mg Rp 28.400

Alloris Rp 30.300

Rantin 150mg Rp 70.700

Vantiz x Rp 30..200

TOTAL Rp 159.600

Alternative2 ;Methyl Prednisolon Rp 16.900

Loratadine Rp 5.200

Ranitidine Rp 43.900

Vantiz x Rp 30.200

TOTAL Rp 65.200

Original;

Daonil XXXX Rp 93.700

Glucopace 500 LX Rp 74..000

Nervitone XXX Rp 25.700

TOTAL Rp 193.500

Alternatiive I ;Prodiamel Rp 16.400

Glukotika 500 Rp 65.600

Nervitone E Rp 25.700

TOTAL Rp 107.700

Alternative2 ;Glibenclamide Rp 7.000

Methormine 500 Rp 28.400

Nervitone E Rp 25.700

TOTAL Rp 61.100

Original ;

Duricef 350 mg X Rp 134.000

Puyer no XV Rp 8.600

TOTAL Rp 142.600

AlternativeI ;Doxcef Rp 48.900

Puyer no XV Rp 8.600

TOTAL Rp 57.500

Alternativef 2 ;Cefadroxil Rp 23.700

Puyer no XV Rp 8.600

TOTAL Rp 32.300

A Drs Pres in aCempaka Putih

R in DharmaisHospital

Sumber; Gatra 1 th 2006/Danutirto

R/ in Islam ic Jakarta R in Prov Health

Variations and Substitutions of Prescriptions

Drugs in Indonesia

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Price Survey, 2004

No NAMA OBAT AP.1 AP.2 AP.3 AP4. AP.5 AP 6. AP 7 AP 8.

1. Amoxyl 250 (SKB/GSK) 2.610 2.313 2.750 - 1.720 2994 - -

Amoxan 250 (Sanbe) 1.862 1.650 - 1.750 1.650 1782 1760 1.650

Amoksisilin 250 (G) 310 272 300 355 355 283 300 272

2. Cyproxin 500 (Bayer) 28.765 25.485 20.000 - 20.000 27.524 - 20.625Baquinor 500 (Sanbe) 13.425 11.894 - 10.000 9.750 12.895 12.70

011.894

Siprofloksasin 500 (G) 1.600 1.404 2.000 1.459 1.450 1.123 1.300 1.080

3 Cozaar 50 (MSD) 12.518 - - 12.667 - 13.167 - -

Insaar 50 (Interbat) 10.855 - 8.000 10.000 - 10.395 - -

Losartan 50 - - - - - - - -

MARGIN 33% 25% 20% 28% 30% 30-35%

33.33%

25%

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Retail Prices in Public Hospitals are

More Expensives

No Drug Names Hosp1

Hosp2

Hosp3

Hosp4

Hosp5

Hosp6

1. Amoxyl 250 (SKB/GSK) - - - 2.902 - -

Amoxan 250 (Sanbe) 1.584 - 1.657 1.772 1.652 1.320

Amoksisilin 250 (G) 259,52 293,75 455 450 362 210

2. Cyproxin 500 (Bayer) - 25.257 - 28.075 - 20.388

Baquinor 500 (Sanbe) 11.018 11.562 - 12.775 - 9.515

Siprofloksasin 500 (G) 518,43 420 339,7 2.142 - 1.120

3 Cozaar 50 (MSD) - 8.955 - 12.760 - -

Insaar 50 (Interbat) - 8.020 - 9.846 9.305 7.760

Losartan 50 - - 9.183 9.305 7.700

MARGIN 20% 33% 25% 20% 25% 20%

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Average Prices of Cifrofloxacin per Episode of

Treatment in Several ASEAN Countries, US$

4,81 4,35 4,052,92

2,36

0,00

1,00

2,00

3,00

4,00

5,00

Singapore Malaysia Indonesia Thailand Philipines

Sumber IMS/BPOM

USD

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Comparison of Drug Prices: Generic, Lowest and

Highest Prices

Sumber: Health Action International, July 2010

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Global Price

Comparison

an example

Source : HAI (Healthcare Action International) Europe.http://www.haiweb.org/medicineprices/

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Conclusion

1. In Indonesia, prices of drugs are relativelyexpensive both per pack and per episode oftreatment (compared to the average income)

2. Competition on pharmaceutical companiesdid not lower drug prices

3. Local company seemed follow the originator

prices, with relative small lower prices4. Innovations for tier-pricing or other access to

medicine programs could help the people

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Pharma Innovations to Improve Accessbefore UHC Could Contribute

Significantly to the Health of the

Population