How companies push up medicine prices, driving families to endless pain

Kenyans are paying as high as 500 per cent more for drugs compared to other countries — meaning that families have to sometimes forgo treatment because they can’t afford it.

A drug such as Eloxatin, used to treat colon and rectal cancer, for instance, is sold at Sh29,500 per 100 milligram vial in US and Turkey and yet in Kenya it goes for Sh67,244.

The drug can prolong a cancer patient’s life significantly.

A patient requires at least four vials, which means that the actual cost is about Sh300,000 excluding other supplementary drugs that go with it.

An antibiotic, Augmentin, manufactured by the UK pharmaceutical GSK, is sold at Sh1,591 for 10 tablets in London and Sh8,600 in Kenya.

The Pharmacy and Poisons Board (PPB) has called for the re-introduction of the drug pricing policy that was scrapped in 1994 to cushion poor Kenyans who cannot afford to buy prescription drugs out of pocket.

Chief Pharmacist Kipkerich Koskei told the Nation that the high cost of drugs caused by a liberalised market burdens Kenyans and puts the country at risk of proliferation of fake medicine.

LACK OF PRICING POLICY

Since Kenya lacks a pricing policy, patients end up paying more than they should for some of the drugs they require as part of their treatment.

Official data shows that for the same product manufactured by multinationals for both rich and poor countries, there is a difference of up to about 1,000 per cent for the medicines sold in Kenya.

“What is the need to have overpriced drugs if the people in need cannot afford even a tablet?” asked Dr Koskei.

“Company agents are taking advantage of the free market... A drug pricing policy is a matter of importance that should be considered so that we can cushion the people who cannot afford,” he said.

Dr Koskei said that these price differences affect how some drugs are perceived and asked multinationals to keep in mind the cost transferred to patients.

“Prices should be the same in dollars for all countries… I think it is unfair that within the East African Community (EAC) one country (Kenya) is over charged 1 there must be some form of price control,” he said, adding that countries such as Uganda have subsidised prices.

He said most of the managing directors of multinationals in East African region  are based in Nairobi, which is perceived as an expensive city and therefore appointed dealers were forced to raise prices as dictated by manufacturers to cater for the expenditure on the officials.

“All these directors are being housed in Nairobi and I believe they transfer that cost to the medicines. They say everything in Kenya is expensive including water and electricity but I would not know beyond that,” said Dr Koskei.

A price control policy was in place in Kenya up to 1993 during the Moi era, said Dr Koskei, adding that part of the prescription by the International Monetary Fund (IMF) then was to remove price controls in Kenya for everything not just medicine.

India and Pakistan have put cost labels on medicine packs to control the prices. Anyone one caught charging patients beyond the prescribed prices faces a jail term. 

The high prices have pushed Kenyans to do parallel importations by buying drugs of high value but low volume and which are sometimes not certified by the board, said Dr Koskei.

 Health Cabinet Secretary, Cleopa Mailu said inflated pricing was unacceptable but added that it would be difficult to make changes in a liberalised economy.

 He said the introduction of patent rights had made it difficult for developing countries to reproduce generic medicines, especially for chronic ailments such as cancer.

“We would wish to bring down the cost of drugs though it is difficult in a free market. What we will be relooking is the maximum retail price which should be printed on all products so that the public is not exploited,” said Dr Mailu.

The ministry would analyse and publicise the cost of production, importation and recommended prices to protect Kenyans from greedy dealers.

Dr Mailu said Kenya was negotiating for developing country tariffs with the World Trade Organisation.

“We are also seeking rebates for drug importers to reduce costs so the prices for end consumers can be low,” he said.

The vice chairperson of the Parliamentary Health Committee, Robert Pukose, said they did not make any provision for a drug pricing policy in the Health Bill that is awaiting approval.

But he said the Senate can still introduce a provision for the policy.

He said there were no price caps on medicine globally and that retailers are encouraged to add about 33 per cent to the cost of the drugs to cater for logistics incurred hence pushing up prices .

“For now the government needs to pump in more money into procurement of drugs and subsidise prices for poor Kenyans. The unfortunate thing is reduced stocks and increased demand which forces some distributors to raise prices,” said Dr Pukose.

Drugs for killer diseases such as malaria, Aids and TB are currently being given out free in the country.

Kenya only produces drugs for common ailments such as headaches and hypertension due to lack of special skills and raw materials, 80 per cent of  which are imported from China and India.

A World Health Organisation (WHO) report dubbed “Medicine Prices in Kenya” states that a third of the global population lacks reliable access to medicines, due to high prices.

The report shows that the burden is especially great for families that need treatment for several conditions at the same time.

“For innovator brands, patient prices were found to range from 17.75 times to 140.07 times the international reference price. The prices are highest in Nairobi than other regions,” said the report, which recommended an examination of the components that make up the price of medicines as a first step in determining how to reduce them.

The report recommends that Kenya should develop and implement a medicine pricing policy to achieve a greater level of transparency.