To analyse the data, compare the me

To analyse the data, compare the median treatment price and number of days’
wages required across sectors and for different product types. Although it is dif-
fi cult to assess true affordability, treatments costing one day’s wage or less (for
a full course of treatment for an acute condition or a 30-day supply of medicine
for chronic diseases) are generally considered affordable. In the example, median
treatment costs for omeprazole treatment in public sector health facilities, private
pharmacies and NGO facilities are very similar, with the exception of lowest-priced
generics in the public sector. In all other cases, purchasing a month of therapy with
originator brand or lowest-priced generic omeprazole would require 3.5 to 4.3 days’
wages. In contrast, purchasing the lowest-priced generic omeprazole from the pub-
lic sector is about half as expensive, costing 2.2 days’ wages. Several conclusions
can be drawn:
? Treating an ulcer with omeprazole may be unaffordable for many patients in all
sectors.
? Even the lowest-priced generic omeprazole in the public sector is still unafford-
able for many low-income patients, at just over 2 days’ wages.
? In the public sector, patients would need to spend nearly twice as much to
purchase originator brand omeprazole than the lowest-priced generic.
When analysing standard treatment data, be sure to examine the range of varia-
tion in medicine prices within each of the sectors in the summary ratio section of
the Field Data Consolidation pages (see Fig. 8.3). Treatments for which the median
prices are similar in two sectors may actually vary widely across outlets within the
sectors.
Remember that for standard treatments that require more than one medicine, it will
be necessary to enter each medicine separately and then add together the data on
Median Treatment Price and Days’ Wages for both medicines to get correct sum-
mary information for the treatment as a whole.
Treatment affordability should always be examined in conjunction with availability
data. A treatment may appear affordable in a given sector, but if the availability
of the medicine in that sector is low, patients will not benefi t from this low cost.
Instead, they will be forced to obtain medicines from a different sector where treat-
ments may be much less affordable. When analysing affordability, always check the
availability of medicines used in different courses of treatment. Where a treatment
appears affordable in a given sector but availability in that sector is low, this should
be noted in the survey report.
The section on affordability in your report should highlight the fi ndings for key condi-
tions of public health importance in your setting. Some conditions may be affordable
Fig. 8.11 Example of standard treatment and affordability for treating an ulcer with one month’s
supply of omeprazole 20mg daily
128
MEASURING MEDICINE PRICES, AVAILABILITY, AFFORDABILITY AND PRICE COMPONENTS
for low-paid workers to treat, while others may be completely out of their range. Try
to describe the situation for both acute and chronic illnesses. For chronic illnesses,
you should express the treatment in monthly amounts, which you would calculate by
multiplying the daily dose by 30. Be sure to use the amount for a month’s treatment
for chronic conditions in the Total # of Units per Treatment fi eld.