The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62969

Maggie Huff-Rousselle, MA, MBA, PhD, Social Sectors Development Strategies, Inc., 464 Shawmut Avenue, Boston, MA 02118, 617-421-9644, mhuffrousselle@ssds.net and Chris Atim, PhD, PHRplus Project, Abt Associates Inc, B P 16659, Dakar, Senegal.

Based on a comprehensive review of previous studies and both qualitative and quantitative primary data, this study raises complex, interrelated issues that support the Ministry of Health policy debate on pricing in Ghana. Within the series of MOH revolving drug funds – from the Central Medical Stores level down to the final service delivery points – each facility is expected to replenish stock with funds from the sale of existing stock, and different facilities have different pricing mark-ups. A more client-oriented, efficient ordering process in the private sector, combined with the private sector’s ability to deliver and offer lower prices, has encouraged larger MOH facilities to purchase directly from private sector wholesalers. Smaller SDP facilities are decaptializing because of theire lower mark-ups, dependence on the MOH, and the roughtly year-long cashflow lagtime between the granting and reimbursement of exemptions. The purchasing behavior of poor consumers is unlike that the MOH facilities. Patients purchase most products epidosically, have little or no comparative price information, and typically equate price and quality. When they compare, they care about total out-of-pocket costs for a visit and do not typically consider the cost of a single product. Therefore, reducing over-prescribing (4.6 items per encounter) rather than keeping SDP level mark-ups low could offer greater economic relief to patients without undermining the financial integrity of the public supply system.

Learning Objectives:

• to understand the logic behind pharmaceutical pricing mark-ups at the wholesale and retails levels
• to identify and contrast the key characteristics of buying behaviour at the institutional and consumer level

Keywords: Financing, Drugs

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.