Assessment of medicines price variation among community pharmacies in the state of Penang,Malaysia by using simulated client method

Abstract

Background

Malaysia is now confronting a challenge of increasing health care expenditures over the years. Due to the absence of drug price regulation in Malaysia, pharmaceutical companies, wholesaler, and health care professional can set their own retail selling price. Consequently, it has caused highly markup of pharmaceutical products by unscrupulous health care professional. The aim of this study was to test the feasibility of simulated client method in obtaining medicine price, to access the actual selling price of selected medicines, to evaluate the medicine price variation according to different districts and types of pharmacies, and to identify the percentage of profit margin of selected medicines.

Method

Simulated client method was adopted in this study by using cluster random sampling technique. The selected 85 community pharmacies all were from state of Penang. Ten people of Universiti Sains Malaysia undergraduate students had been recruited as simulated clients to elicit information about pharmaceutical prices variation for the top 5 most common Group B Innovator Brand, five Group B lower price generic medicines, and five types of Group C dispensing medicines which are highly used in Malaysia. The collected data were analyzed by using Statistical Package for the Social Sciences version 17.0.

Results

From the 80 pharmacies, 34 (42.5%) of them were located in Penang Island and 46 (57.5%) were located in the Penang mainland. The price of Plavix®(Clopidogrel) 75 mg was highly variable within Penang (Ringgit Malaysia 3.94 ± 0.51). The prices of Norvasc® 5 mg and Plavix® were reported significant from the selected five districts [(p = 0.001) and (p = 0.031), respectively]. The actual selling prices of the five types of innovator prescription drugs were lower than the recommended selling price by Malaysia Pharmaceutical Service Division with at least 35%.

Conclusion

The high price of medicines in Malaysia is not mainly due to markup from community pharmacies, but the high markups along the pharmaceutical supply chain.

Keywords

Drug price regulation simulated client method pharmaceutical price war

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