Masters of Public Health - see Magister Public Health / Overreliance on donor supported health programs has crippled many African countries and there is inadequate long-term planning on the future sustainability of health systems. In the age of uncertainty in global politics and global economy, the future of these donor funded programs is also uncertain. It is imperative for African nations to begin to take responsibility for their health programs. In as much as the name “donation” suggests that something is given free of charge, in actual sense this may not be the case due to hidden costs attached. In medicine access, the hidden costs are the supply chain costs including cost for clearance, storage and distribution of such medicines which are charged as a percentage of claimed commodity costs on donors’ or suppliers’ invoices. Since the medicines donated are in originators’ brands, the invoiced prices are high thus supply chain costs are high as well. In some cases, it is thought that the hidden costs are higher than the cost of medicines had they been sourced locally as generics. The aim of this research was to assess and determine the hidden supply chain costs associated with the four medicine donation programs supporting the Tanzania Neglected Tropical Diseases Program and inform policy decision on optimal financing options for the program Methodology The cost analysis of the two options was undertaken from a payers’ perspective which in this case is the Government of Tanzania (Ministry of Health). Data was collected on both product and supply chain cost drivers incurred in the medicine donation programs from July 2014 to June 2017. Costs of the current mechanism were obtained from the program’s quantification reports and transaction data for the study period. Transactional data was obtained from shipment documents including sales invoices, parking list, proof of delivery and goods receiving notes were evaluated for actual quantities shipped, commodity prices and other supply chain cost. To verify the actual supply chain cost charged by the program, both the official bills from Medical Stores Department (MSD) to the program and the electronic bills available at MSD electronic database covering the study period were studied.

Made available in DSpace on 2010-04-20T21:00:13Z (GMT). No. of bitstreams: 4 Jose Antonio Lopes.pdf.jpg: 14118 bytes, checksum: c889b29f5f70038e9202ed5ff58975d8 (MD5) Jose Antonio Lopes.pdf.txt: 99454 bytes, checksum: 3a0d9e5475dc749d8ee501b09eeee580 (MD5) Jose Antonio Lopes.pdf: 583370 bytes, checksum: 8f59c41f14df7e84775fb3ddcb57e4a6 (MD5) license.txt: 4886 bytes, checksum: 2af242f47fcec166b0886a2531cbaf60 (MD5) Previous issue date: 2009-01-16T00:00:00Z / The aim of this document is to evaluate the price behavior in the Brazilian market for drugs that are market leader in its segment after the presence of competitors such as similar and generics drugs. According to some American studies, leading drugs reacts positively in relation to price variance when generic competitors are introduced in the market after patent expiration of original brands. Leading drugs accommodate share growth of the followers, turning towards an inelastic market segment that is less sensitive to changes in the leading drug prices. This behavior is not aligned with the economic common sense that expects price reduction of leading brands when facing new competitors in a specific market. The results of this study related to the Brazilian pharmaceutical market, demonstrates that leading drugs reacts positively in relation to price variance when losing market share for generic and similar brands. On the other hand, a fierce competition among similar and generic brands leads their price to go down and its dispersion relatively to the leader price tends to go up. / O objetivo desse trabalho é avaliar o comportamento da variável preço para os medicamentos líderes de mercado no Brasil após a entrada de concorrentes similares e posteriormente a instituição dos medicamentos genéricos no Brasil. Segundo estudos realizados no mercado norte-americano, os medicamentos originais reagiriam à entrada de concorrentes genéricos de forma positiva no que se refere à variação de seu preço de comercialização. Dessa forma, os medicamentos originais se concentrariam nos segmentos de mercado mais inelásticos e com menor sensibilidade a possíveis alterações no seu preço de venda. Tal comportamento contradiz a intuição econômica comum de que a entrada de novos concorrentes em um mercado levaria a redução de preços por parte da empresa dominante. Os resultados desse trabalho, sobre o mercado farmacêutico brasileiro, indicam que as marcas líderes respondem positivamente em relação a aumento de seus preços quando da perda de participação de mercado para marcas seguidoras como genéricos e similares. Por outro lado, quando da presença de um aumento de competição entre as marcas seguidoras, se verifica uma diminuição de preços dessas marcas e um aumento da dispersão relativa dos preços das marcas seguidoras em relação à marca líder.

This master thesis analyses factors that determine the prices of prescription medicine. The theoretical part is outlining the fundamentals of pharmaceutical market, identifying the main price components and determinants with main focus on pricing and reimbursement policies in the world. The empirical part is dedicated to the pharmaceutical market in the Czech Republic. It explores the impact of state regulatory measures such as internal and external reference pricing on the prescription medicine prices. A regression analysis was conducted to determine what factors have significant impact on the prices. Furthermore a t-test was performed to discover differences in price levels between regulated and unregulated drugs as well as between originator medicine and generics.