Methodology

The 2019 Medicine Price Index compares and analyses the cost of medicine around the world. The study takes a comprehensive look into the cost of 13 prevalent medications, examining the average price per dose of both the original (brand name) drugs, and their generic versions. It also analyses how far the price of each medication deviates from the global median. The individual percentages are then aggregated to reveal the total deviation from the global median on a country level for all 13 medications. As a UK-based enterprise, the total deviations were calculated from the medicine price in GBP. Due to this, there may be minimal differences in the deviations in other currencies.

For the purposes of the study, the terms ‘branded drug’ (e.g. Viagra) and ‘generic drug’ (e.g. Sildenafil) were defined as follows according to the US Food & Drug Administration (FDA): “A generic drug is a medication created to be the same as an existing approved brand-name drug in dosage form, safety, strength, route of administration, quality, and performance characteristics. A generic medicine works in the same way and provides the same clinical benefit as its brand-name version.”

Please note: due to differences in the availability of patents in each country, some locations in the table feature the price of the generic compounds only.

Below you can find a description of how each deviation was calculated, how the prices were collected, as well as each medication within the study and the sources used.

Calculation of Deviation:

Branded and Generic, Deviation from Median Price

In order to determine the deviation from the median price, the average price of branded and generic drugs was calculated for every country. The deviation from median is calculated using the following formula:

(Xi - Median of all country averages) / Median of all country averages

Branded drugs, Deviation from Median Price

In order to determine the deviation from the median price, the average of the prices for branded drugs was calculated for every country. The deviation from median is calculated using the following formula:

(Xi - Median of all country averages for branded drugs) / Median of all country averages for branded drugs

Generic drugs, Deviation from Median Price

In order to determine the deviation from the median price, the average of the prices for generic drugs was calculated for every country. The deviation from median is calculated using the following formula:

(Xi - Median of all country averages for generic drugs) / Median of all country averages for generic drug

Compounds, Deviation from Median Price

In order to determine the deviation from the median price, the median price for each compound (branded and generic drugs) was calculated. The deviation from median is calculated using the following formula:

(Average of Xbranded drug and Xgeneric drug - Median of all branded and generic prices for a compound) / Median of all branded and generic prices for a compound

Price Collection:

The price was collected from online pharmacies, governmental websites and information portals around the globe.

The prices for the branded and generic drugs were collected according to the profiles laid out in the section condition and compounds (below). If more than one generic drug was available, the drug with the cheapest regular price was chosen.

For the UK, in addition to the indicative price pharmacy fees, fees such as the single activity fee and the fee for controlled drugs were added to the price to enhance comparability.

Price per Dose

The price calculated by 1 unit or 100g/ml of the medication, e.g. per tablet (100g), capsule (100ml), syringe (unit) or inhaler (unit).

Condition and Compounds

Erectile Dysfunction (Sildenafil)

Sildenafil is a compound used to treat erectile dysfunction.

The original brand is Viagra, manufactured by Pfizer.

Data was mainly collected for the following specifications:

Compound strength: 50 mg

Package size: 4 tablets

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Epilepsy, Fibromyalgia, Generalized Anxiety Disorder, among others (Pregabalin)

Pregabalin is used to treat epilepsy, neuropathic pain, fibromyalgia, restless leg syndrome, and generalized anxiety disorder.

The original brand is Lyrica, manufactured by Pfizer.

Data was mainly collected for the following specifications:

Compound strength: 75 mg

Package size: 30 capsules

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Cardiovascular Disease, High Cholesterol (Atorvastatin)

Atorvastatin is used to prevent cardiovascular disease.

The original brand is Lipitor, manufactured by Pfizer.

Data was mainly collected for the following specifications:

Compound strength:20 mg

Package size:30 tablets

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Asthma, Chronic Obstructive Pulmonary Disease (Salbutamol)

Salbutamol (also known as Albutol) is used to treat asthma, including asthma attacks, exercise-induced bronchoconstriction, and chronic obstructive pulmonary disease (COPD).

The original brand is Ventolin, manufactured by GlaxoSmithKline.

Data was mainly collected for the following specifications:

Compound strength:100 mcg per dose

Package size:1 inhaler (200 doses)

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Bacterial Infection (Azithromycin)

Azithromycin is an antibiotic used for the treatment of a number of bacterial infections including middle ear infections, strep throat, pneumonia, traveler's diarrhea, other intestinal infections and sexually transmitted infections (e.g. chlamydia and gonorrhea).

The original brand is Zithromax manufactured by Pfizer. In Eastern Europe, it is also known as Sumamed and is manufactured by Pliva.

Data was mainly collected for the following specifications:

Compound strength:500 mg

Package size:3 tablets

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Diabetes Type I and II (Insulin Glargine)

Insulin Glargine is a long-acting Insulin used in the treatment of type I and type II diabetes.

The original brand is Lantus, manufactured by Sanofi-Aventis.

Data was mainly collected for the following specifications:

Compound strength:100 Units per ml

Package size:5 pens with 3 ml

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Immunosuppression, Transplant Rejection Prevention (Tacrolimus)

Tacrolimus is an immunosuppressive drug which is used after organ transplantation to lower the risk of rejection.

The original brand is Prograf, manufactured by Astellas.

Data was mainly collected for the following specifications:

Compound strength:1 mg

Package size:50 capsules

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Female Contraception (Drospirenone/Ethinylestradiol)

The birth control pill is used to prevent pregnancies.

The original brand is Yasmin, manufactured by Bayer.

Data was mainly collected for the following specifications:

Compound strength:3 mg Drospirenone and 0.03 mg Ethinylestradiol

Package size:21 tablets. In some countries, the package contains 28 tablets, but 7 of them come without a compound.

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Depression, Bulimia, Obsessive-compulsive disorder (OCD), among others (Fluoxetine)

Fluoxetine is an antidepressant used to treat major depressive disorder, obsessive–compulsive disorder (OCD), post-traumatic stress disorder (PTSD), bulimia nervosa, panic disorder, premenstrual dysphoric disorder, and trichotillomania.

The original brand is Prozac, manufactured by Eli Lilly.

Data was mainly collected for the following specifications:

Compound strength:20 mg

Package size:30 capsules

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Anxiety and Panic Disorder (Alprazolam)

Alprazolam is a benzodiazepine used for the treatment of anxiety disorders, specifically panic disorder or generalized anxiety disorder (GAD).

The original brand is Xanax, manufactured by Pfizer.

Data was mainly collected for the following specifications:

Compound strength:1 mg

Package size:8 tablets

If this profile was unavailable in a country, the closest available compound strength and package size was used.

High Blood Pressure (Lisinopril)

Lisinopril is an ACE inhibitor used to treat high blood pressure, heart failure, and after heart attacks.

The original brand is Zestril, manufactured by AstraZeneca.

Data was mainly collected for the following specifications:

Compound strength:20 mg

Package size:28 tablets.

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Hepatitis B, HIV/AIDS (Tenofovir)

Tenofovir disoproxil is a medication used to treat chronic hepatitis B and to prevent and treat HIV/AIDS.

The original brand is Viread, manufactured by Gilead Sciences.

Data was mainly collected for the following specifications:

Compound strength:245 mg

Package size:30 tablets

If this profile was unavailable in a country, the closest available compound strength and package size was used.

Arthritis, Bowel Disease, Skin Disorders, among others (Adalimumab)

Adalimumab is a compound used to treat autoimmune diseases like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriasis, hidradenitis suppurativa, uveitis, and juvenile idiopathic arthritis.

The original brand is Humira, manufactured by AbbVie.

The generic drug in this case is not technically a generic drug, but a biosimilar.

Data was mainly collected for the following specifications:

Compound strength:40 ml per 0.4 ml solution

Package size:2 syringes

If this profile was unavailable in a country, the closest available compound strength and package size was used.

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