1. Medicines Transparency Alliance31/10/2015 1 MeTA Zambia – Pricing Goodwell Lungu MeTA Secretary General

2. Medicines Transparency Alliance31/10/20152 Situation analysis in Zambia Zambia has no laws/policies that govern consumer and ex manufacturer prices in the public, private and non-profit sectors The Zambia Public Procurement Act 2009 (ZPPA) provides regulations on competitive bidding/tendering processes which governs disclosure of procurement prices However, enforcement seems to be weak as evidenced by happenings related to procurement in the Ministry of Health Imported essential medicines are tax and duty free (though the industry has complained of high product registration/retention fees) whilst APIs/packaging materials for local manufacturers attract duty tariffs and taxes respectively Government provides free medicines through its public hospitals and clinics; however, frequent stock outs Private sector medicine prices high Private Hospitals/Clinics dispense drugs mostly at higher prices than retail pharmacies

3. Medicines Transparency Alliance How MeTA has addressed pricing? In order to obtain evidence based data on medicines pricing structures in Zambia, MeTA commissioned four surveys/studies as follows: Private Sector Mapping Survey The MeTA Data Disclosure Survey Study on Medicines Pricing Components in the Public, Private and Non-Profit sectors in Zambia Challenges faced by Local Pharmaceutical Manufacturers in Zambia 31/10/20153

4. Medicines Transparency Alliance Successes Yet to be established 31/10/20154

5. Medicines Transparency Alliance Challenges Difficulty in disclosure of price data by both public and private sectors Lobbying of Zambian government to offer special incentives through special tax rebates on APIs/packaging materials, waiving of tax on equipment etc to reduce the cost of manufacturing Lobbying of Zambian government to intervene in creating a conducive macroeconomic environment which will facilitate lower pricing of medicines Engagement of pharma industry to introduce RRP for tracer list of essential medicines on voluntary basis; for patients to make informed choices on medicine purchase prices Access to essential medicines affected as players are free to set prices depending on demand and supply forces. 31/10/20155

6. Medicines Transparency Alliance Lessons Learned It is clear that families have difficulties purchasing their medicines translating to ZMK 2,600 per day, with the Food Poverty Line at ZMK 80,000, per adult per month With the first line treatment for malaria, artemether/lumefantrine (Coartem) costing an average price of ZMK 29,961, (11 times higher than the ZMK 2,600 Food Poverty Line per day per adult); makes the medicine unaffordable for 29% of the population in Lusaka province. Due to frequent stock outs in public health facilities, patients are usually given prescriptions to buy from private sector out of own pocket However, majority can’t afford the high prices; therefore go without meds, seek traditional interventions or buy cheaper sub-standard meds from ‘illegal drug stores’ Hike of registration and retention product fees has led to some increase in pricing of essential medicinets Health Insurers would welcome recommended retail price (RRP) as this would promote transparency in the medicines supply and chain 31/10/20156

7. Medicines Transparency Alliance Lessons Learned cont’d Need to develop policies on medicines price components in Zambia - with the participation of all stakeholders in the areas of medicines manufacturing, procurement, distribution and consumption. 31/10/20157

8. Medicines Transparency Alliance31/10/20158 Thank you Name of presenter: Goodwell Lungu Email: glungu@tizambia.org.zm Mobile number: +260 977 455 455 Skype: Website: www.metazambia.org