Estimated costs of production and potential prices for the WHO Essential Medicines List
Open accessAbstract
Introduction: There are persistent gaps in access to affordable medicines. The WHO Model List of Essential Medicines (EML) includes medicines considered necessary for functional health systems. Methods: A generic price estimation formula was developed by reviewing published analyses of cost of production for medicines and assuming manufacture in India, which included costs of formulation, packaging, taxation and a 10% profit margin. Data on per-kilogram prices of active pharmaceutical ingredient exported from India were retrieved from an online database. Estimated prices were compared with the lowest globally available prices for HIV/AIDS, tuberculosis (TB) and malaria medicines, and current prices in the UK, South Africa and India. Results: The estimation formula had good predictive accuracy for HIV/AIDS, TB and malaria medicines. Estimated generic prices ranged from US$0.01 to US$1.45 per unit, with most in the lower end of this range. Lowest available prices were greater than estimated generic prices for 214/277 (77%) comparable items in the UK, 142/212 (67%) in South Africa and 118/298 (40%) in India. Lowest available prices were more than three times above estimated generic price for 47% of cases compared in the UK and 22% in South Africa. Conclusion: A wide range of medicines in the EML can be profitably manufactured at very low cost. Most EML medicines are sold in the UK and South Africa at prices significantly higher than those estimated from production costs. Generic price estimation and international price comparisons could empower government price negotiations and support cost-effectiveness calculations.
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The minimum price estimates were calculated from export data using an established and published methodology based on costs of active pharmaceutical ingredients extracted from Panjiva.
“The minimum price estimates were calculated from export data using an established and published methodology based on costs of API [15,16] extracted from Panjiva, a global shipping records database [17].”
From Estimated minimum prices and lowest available national prices for antiobesity medications: Improving affordability and access to treatment (2023) · cites this paper as [16]
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Kassebaum, N. J., Arora, M., Barber, R. M., Bhutta, Z. A., Brown, J., Carter, A., Casey, D. C., Charlson, F. J., Coates, M. M., Coggeshall, M., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31460-x · Cited by 2,163 · see citing works
Driving a decade of change: HIV/AIDS, patents and access to medicines for all
Hoen, E. '., Berger, J., Calmy, A., & Moon, S. (2011) · Journal of the International AIDS Society · doi:10.1186/1758-2652-14-15 · Cited by 334 · see citing works
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Levi, J., Wang, J., Venter, F., & Hill, A. (2023) · Obesity · doi:10.1002/oby.23725 · Cited by 69 · see citing works
“Therefore, we also searched for individual national prices of topiramate and phentermine separately and combined the available data together (from the United States, South Africa, and Kenya), which are also shown in Figure 2B. EMPs for each drug individually were $0.86 for topiramate and $0.53 for phentermine (total o…”
MethodInfluentialSelf-citation
- Authors
- Hill, A. M., Barber, M. J., & Gotham, D.
- Affiliations
- University of Liverpool (GB)
- Harvard University (US)
- Imperial College London (GB)
- Corresponding author
- Gotham, Dzintars
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2018-01
- Volume
- 3
- Issue
- 1
- Pages
- e000571
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC5859811
- OpenAlex
- W2786620864
- Cited by
- 101
- References
- 2
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 14 · 2023: 9 · 2022: 12 · 2021: 15 · 2020: 15 · 2019: 11 · 2018: 2
- FWCI
- 16.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Economics, Econometrics and Finance › Finance › Healthcare Systems and Reforms
- Keywords
- WHO Model List of Essential Medicines, production costs, generic drug pricing, access to affordable medicines, active pharmaceutical ingredients, international price comparisons, cost-effectiveness
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