Bitter Pills:Medicines & The Third World Poor | Page 53

CHAPTER 4
POOR VALUE
FOR THE POOR?
Drug prices
"It has now become common knowledge that international
trade - and specifically North-South trade in
Pharmaceuticals - bears hardly any relation to the objective
costs faced by suppliers, but is rather one of the most
striking manifestations of unequal exchange which has the
ultimate effect of creating and sustaining the
underdevelopment of the Third World." (Dr. Rainford,
Deputy Secretary General of the Secretariat of the
Caribbean Co mmunity (CARICOM), 1980.) "'
TO POOR PEOPLE throughout the Third World drug prices are astronomically
high both in relation to wages and to the cost of basic necessities. In Mexico the
best-selling brand of the antibacterial drug cotrimoxazole is Roche's Bactrim.
Just 20 tablets-enough for a short course of treatment -cost Pesos 138.60 (over
£3) in 1978. A peasant family lucky enough to have a few hens would have had
to sell 1 lOeggs to buy those 20 tablets of Bactrim. For the same amount of money
a family of four could have bought enough black beans to provide their basic
diet for two weeks, or 33 kilos of tortillas, equivalent to bread in Europe or chapatis
in India. i:)
The same drug, cotrimoxazole, is available locally from other manufacturers at
less than half the price. But Mexicans buy over a million packs of Bactrim each
year. The products of the 'big name' manufacturers are usually the most expensive.
Promotion ensures that they are also the market leaders. Out of about 9,900
different pharmaceutical products on the Mexican market in 1978, just 80 cornered
a third of the total market. Without exception, these top- selling drugs are brandname products of the major US and European research- based companies. Only
six were developed within the last 2-6 years. The remainder are well-established
and many are now off patent. They could be bought far more cheaply from nonresearch-based manufacturers. Ul
The situation in Mexico is in no way unique. Throughout the Third World poor
people pay high prices for expensive brands when far cheaper alternatives exist.
In this chapter we explore the huge variations in drug prices and the problems
created by an obvious conflict of interests. On the one hand, poor people and
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