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Table 3 Mark ups on anti-malarial drugs

From: Retail sector distribution chains for malaria treatment in the developing world: a review of the literature

Country

Methods (study reference)

Generic name* (drug type or brand)

Product description, (as provided in the literature)

Mark ups across supply chain levels

    

Primary

Intermediate 1

Intermediate 2

Terminal

Retail (location where available)

        

Pharmacies

Drug shops

General shops

Burkina Faso

Document review; KII§ Semi-structured interviews with suppliers [54]

CQ

1 dose

-

-

-

-

100%

-

-

  

SP

1 dose

-

-

-

-

100%

-

-

  

ACT

1 dose

-

-

-

30%

100%

-

-

Cameroon

KII [54]

ACT

1 dose

-

-

-

14%

34%

-

-

Cambodia

Semi-structured interviews with suppliers and retailers [48, 55]

AS

18 tablets

-

-

-

2%

3%

-

-

  

AS+M ± (Malarine®)

Child dose

-

-

-

50%

3%

-

-

 

Structured interviews with suppliers [58]

AS+M ± (Malarine®)

Adult dose

-

-

-

-

71% **

-

  

AS+M ± (Malarine®)

Child dose

-

-

-

-

65% **

-

  

AS+M2

8 tablets

-

-

-

-

29% **

-

  

AS+M3

12 tablets

-

-

-

-

15% **

-

  

AS+M4

17 tablets

-

-

-

-

16% **

-

Kenya

KII and structured survey of retailers [78]

AQ (IB)

9 tablets

40%

-

-

15%

33%

-

-

  

SP (IB)

3 tablets

29.5%

-

-

15%

33%

-

-

  

SP (G, LPG)

3 tablets

-

-

-

15%

203%

-

-

 

Semi-structured interviews with retailers [25]

AQ (Malaramed®)

Child dose, syrup

-

-

-

-

86%

-

-

  

AQ

(Amobin®)

Child dose, syrup

-

-

-

-

22.9%

-

-

  

AQ (Malaratab®)

Child dose

-

-

-

-

189%

-

-

  

SP

(Laridox®)

Child dose

-

-

-

-

151%

-

-

  

SP

(Fansidar®)

Child dose

-

-

-

-

13%

-

-

  

SP

(Falcidin®)

Child dose

-

-

-

-

28%

-

-

 

Document review [61]

AMs

-

-

-

-

15%

20%

-

-

 

KII [54]

ACT

1 pack

-

-

-

10%

33%

-

-

Senegal

KII; Mystery shopper technique at retail level [62]

AS+AQ ±

Adult dose

-

-

-

15%

3-5%

-

-

   

Child dose

-

-

-

15%

11-22%

-

-

 

Semi-structured interviews with suppliers and retailers [55]

Q (IB, BG)

1 dose (injection)

-

-

-

18%

41%

-

  

Q (G)

1 dose (injection)

-

-

-

15%

30%

-

Tanzania

Semi-structured interviews with suppliers and retailers [20, 32]

AQ

1 tablet

-

-

-

9%

-

270%-669% (rural)

-

  

AQ

1 tablet

-

-

8%

-

-

-

-

  

Q

1 tablet

-

-

-

26%

-

150%-203%

(rural)

-

 

Semi-structured interviews with suppliers and retailers [31]

SP

3 tablets

48%

-

-

13%

-

-

100-233%

 

Semi-structured interviews with suppliers and retailers [29, 30]

AL (IB) ±i

5<15 kg dose

-

-

-

67% **

-

100-200%

-

   

15<25 kg dose

-

-

-

56% **

-

60%-221%

-

   

25<35 kg dose

-

-

-

52% **

-

47%-230%

-

   

35+ kg dose

-

-

-

50% **

-

39%-233%

-

  

AL (IB) ±ii

5 <15 kg dose

43%

-

-

-

-

100-200%

-

   

15<25 kg dose

34%

-

-

-

-

60%-221%

-

   

25<35 kg dose

31%

-

-

-

-

47%-230%

-

   

35+ kg dose

27-30% **

-

-

-

-

39%-233%

-

 

Semi-structured interviews with suppliers and retailers [34]

ACT (IB)

n/a†

-

-

-

21%

-

54% (rural)

-

  

AMT(IB)

n/a†

-

-

-

18%

-

44% (rural)

-

  

SP

n/a†

-

-

-

23%

-

110%

(rural)

-

  

AQ

n/a†

-

-

-

41%

-

96% (rural)

-

  

Quinine

n/a†

-

-

-

38%

-

64% (rural)

-

Uganda

Semi-structured interviews with suppliers and retailers [59]

SP (MSG)

3 tablets

-

-

6%

-

410%

-

-

  

SP (LPG)

3 tablets

27%

-

-

29%

501%

-

-

 

KII; Semi-structured interviews with retailers [54]

All AMs

n/a

40-50%

-

-

7-8%

-

-

-

  

AL (G)

1 dose

-

-

-

-

38%

-

  

CQ (G)

1 dose

-

-

-

-

100%

-

 

Semi-structured interviews with suppliers and retailers [26]

DHA+PP (IB)

1 tablet

32%

-

-

14%

-

29%

(rural)

-

  

DHA+PP (IB)

1 tablet

32%

-

-

21%

22% (rural)

-

-

  

SP (IB)

1 tablet

57%

-

-

8%

-

43%

(rural)

-

  

SP (IB)

1 tablet

57%

-

-

16%

50%(rural)

-

-

  

SP (G)

1 tablet

-

-

-

40%

-

198%

(rural)

-

  

SP (G)

1 tablet

-

-

-

13%

271%(rural)

-

-

  

CQ (G)

1 tablet

-

-

-

18%

152%(rural)

-

-

  

Artemether (IB)

1 ampoule

99%

-

-

33%

-

50%

(rural)

-

  

Artemether (IB)

1 ampoule

56%

-

-

16%

28%(rural)

-

-

  

SP (G)

1 tablet

-

-

-

25%

-

200%

(rural)

-

  

CQ (G)

1 tablet

-

-

-

41%

-

92%

(rural)

-

  

DHA+PP (IB)

1 tablet

36%

-

-

11%

65%(urban)

-

-

  

Artemether

1 ampoule

56%

-

-

17%

-

136%

(urban)

-

  

Artemether

1 ampoule

56%

-

-

17%

82%(urban)

-

-

  

SP (IB)

1 tablet

57%

-

-

5%

85%(urban)

-

-

  

SP (G)

1 tablet

-

-

-

25%

566%

(urban)

-

-

  

CQ (G)

1 tablet

-

-

-

24%

143%

(urban)

-

-

Zambia

Structured interviews with suppliers [33]

ACT

-

-

-

-

-

-

60%

-

  

SP

-

-

-

-

-

182%

-

-

  

ACT

-

-

-

-

-

29%, 11%-100% (urban)

  

ACT

-

-

-

-

-

67%,13%-100% (peri-urban)

  

ACT

-

-

-

-

-

54%, 50-100% (rural)

  

SP

-

-

-

-

-

50%, 15%-327% (urban)

  

SP

-

-

-

-

-

300%, 50%-517% (peri-urban)

  

SP

-

-

-

-

-

50%, 15%-500% (rural)

 

Semi-structured interviews with suppliers and retailers [48, 55]

Selected AM ¥

-

-

-

-

-

30%

  1. * AM = anti-malarials; AMT = artemisinin monotherapies; mg = milligrams; ml = millilitres; AS = Artesunate; M = Mefloquine; AS+M2 = combination for children weighing between 16 kgs to 24 kgs; AS+M3 = combination for children weighing between 25 kgs to 35 kgs; AS+M4 = combination for adults; AQ = Amodiaquine; SP = Sulphadoxine-Pyrimethamine; Q = Quinine; AL = Artemether-Lumefantrine; DHA+PP = Dihydroartemisinin+Piperaquine; IB = imported innovator brand, IG = imported generic, B = branded; G = locally produced generic, MSG = most sold generic, LPG = lowest priced generic, BG = branded generic; I = imported, LP = locally produced; SC = supply chain; ± = subsidized product; - = level of the chain did not exist or data not available; **Author's own calculations; † mean across all products within drug class. i primary supplier is the terminal supplier, ii primary supplier sells to terminal regional supplier. ¥ included AQ (3 tablets), Artemether (not stated), AS (6 tablets), CQ (1000 tablets), DHA (not stated), Halofantrine (6 tablets), Mefloquine (3 tablets), Proguanil (not stated), Q (1000 tablets), AL IB (6 tablets), SP (3 tablets). IFC = International Finance Corporation. Mark-up data were rounded to the nearest whole number. §KII = key informant interviews; Mystery shopper technique = unobtrusive observation of shop attendants by researchers who pose as client seeking care from a provider who is unaware of their identity.
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Malaria Journal

ISSN: 1475-2875

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