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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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