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Morocco - Making drugs affordable for public

Tuesday, 15 December 2009 14:46

A recent governmental report has found that Moroccans pay significantly more than other nations for their medicine. To reduce the cost burden of medical treatment the report has recommended the formation of a new government body tasked with making drugs affordable for the general public.

On November 3, a parliamentary commission published a report entitled "Fact-Finding Mission on Drug Pricing in Morocco" (Mission d'Information sur le Prix du Médicament au Maroc) charging that the nation's drugs were "abnormally" overpriced. As a case example, the authors showed that 11 out of the 14 most popular drugs, including amoxicillin and flucloxacillin, were on average 30% more expensive than in France, despite the relatively low purchasing power of Moroccans.

The report also indicated that drug prices were highly variable, with an up to 600% difference among different brands of the same drug. The same drug of a same brand also varied up to 300% in price depending on which region of the country it was sold in or whether it was purchased from a hospital or pharmacy. For example, a bottle of docetaxel, used in chemotherapy treatment, cost up to DH11,243 (€984) on the Moroccan market depending on the brand, while the National Fund for Social Welfare Organisations (Caisse Nationale des Organismes de Prévoyance Sociale) provided it for DH2984 (€261). In contrast, the drug costs DH950 (€81) in Thailand. Physicians were also found to have prescribed 50 more times the amount of the most expensive brand of docetaxel than the cheapest.

According to the report, "Outdated regulations and loopholes were exploited by the pharmaceutical industry," leading to higher prices for the populace. To address this situation, the report recommended that drug pricing be removed from the jurisdiction of the Ministry of Health and a new government body be formed to ensure lower prices. The organisation is to be composed of representatives from the Ministry and the private sector, as well as the Council on Competitiveness, a state council dedicated to improving business relations in Morocco.

Local press reported MP Reda Benkhaldoun as saying that the provision of affordable drugs is "of the utmost importance, especially for people without health insurance who can't afford the medication to treat illnesses". The average per-person expenditure on pharmaceuticals increased from €21.60 in 2006, when Morocco instituted compulsory health insurance, to €30.60 in 2008.

"Even those Moroccans lucky enough to be covered by Assurance Maladie Obligitoire (AMO) and Regime d'Assistance Medicale (RAMED) health insurance plans risk becoming unable to afford the cost of prescribed medications in the medium term," Benkhaldoun added. As AMO, the basic state health insurance, currently only reimburses about 67% of treatment for serious chronic conditions, citizens bear a financial burden disproportionate to their income, in comparison to other countries.

As part of a five-year health plan launched in 2008, the amount of money to be paid for reimbursements was to be nearly doubled to DH980m (€88.2m) in 2009, which should help cut the contribution of individual household spending on health care to 25% from its current 54%. The plan also aims to make RAMED, the state insurance plan for Morocco's lowest-income population, available to all citizens in need by 2012.

While increasing state funds for reimbursements is one component of the solution, the government also seeks to reduce the prices of drugs overall. A country with nearly the same level of per-capita medicine consumption as Morocco, Tunisia provides a model of a successful centralised purchase system, according to the report. By buying in large quantities, the Tunisian government has been able to negotiate lower prices. Morocco's prices for 14 popular drugs ranged from 31% to 189% higher than Tunisia's.

Another angle for the government to pursue is promoting the use of generic drugs, which now comprise 20% of drug market revenues in Morocco. Only a few generics have comparable prices to neighbouring countries. The report advises that the government follow the example of New Zealand and hold tenders for which drugs to reimburse, something that decreases the prices of both generics and brand name drugs. At present, all drugs may be partially reimbursed, and pharmacists are forbidden by law from substituting a prescribed drug for another drug.

Moreover, the report states that inaccurate information has been disseminated by drug companies regarding the effectiveness of generics, with many Moroccans currently believing that they are inferior to brand name products. The new government body will be tasked with combating this attitude, as well as encouraging doctors not to prescribe expensive brand drugs where there is a suitable generic alternative.

Global Arab Network

This article is published in partnership with Oxford Business Group

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