Health Economics Review (Nov 2024)

Regulation of mark-up on medicine prices in Zimbabwe: a pilot survey from 92 community pharmacies in the metropolitan area of Harare

  • Hilma N Nakambale,
  • Penelope Tambama,
  • Varsha Bangalee

DOI
https://doi.org/10.1186/s13561-024-00574-8
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 7

Abstract

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Abstract Background Medicine pricing in the community pharmacy sector in Zimbabwe significantly influences accessibility to health care. In this pilot survey, we investigated how community pharmacies in Zimbabwe apply various mark-up strategies to essential and non-essential medicines, and gathered community pharmacists’ perspectives on mark-up regulation. Methods Using an adapted methodology endorsed by the World Health Organization and Health Action International for studying medicine prices and availability, we conducted a quantitative cross-sectional pilot survey for 46 medicines (31 essential and 15 non-essential) identified using the Zimbabwe Essential Medicines List and classified according to the Vital, Essential, and Non-essential (VEN) tool. We conducted the pilot survey in 92 community pharmacies in the metropolitan area of Harare, Zimbabwe. Results We gathered a total of 92 responses from 167 distributed questionnaires. The most prevalent mark-up strategy was the cost-plus fixed percentage.The median mark-up for all medicines in the community pharmacies was 60% (interquartile range 50- 82%). We found a statistically significant difference in the median mark-up by essentiality of medicines (p < 0.001), essential medicines had a median mark-up price of 62% while non-essential medicines had a mark-up of 56%. Antipsychotics had the highest mark-up at 82%, while anti-neoplastic medicine had the lowest at 36%. Overall, 55% of the community pharmacists did not support mark-up regulation. Conclusion Mark-up strategies varied across community pharmacies in the metropolitan area of Harare. Without mark-up regulation, essential medicines remain significantly expensive in Zimbabwe. We recommend mark-up regulation in Zimbabwe’s community pharmacy sector and emphasize the effective use of multiple pricing strategies to reduce medicine prices. .

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