When patients get drugged

Patients may get it wrong when referring to the facts and figures about drug prices announced by competent State agencies in local media. The true fact beyond all such facts and figures is that they are paying several times more than what they get, despite assurances from authorities that drug prices are stable, and that local prices are just one-third or one quarter of those in Thailand and China.

Nguyen Thanh Lam, head of the Drug Pricing Division of the Vietnam Drug Administration under the Health Ministry, asserts in an interview with Nguoi Lao Dong that drug prices are among the most stable in the commodities basket used for calculating the consumer price index in this year’s first half. “The CPI for drug and healthcare services in the year’s first six months increased a mere 2.08%, still lower than the whole CPI of 2.52%,” Lam is quoted as saying.
Asked to comment on complaints that drug prices in Vietnam have long stayed much higher than the real value, Lam refers to a recent survey of prices of 36 types of drug conducted by the ministry in Thailand and China, saying prices of similar drugs in Thailand are 2.25 times higher while drugs in China are 3.17 times more expensive.
Investigative reports by local media, however, point to another picture in which drug producers and hospitals are colluding with one another to push up drug prices, which are constantly rising. A drugstore owner in Hanoi City’s Hoan Kiem District says in Nguoi Lao Dong that she has received multiple notices from producers on raising drug prices since end-June to early July. Zuellig Pharma, for example, has announced a price hike of between 7% and 10% for 16 types of drug.
In HCMC, many drugstores also report the same situation, while distributors and importers have informed drugstores of a new price level, with increases of 10% to 15%, or even 30% for certain types, according to the paper. Nguyen Duc Chinh, vice chairman of the Drug Trading and Production Association, reveals in the newspaper that 28 drug items had prices increasing by an average 9.3% in June, while six other items had prices falling by 3% in the month.
While authorities claim that drug prices are stable, Nguoi Lao Dong ironically says “drug prices are stable at a high level for the past several years” beyond the knowledge of competent State agencies.
Phu Nu clarifies that actual drug prices in the country are many times higher than those registered with the drug authority. The paper says that prices of drugs in tenders to supply hospitals in Vietnam are quite different from the prices known to the drug administration. For example, the South Korean-produced Codzidime distributed by the local firm Vimedimex is registered on the website of the Vietnam Drug Administration at only VND38,500, but the winning price offered to hospitals last year rose to VND60,000. Similarly, the Indian-made Micropime is registered with the drug authority at only VND28,500, while the tender price has rocketed to VND105,000, and the retail price on the market has risen further to VND135,000, or nearly five times higher than registered. Meanwhile, prevalent regulations require that tender prices must not be higher than the prices registered with the drug administration, according to Tuoi Tre.
The Health Ministry allows for drug traders to have a profit margin of 90%, but the past many years have seen the margin to widen to as much as 400%, according to Phu Nu.
Even those drugs that are not put under tenders can still be prescribed in hospitals for patients, of course at a price. A doctor in a Hanoi hospital says in Phu Nu that the kickback for the hospital is some 40% of each prescription. “The Drug Administration has surveyed drug prices in other countries, but has skipped those steps in the country that have pushed up drug prices,” says the paper.
In a stunning investigative report, Tuoi Tre sheds light on the way drug prices are stoked up in the country, pointing the accusing finger at GSK as a well-known foreign drug firm.
GSK is selling drugs manufactured by the local firm Savipharm at a price three or four times higher, earning hefty profit, says the paper.
In a specific deal, Savipharm exported six batches of medicines at a price of VND3.1 billion to GSK via the HCMC-based dealer Phytopharma, but the dealer in making customs procedures for the batches declared a total price of over US$1 million, and in this very first step, the difference has amounted to over VND18 billion.
Tran Tuu, board chairman of Savipharm, explains to Tuoi Tre that the cooperation between his firm and GSK make it possible for local patients to have quality medicines at prices equal to 40-50% of imported drugs only. However, when asked why drug prices offered to end-users are many times higher, the board chairman says he does not know about it.
A doctor reveals in Nguoi Lao Dong that many drugs when reaching end-users have had prices increasing scores of times, or even hundreds of times compared to the original prices, beyond the knowledge of patients. When patients are being drugged in the price cycle for the sake of producers’ profits, authorities are also to blame.
Truong Van Tuan, president of the HCMC Hospitals’ Pharmacists Association, plainly puts it in Nguoi Lao Dong: “Collusion to hike drug prices is inhuman towards patients.”

The Saigon Times Daily