Evidences of Drug Prices in

Indonesia

Erni Widiastri and Hasbullah Thabrany

Center for Health Economics and Policy
Analysis, Universitas Indonesia
hasbullah.thabrany@ui.edu
 Drugs and Other Cossumables?
Drugs
• Huge asymetric of
information
• Barrier to entry
• Essential product, life
threthening
• Income and price inelastis
• Consumers are much less
rational
• Doctors decide
consumption
Other Consumables: Very
Responsive to Market
• Much less information
asymetry
• Free entry and exit of
supply
• Normal good
• Price and income elastis
• Consumers are rational
• Consumers direct decision
to consume
The Size of Pharmacy Market in Indonesia

Year Pharma US$

Market (Bill Estimate
IDR) (Bill US$)
2005 23,629 2.5
2006 23,174 2.4
2007 25,700 2.7
2008 29,700 3.1
2009 32,900 3.2
 Retail Prices in Public Hospitals in
Indonesia
100

90 86.81

Brand 80.72
80
Most Sold 73.09
Median Price Ratio

70 Lowest Price

60

50
40.49 40.94
40

30
21.8
20
10.67 9.5
10 6.03 5.32 5.51 5.51
1.77 1.69 1.69
0
Amoxicillin 500 Captopril 25 mg, tab Ciprofloxacin 500 Diazepam 5 mg, tab Glibenclamide 5 mg
mg,tab/cap mg, tab tab

Generic Name
Sumber: BPOM 2004
 Variations and Substitutions of Prescriptions
Drugs in Indonesia

R in Dharmais R/ in Islam ic Jakarta R in Prov Health

A Dr’s Pres in a Hospital
Cempaka Putih

Original ; Original; Original;

Ponstan 250 mg XV Rp 18.700 Medrol 4 mg X Rp 31.300 Daonil XXXX Rp 93.700
Original ;
Ciproxin 500 mg X Rp 289.200 Claritin VII Rp 41.850 Glucopace 500 LX Rp 74..000
Duricef 350 mg X Rp 134.000
Immunos VII Rp 43.900 Zantac XV Rp 106.300 Nervitone XXX Rp 25.700
Puyer no XV Rp 8.600
Max C 500 mg VII Rp 18.800 Vantiz X Rp 30..200 TOTAL Rp 193.500
TOTAL Rp 370.600 TOTAL Rp 209.650
TOTAL Rp 142.600

AlternativeI ; AlternativeI ; Alternatiive I ;

Lameson 4 mg Rp 28.400 AlternativeI ;
Pondex 250 mg XV Rp 7.100 Prodiamel Rp 16.400
Alloris Rp 30.300 Doxcef Rp 48.900
Baquinor 500 mg X Rp 128.700 Glukotika 500 Rp 65.600
Rantin 150mg Rp 70.700 Puyer no XV Rp 8.600
Immunos VII Rp 43.900 Nervitone E Rp 25.700
Max C 500 mg VII Rp 198.500 Vantiz x Rp 30..200 TOTAL Rp 107.700
TOTAL Rp 159.600 TOTAL Rp 57.500
. TOTAL Rp 107.700

Alternative2 ; Alternative2 ; Alternativef 2 ;

Alternative2 ; Glibenclamide Rp 7.000 Cefadroxil Rp 23.700
Methyl Prednisolon Rp 16.900
As mefenamat 250 Rp 3.000 Methormine 500 Rp 28.400 Puyer no XV Rp 8.600
Loratadine Rp 5.200
Ciprofloxasin 500 Rp 14.500 Nervitone E Rp 25.700
Ranitidine Rp 43.900
Immunos VII Rp 43.900 TOTAL Rp 61.100 TOTAL Rp 32.300
Vantiz x Rp 30.200
Max C 500 mg VII Rp 18.800
TOTAL Rp 65.200
TOTAL Rp 81.100

Sumber ; Gatra 1 th 2006/Danutirto

 Price Survey, 2004
No NAMA OBAT AP.1 AP.2 AP.3 AP4. AP.5 AP 6. AP 7 AP 8.
1. Amoxyl 250 (SKB/GSK) 2.610 2.313 2.750 - 1.720 2994 - -
Amoxan 250 (Sanbe) 1.862 1.650 - 1.750 1.650 1782 1760 1.650
Amoksisilin 250 (G) 310 272 300 355 355 283 300 272

2. Cyproxin 500 (Bayer) 28.765 25.485 20.000 - 20.000 27.524 - 20.625

Baquinor 500 (Sanbe) 13.425 11.894 - 10.000 9.750 12.895 12.70 11.894
0
Siprofloksasin 500 (G) 1.600 1.404 2.000 1.459 1.450 1.123 1.300 1.080

3 Cozaar 50 (MSD) 12.518 - - 12.667 - 13.167 - -

Insaar 50 (Interbat) 10.855 - 8.000 10.000 - 10.395 - -
Losartan 50 - - - - - - - -
MARGIN 33% 25% 20% 28% 30% 30- 33.33 25%
35% %
 Retail Prices in Public Hospitals are
More Expensives
No Drug Names Hosp Hosp Hosp Hosp Hosp Hosp
1 2 3 4 5 6
1. Amoxyl 250 (SKB/GSK) - - - 2.902 - -
Amoxan 250 (Sanbe) 1.584 - 1.657 1.772 1.652 1.320
Amoksisilin 250 (G) 259,52 293,75 455 450 362 210

2. Cyproxin 500 (Bayer) - 25.257 - 28.075 - 20.388

Baquinor 500 (Sanbe) 11.018 11.562 - 12.775 - 9.515
Siprofloksasin 500 (G) 518,43 420 339,7 2.142 - 1.120

3 Cozaar 50 (MSD) - 8.955 - 12.760 - -

Insaar 50 (Interbat) - 8.020 - 9.846 9.305 7.760

Losartan 50 - - 9.183 9.305 7.700

MARGIN 20% 33% 25% 20% 25% 20%

Average Prices of Cifrofloxacin per Episode of
Treatment in Several ASEAN Countries, US$
USD
5,00

4,00

3,00
4,81 4,35 4,05
2,00 2,92
2,36

1,00

0,00
Singapore Malaysia Indonesia Thailand Philipines

Sumber IMS/BPOM
 Comparison of Drug Prices: Generic, Lowest and
Highest Prices

Sumber: Health Action International, July 2010

 Global Price
Comparison

… an example

Source : HAI (Healthcare Action International) Europe.

http://www.haiweb.org/medicineprices/
 Conclusion
1. In Indonesia, prices of drugs are relatively
expensive both per pack and per episode of
treatment (compared to the average income)
2. Competition on pharmaceutical companies
did not lower drug prices
3. Local company seemed follow the originator
prices, with relative small lower prices
4. Innovations for tier-pricing or other access to
medicine programs could help the people
Pharma Innovations to Improve Access
before UHC Could Contribute
Significantly to the Health of the
Population