Cut in drug prices unlikely but supply guaranteed

JAKARTA (JP): The economic crisis, said Naswan, a 52-year-old worker with serious heart problems, has had a "good effect" on him.

"Now, I'm paying serious attention to my diet," said Naswan. He used to ignore his doctor's advice to control his diet and reduce work hours.

"I obey him not only because of the high medical costs but also out of fear that my drugs will no longer be available in the drugstores," Naswan said.

While local drug-producing companies are experiencing difficulties, members of the International Pharmaceutical Manufacturers Group said the public can rest assured of their drug supplies.

The government's Rp 700 billion subsidy for imported generic drugs and life-saving medical equipment, and the issuance of a US$58 million Letter of Credit in February to help cover pharmaceutical needs for three months, do not include the group's 39 members.

Neil Weston, president director of the Servier pharmaceutical manufacturer, said international pharmaceutical companies are continuing supplies as normal.

Members are basically foreign companies which have access to raw materials and active ingredients, many of which they produce themselves.

"We have enough stocks of raw materials. Our total inventory normally covers four months average at any time," said Richard Husada, president director of the Dumex-Alpharma pharmaceutical company and the group's vice chairman.

The firm, he said, has seen a decline in sales by 30 percent.

The group's members produce both patent and generic products.

As most raw materials for their products are imported, the group's members have raised prices by up to 90 percent.

"Products that have had the highest increases are those that are fully imported and paid for in U.S. dollars. Others which have a lower dollar component have been able to be more moderately priced," said Bruce Murdoch, the group's chairman and president director of Schering Plough.

Richard said Dumex-Alpharma spends an average of 40 percent of the net price on imported raw materials.

Consumers reporting higher drug prices have complained of increases of up to 300 percent.

For instance, insulin has increased from Rp 300,000 to Rp 1.2 million.

In response to the reports, the group said it has not raised prices to such an extent, but, as Weston acknowledged, the manufacturers cannot control the prices passed on to consumers.

Meanwhile, the price of generic drugs are monitored by a government team, to prevent pharmacies from raising the prices above the allowed margin of 50 percent.

The soaring drug prices have caught the attention of the Indonesian Consumers Foundation, which has just completed its latest survey on the country's drugs' prices.

The findings will be compared with other countries in the Asia-Pacific region before being made public in the next few months.

In its 1995 survey, before the crisis hit, the foundation found that prices were up to four times higher than in some other countries.

Ida Marlinda, project head for the foundation's latest survey on drug prices, said the increase in prices may be higher now than reported.

Because patent drug prices are not being controlled by the government, and because pharmacies can increase manufacturers' prices, she said "the increase of prices is difficult to determine".

Pharmacies have also said they must adjust prices because prices set by distributors have increased by more than 50 percent.

Chairman of the Indonesian Medical Association, Merdias Almatsier, joined the call for manufacturers, distributors and pharmacies against further increasing drug prices.

"People are already facing many problems now ... don't burden them more. The pharmaceutical business is not merely about gaining profits but also about saving lives," he said.

One reason patent drugs are more expensive is the cost for research.

According to the International Federation of Pharmaceutical Manufacturers, the research and development cost for each new drug entity is between $150 million and $350 million.

The problem of reducing drug manufacturers' high dependence on imported raw materials has become classic -- large investments.

"It is only possible to reduce the dependence on imported raw materials, or active ingredients, if a domestic chemical industry is developed. This would take substantial investment," said the federation's chairman Murdoch.

The average chemical plant producing two to three active ingredients would cost between $150 million to $350 million, he said. To enable lower costs in drug manufacturing and distribution, Weston suggested reducing import tariffs and deregulating the pharmaceutical industry. (ste)

Table: Price list of some patent drugs (in rupiah)

(No; Products; Jan. 1 1997; Jan. 1 1998; Jan. 20 1998; Feb. 10 1998): (1; Amcillin caps. 250 mg/100; 27,720; 32,930; 32,950; 49,500), (2; Amcillin tabs. 500 mg/100; 53,724; 63,820; 63,900; 96,860), (3; Amcillin D.S syrup 60 ml; 6,720; 7,900; 8,000; 12;000), (4; Amcillin inj.500 mg/10 vls; 27,800; 30,086; 30,100; 45,150), (5; Amcillin inj. 1g/10vls; 44,800; 46,384; 48,400; 72,800), (6; Chloramex caps 250 mg/100; 25,500; 25,500; 28,100; 42,150), (7; Chloramex syrup 60 ml; 4,600; 4,600; 5,100; 7,050), (8; Chloramex inj. 1g/10 vls; 40,000; 40,000; 44,000; 66,000), (9; Colistine tabs. 0.25 Mlu; 26,400; 32,080; 32,100; 45,150), (10; Colistine tabs. 1.5 Mlu; 72,276; 87,615; 87,000; 131,850), (11; Danoxilin caps. 250 mg/100; 66,792; 79,350; 79,350; 119,000), (12; Danoxilin inj. 1 g/10vls; 79,200; 85,538; 86,000; 128,400), (13; Danoxilin disp. tabs 500mg; --; 62,500; 62,500; 93,750), (14; Dinomark inj. 400 mg/10vls; 70,000; 70,000; 77,000;116,500), (15; Dinomark tabs. 200 mg; 86,000; 86,000; 93,500; 140,250), (16; Dumocycline caps. 250 mg; 56,373; 60,883; 60,900; 110,000), (17; Dumocycline tabs. 500 mg; 34,630; 42,075; 42,100; 63,150), (18; Dumoxin tabs. 100 mg /50; 74,250; 74,250; 81,700; 122,550), (19; Fenocin tabs. 0.2 Mlu; 43,550; 43,550; 47,900; 79,000), (20; Kanoxin inj. 1 g/10vls; 24,545; 24,545; 27,000; 40,500), (21; Dumotrim tabs. /100; 36,960; 36,960; 40,750; 61,125), (22; Dumotrim forte/100; 75,000; 75,000; 82,600; 123,750), (23; Dumotrim syrup 50 ml; 8,710; 8,710; 9,600; 14,400), (24; Elyzol tabs. 500 mg/100; 102,276; 102,276; 112,500; 168,750), (25; Elyzol infus 500 mg/100 ml; --; 20,000; 22,000; 33,000), (26; Isonex syrup 225 ml; 4,410; 4,410; 4,900; 7,500), (27; Malarex tabs. 250 mg/1,000; 97,700; 97,700; 107,500; 151,250), (28; Suldox tabs. 15x4g; 36,730; 36,730; 40,500; 60,750), (29; Dumolid tabs. 5 mg/100; 41,760; 50,740; 50,750; 77,000), (30; Stesolid tabs. 5 mg/100; 33,192; 42,330; 42,400; 65,000), (31; Stesolid syrup 60 ml; 7,728; 9,390; 9,500; 14,250), (32; Stesolid inj. 2 ml/5 amp; 9,804; 11,925; 11,950; 18,000), (33; Stesolid Rectal tube 10mg; 27,628; 33,440; 33,500; 50,500), (34; Confortid caps. 25 mg/100; 43,920; 43,920; 48,500; 72,750), (35; Somadril comp./100; 34,500; 41,000; 41,000; 61,500), (36; Diflonid tabs. 500 mg/50; 53,440; 53,440; 54,300; 96,450), (37; Deflamat inj.2ml/5 amp; --; 21,000; 23,100; 34,680), (38; Dains caps. 10 mg/50; --; 32,500; 35,760; 53,700), (39; Dains D tabs 20 mg/50; --; --; --; 110,000), (40; Dopamet tabs. 250 mg/100; 39,180; 39,180; 43,100; 65,000), (41; Dubrozil caps. 300 mg/100; --; 90,000; 99,000; 128,700), (42; Dubrozil caplet 600 mg/50; --; 85,000; 93,500; 121,560), (43; Decreten tabs. 10 mg/50; 61,000; 61,000; 67,500; 101,250), (44; Impugan tabs. 40 mg/100; 48,750; 48,750; 53,700; 80,550), (45; Impugan inj. 2ml/8 amp; 7,841; 7,841; 8,700; 13,500), (46; Lorinid tabs./50; 34,440; 34,440; 37,900; 58,650), (47; Lorinid Mita /50; 26,775; 26,775; 29,600; 44,250), (48; Antabuse /20; 9,146; 9,146; 9,146; 15,000), (49; Apolar cream 10gr/tube; 8,334; 10,125; 10,125; 15,200), (50; Apolar-N cream 10gr/tube; 9,444; 11,475; 11,475; 17,300), (51; Ennamax tabs/100; 11,000; 11,000; 12,250; 18,400), (52; Raclonid tabs./100; 30,460; 30,460; 33,800; 50,400), (53; Raclonid syrup 50ml; 4,290; 4,290; 4,750; 7,200), (54; Raclonid inj./5 amp; 10,890; 10,890; 12,000; 16,000), (55; Ascoplex caps./100; 22,800; 22,800; 25,500; 38,250), (56; Biomex tabs/100; 28,895; 28,895; 31,800; 47,700), (57; Dumocalcin Peppermint/100; 12,650; 15,370; 15,500; 23,250), (58; Dumocalcin Chocolate/100; 12,650; 15,370; 15,500; 23,250), (59; Durol tonic 60 ml; 1,400; 1,400; 1,500; 3,500), (60; Multivitaplex elixir 126ml; 5,900; 5,900; 6,500; 9,750), (61; Multivitaplex P.Drops 15ml; 4,610; 4,610; 5,100; 7,650), (62; Multivitaplex tabs./100; 6,100; 6,100; 6,800; 10,200), (63; Vitamineral tabs./100; 15,300; 15,300; 16,900; 25,360), (64; Koffex syrup 120 ml; 5,420; 5,420; 6,000; 8,000), (65; Longatin syrup 60 ml; 4,579; 4,579; 5,200; 7,800), (66; Longatin caps. 50 mg/100; 34,267; 34,267; 37,750; 56,700), (67; Dumin tabs. 500 mg/1,000; 92,808; 112,400; 12,500; 168,750), (68; Dumin syrup 60 ml; 4,120; 5,000; 5,000; 7,500), (69; Dusal tabs.; 6,958; 6,958; 7,750; 11,750), (70; Floxil Lozenges; 10,450; 10,450; 11,500; 17,250), (71; Stimol sachet/30; 49,000; 49,000; 53,900; 81,000), (72; Waxsol 10 ml; 10,150; 10,150; 11,200; 16,800), (73; Pyralvex 10 ml; 10,000; 10,000; 11,000; 16,500), (74; Decubal Cream 20 g; 4,500; 4,500; 4,950; 7,500)

Source: Dumex-Alpharma price list dated March 11, 1998. Prices do not include value-added tax.