title: International price comparisons of Alzheimer's drugs: a way to close the affordability gap.
abstract: BACKGROUND
  Alzheimer's drugs are believed to have limited availability and to be unaffordable in low- and middle-income countries compared to high-income countries. The price, availability and affordability of Alzheimer's drugs have not been reported before.
  
  
  METHODS
  During 2007 an international survey was conducted in 21 countries in six continents (Argentina, Australia, Brazil, the Dominican Republic, France, India, Japan, Macedonia, Mexico, New Zealand, Nigeria, the Philippines, Portugal, Serbia, South Korea, Switzerland, Taiwan, Thailand, Uganda, the U.K. and the U.S.A.). Prices of Alzheimer's drugs were compared using the affordability index (the total number of units purchasable with one's daily income) derived from purchasing power parity (PPP) converted prices as well as raw prices.
  
  
  RESULTS
  Donepezil is available in all 21 countries, whereas the newer drugs are less available. A 5 mg tablet of branded originator donepezil costs just US$0.26 in India and US$0.31 in Mexico, whereas it costs US$6.64 in the U.S.A. Pricing conditions of rivastigmine, galantamine and memantine appear to be similar to that of donepezil. The cheapest branded originators are from India and Mexico. However, in terms of PPP, Alzheimer's drugs in other low- and middle-income countries are much more expensive than in high-income countries. Most people in low- and middle-income countries cannot afford Alzheimer's drugs.
  
  
  CONCLUSIONS
  Alzheimer's drugs, albeit available, are often unaffordable for those who need them most. It is hoped that equitable differential pricing will be applied to Alzheimer's drugs.
authors.affiliation: Department of Psychiatry, Hallym University College of Medicine, Seoul, Korea. suhgh@chol.com
authors.forename: Guk-Hee
authors.initials: GH
authors.lastname: Suh
authors.forename: Anders
authors.initials: A
authors.lastname: Wimo
authors.forename: Serge
authors.initials: S
authors.lastname: Gauthier
authors.forename: Daniel
authors.initials: D
authors.lastname: O'Connor
authors.forename: Manabu
authors.initials: M
authors.lastname: Ikeda
authors.forename: Akira
authors.initials: A
authors.lastname: Homma
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Dominguez
authors.forename: Bong-Min
authors.initials: BM
authors.lastname: Yang
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000191:economics*; D003431:Cross-Cultural Comparison; D003906:Developing Countries; D000077265:Donepezil; D016527:Drug Costs / Q000706:statistics & numerical data*; D004467:Economics; D005702:Galantamine / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D006801:Humans; D007182:Income; D007189:Indans / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D007194:India; D008559:Memantine / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D008800:Mexico; D018697:Nootropic Agents / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use*; D048448:Phenylcarbamates / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D010880:Piperidines / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D000068836:Rivastigmine; D014481:United States
chemical_list: D007189:Indans; D018697:Nootropic Agents; D048448:Phenylcarbamates; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil; D000068836:Rivastigmine; D008559:Memantine