In the Europe region, Romania, the private sector in Russia and the Ukraine saw an increase in the Global Price per Standard Unit Index. In Romania, a change may occur in 2009 as new therapeutic reference systems come into play, but in the private sector in Russia early signs indicate that prices continue to rise. The Netherlands is the only country to show sustained and significant decreases quarter-on-quarter in this index, with most high-income countries remaining relatively flat.
In South East Asia and the Western Pacific regions, only China shows any evidence of an increase in the Global Price per Standard Unit index, but even there the data presents an inconsistent picture.
Some of the increase may be due to increases in list prices rather than actual prices -- with significant pharmacy purchase discounts offered and frequent claw backs by governments. The major reason for such prices increases is likely a decline in national currency exchange rates with a decline in purchasing power. Some countries, including Canada, Puerto Rico, the U.S., Uruguay, (Public), The Netherlands, Australia and New Zealand, had declines in prices per standard unit in at least three quarters during the time period studied when compared with the same quarter in the prior year.
Compared with the five quarters before the economic crisis began, there has been little change in consumption of medicines in the most recent five quarters to Q1 2009. This may be the result of pipeline supply, the protective effect of social health insurance (where it exists) or ongoing attempts by governments to maintain health systems. Alternatively, it may just be too early to detect the impact of the economic crisis in the data so far collected by IMS.
Declines in the volume of pharmaceutical consumption generally do not appear to have occurred, with the exception of Estonia and the private sector in Russia where three consecutive quarters of volume decline have been observed. To date, there does not appear to be a major change in the volumes of original and licensed medicines used or a decline in the consumption of medicines used to treat chronic diseases.
From the data available to Q1 2009, it appears that the global economic crisis has not yet had an impact on pharmaceutical consumption overall. Previous economic crises demonstrate that the impact is rarely consistent across countries. While it is sometimes difficult to isolate the impact of economic crises from changes in government policies, the data collection methods and analytic tools used in the study will enable detection of significant changes if and when they occur. When changes are detected, governments have a range of policy levers that can be applied to address the situation.