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International price comparisons of Alzheimer's drugs: a way to close the affordability gap

Published online by Cambridge University Press:  08 September 2009

Guk-Hee Suh*
Department of Psychiatry, Hallym University College of Medicine, Seoul, Korea
Anders Wimo
Alzheimer's disease research center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
Serge Gauthier
McGill Center for Studies in Aging, Douglas Institute for Mental Health, Montreal, Quebec, Canada
Daniel O'Connor
Department of Psychological Medicine, Monash University, Kingston Centre, Victoria, Australia
Manabu Ikeda
Department of Psychiatry and Neuropsychiatry, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Akira Homma
Dementia Interventional Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Jacqueline Dominguez
Memory Clinic, Institute of Neuroscience, St. Luke's Medical Center, Quezon City, Phillippines
Bong-Min Yang
School of Public Health, Seoul National University, Seoul, Korea
Correspondence should be addressed to: Professor Guk-Hee Suh, MD, PhD, Department of Psychiatry, Hallym University College of Medicine, Hangang Sacred Heart Hospital, 94–200 Yeongdeungpo-Dong, Seoul, 150-030Korea. Phone: +82-2-2639-5289; Fax: +82-2-2633-5910. Email:


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.

Research Article
Copyright © International Psychogeriatric Association 2009

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