New Delhi: An analysis of prices of about 550 medicines across 72 countries in 2022 has found that people in low- and middle-income nations could be paying more than wealthier ones for the same essential drugs, placing a disproportionate cost burden on patients in poorer nations.

Researchers from Brown University (US) and the London School of Economics and Political Science (UK) said that while the 'nominal price' — the price stated on a medicine — was higher in richer countries, actual prices after accounting for purchasing power in local currency were higher in poorer countries.

The study estimated that the typical number of doses of essential medicines consumed per person in 2022 was highest in Europe (634) and lowest in Southeast Asia (143).

The results, published in The Journal of the American Medical Association (JAMA) Health Forum, indicate that poorer countries face a higher burden of medicine costs.

For example, prices in India were low in nominal terms (fourth lowest of the 72 markets analysed), but moved toward the middle of the range (29th) after adjusting for purchasing power. Pakistan had the lowest nominal prices, yet actual prices were closer to those in Germany after such adjustments.

Drug prices also varied between countries by the disease category. For most countries, the highest-priced drugs were those used for treating mental and behavioural disorders and cardiovascular conditions, while the lowest-priced drugs were for treating hepatitis B and C.

The team analysed eight essential medicines for major causes of death and disability worldwide, including the antibiotic amoxicillin (for community-acquired pneumonia), escitalopram (for depression), and ibuprofen (for pain). Affordability was assessed based on the number of days' minimum wages required to purchase the drugs.

In India, people would need to work about 10 days at minimum wage to afford a monthly regimen of tenofovir disoproxil (used for Hepatitis B and HIV/AIDS) out of pocket.

Affordability was typically highest in Europe and the Western Pacific and lowest in Africa and Southeast Asia.

“Our results show that while drugs may have a lower nominal price in low- and middle-income countries, they may still be less affordable when considering the relative purchasing power of local currencies,” the authors wrote.