The most expensive medicine in the world

A report by University of El Salvador released last week determined that medicine in El Salvador costs more than any place in the world. The study evaluated the price of drugs purchased at more than 100 sources throughout El Salvador, split equally between the public and the private sectors. Drug prices for name brand drugs, still under drug company patents, averaged 50 times the international reference price. Generic drugs, while cheaper, were 20 times the international reference price. The price levels made the cost of drugs in El Salvador the highest anywhere.


To put this cost in practical terms, the study looks at how many days a worker would need to work at minimum wage in a country to purchase a course of treatment for 4 common maladies. In India, it would take 1.5 days, in the Sudan and Philippines between 5 and 6 days, but in El Salvador it would take a full nine days of wages to purchase the necessary medicines.

A 2003 report by Strategies for Enhancing Access to Medicines described the issue in El Salvador's healthcare system:

Pricing and affordability issues are a major concern throughout the public health system. At the central level, which still handles procurement for MSPAS primary care facilities, El Salvador routinely purchases pharmaceutical products at prices above the international median; the SEAM assessment found that, for a list of tracer items, MSPAS central-level purchase prices for pharmaceuticals was 82 percent above median international purchase prices. Decentralized hospital purchase prices were another 23 percent higher overall than the prices paid by central-level purchasers, placing a great financial burden on patients and hindering hospitals' ability to maintain adequate stock.

When MSPAS facilities run out of medicines, patients turn to private pharmacies to fill their prescriptions, paying even higher prices. This creates an even heavier economic burden for workers and their families, particularly for the 28 percent of the Salvadoran population living on less than minimum wage.

Whether your political views come from the left or the right, this is a system in drastic need of reform. Government inefficiency, incompetence or corruption in drug purchases is evident. Any market forces at play are not creating competitive pressures to move prices downward. And thousands of Salvadorans go without necessary drugs because they cannot afford them, or the system has run out of them.