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Concentration and drug prices in the retail market for malaria treatment in rural Tanzania

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Author Info

  • Catherine Goodman
  • S. Patrick Kachur

    (Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA)

  • Salim Abdulla

    (Ifakara Health Institute, Dar es Salaam, Tanzania)

  • Peter Bloland

    (National Center for Zoonotic, Vector-borne, and Enteric Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA)

  • Anne Mills

    (Health Policy Unit, London School of Hygiene and Tropical Medicine, London, UK)

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    Abstract

    The impact of market concentration has been little studied in markets for ambulatory care in the developing world, where the retail sector often accounts for a high proportion of treatments. This study begins to address this gap through an analysis of the consumer market for malaria treatment in rural areas of three districts in Tanzania. We developed methods for investigating market definition, sales volumes and concentration, and used these to explore the relationship between antimalarial retail prices and competition. The market was strongly geographically segmented and highly concentrated in terms of antimalarial sales. Antimalarial prices were positively associated with market concentration. High antimalarial prices were likely to be an important factor in the low proportion of care-seekers obtaining appropriate treatment. Retail sector distribution of subsidised antimalarials has been proposed to increase the coverage of effective treatment, but this analysis indicates that local market power may prevent such subsidies from being passed on to rural customers. Policymakers should consider the potential to maintain lower retail prices by decreasing concentration among antimalarial providers and recommending retail price levels. Copyright © 2009 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.1473
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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 18 (2009)
    Issue (Month): 6 ()
    Pages: 727-742

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    Handle: RePEc:wly:hlthec:v:18:y:2009:i:6:p:727-742

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. Martin Gaynor & William B. Vogt, 1999. "Antitrust and Competition in Health Care Markets," NBER Working Papers 7112, National Bureau of Economic Research, Inc.
    2. Conteh, Lesong & Hanson, Kara, 2003. "Methods for studying private sector supply of public health products in developing countries: a conceptual framework and review," Social Science & Medicine, Elsevier, vol. 57(7), pages 1147-1161, October.
    3. Filmer, Deon & Pritchett, Lant, 1998. "Estimating wealth effects without expenditure data - or tears : with an application to educational enrollments in states of India," Policy Research Working Paper Series 1994, The World Bank.
    4. Dranove, David & Satterthwaite, Mark A., 2000. "The industrial organization of health care markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 20, pages 1093-1139 Elsevier.
    5. Toni Ashton & David Press, 1997. "Market Concentration in Secondary Health Services Under a Purchaser-Provider Split: The New Zealand Experience," Health Economics, John Wiley & Sons, Ltd., vol. 6(1), pages 43-56.
    6. Carol Propper & Neil Söderlund, 1998. "Competition in the NHS internal market: an overview of its effects on hospital prices and costs," Health Economics, John Wiley & Sons, Ltd., vol. 7(3), pages 187-197.
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    Cited by:
    1. Puig-Junoy, Jaume & López-Valcárcel, Beatriz González, 2014. "Launch prices for new pharmaceuticals in the heavily regulated and subsidized Spanish market, 1995–2007," Health Policy, Elsevier, vol. 116(2), pages 170-181.
    2. Schultz Hansen, Kristian & Hjernø Lesner, Tine & Østerdal, Lars Peter, 2013. "Incentivising appropriate malaria treatment-seeking behaviour with price subsidies," COHERE Working Paper 2013:8, COHERE - Centre of Health Economics Research, University of Southern Denmark.

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