Rational Use and Pricing
Commodities are only effective when used rationally. Irrational use of medicines, use of the wrong drugs or the right drugs in the wrong quantities, stemming from inadequate prescription, self prescription, poor availability or high price of required drugs reduces the effectiveness and efficiency of health services and puts patients' lives in danger. Additionally the WHO notes that irrational use of medicine and high priced medicines are two of top ten sources of inefficiencies in health system spending. Rational use of medicines requires that "clients or patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community".
Knowledge of treatment guidelines, good prescription practices by trained health care personnel and availability of appropriately priced quality medicines are key to promoting rational use.
Rational use and availability of medicines is also contingent upon the prices of medicines. The WHO also notes a tendency for countries and patients to overpay for medicines. The prices clients or health providers pay for RMNCH commodities vary according to a number of factors, including:
- the sector in which they are purchased, the price is often higher in the private for-profit sector;
- the type of procurement agent, for example, different prices may be paid for the same product by a public sector purchaser, such as the Ministry of Health, the health facility that supplies the medicine to the patient, and the individual who purchases the medicine;
- the distribution route, a patient who purchases a medicine at a public hospital pharmacy may have to pay more if the hospital pharmacy purchased the product from a local wholesaler than if it has been purchased by tender and supplied through the public health sector distribution system;
- the patent status, the price of patented medicines is often higher than that of their generic equivalent, at least while the patent is in force.”