Table 1 A snapshot of suggestive pharmaceutical pricing policies for Pakistan

1

Internal Reference Pricing

Yes

I.Pakistan, the first generic medicine should be priced 40–50% below the originator, whereas the price of the first biosimilar had to be only 30% lower than the reference product

II.In the case of “Me-too” medicines, a cost-minimization analysis should be done

III.For the new presentation in the same dosage of medicine already marketed. The price should be worked out based on the arithmetic mean of the prices of previously launched medicines [12]

IV.For the presentation of different dosages of medicine already marketed. The price must not exceed the average price, weighted by sales, of available presentations of the medicine that have the same active ingredients, strength, and dosage form

Varies from one country to another

In Brazil Generic medicine price can’t exceeds 65% of the respective reference medicine [37]

In the Czech Republic the first generic medicine had to be priced 32% below the originator, whereas the price of the first biosimilar had to be 15% lower than the reference product [38]

2

External Reference Pricing

Reference countries

India, Bangladesh, Sri Lanka, South Africa, Iran, Saudi Arabia, and New Zealand

Yes ( different countries adapt different practices)

3

Value Based Pricing

Highly specialised unit is required for implementation

Yes

4

Mark-up regulations

Yes

Currently a mark-up of 35 and 15% is applied to the wholesaler and the retailer

(to be applied case to case basis)

Need to develop a regressive mark-up structure, in which the mark-up rate decreases as the price increases (rather than a fixed percentage mark-up for all prices)

5

Cost plus pricing

Difficult to understand current pricing formula. Need clarity and transparency on costs

Not used globally