[What is the real price of SOP and OTC drugs? Pilot study on paracetamol]

Abstract

Objectives: to investigate the actual selling prices of over-the-counter or self-medication (OTC) and non-prescription (SOP) packages of band C medicines, which are freely set by individual pharmacies, para-pharmacies, and corners of the large-scale retail trade. Specifically, the prices charged for paracetamol 500 mg 20 tablets (20 CPR) and 30 tablets (30 CPR) in the online sale, carried out by different retail outlets authorized by the Italian Ministry of Health, were surveyed.

Design: cross-sectional observational descriptive study. The availability for online purchase of one or more packages of paracetamol 500 mg 20 CPR and 30 CPR was checked for each outlet considered; for sites with at least one package available for sale, the lowest real price of each of the two packages (20 and 30 CPR) was recorded, differentiating among: 1. type of outlet (pharmacy or retail outlet); 2. originator (branded) or generic (unbranded) drug; 3. city of residence of the outlet (provincial capital city or not).

Setting and participants: the sample considered consists of 475 online retail sites (pharmacies, para-pharmacies, and large-scale retail stores) based in the 10 major Italian provincial capitals, including sites in the relevant provincial cities.

Main outcome measures: the average real price, calculated as the average of all real prices recorded by packaging type; the minimum real price, i.e., or the lowest real price recorded by packaging type; the average discount, calculated as the difference between the average real price and the average value of the maximum recommended prices (set by the marketing authorization holder, AIC) for branded and unbranded packaging; the maximum discount, calculated as the difference between the minimum real price and the average value of the maximum recommended prices (set by the marketing authorization holder) for branded and unbranded packaging.

Results: a wide availability of paracetamol packages produced by multiple AIC holders (both branded and unbranded) was found in the country. The presence of several manufacturers of paracetamol 500 mg induces high price competition, as evident from the discounts given. However, discounts are very high on non-branded packs and lower on branded packs. However, analysis of consumption at the national level shows that price competitiveness does not reflect true market share competitiveness, as consumption is mainly concentrated on branded packs that have the highest prices.

Conclusions: wide and homogeneous distribution of unbranded products from different holders is available throughout the country. These products have significantly lower prices than branded packages, and they also have heavy discounts applied (up to 70%, with minimum price per tablet going as low as 0.05 euros). However, contrary to what these premises might lead one to think, consumption is concentrated on the branded packages having the highest prices. For proper information to citizens and trade associations, it is important for the media to bring awareness of the real savings opportunities available nationwide for products of frequent and widespread use, such as the case of paracetamol 500 mg.

Keywords: SOP/OTC drugs; discounts; online sale; paracetamol; real sale price.