List of definitions


Item Description
The item description includes the generic name, strength, dosage form, and the route of administration. If the product has two widely used names (for example, vitamin C and ascorbic acid), one name will appear in brackets. (See the List of Synonyms.)


IC
Products under international narcotics control are identified with (IC) next to the description.


Route of Administration
Routes of administration are coded as follows:
Item Type Code
DiagnosticDIAG
Ear preparationOTIC
Eye preparationOPHT
InhalationINHL
Injectable medicineINJ
Nasal DropsN/T
Not applicableN/A
Oral PreparationPO
Rectal PreparationRECT
SublingualSL
TopicalTOP
Vaginal preparationsVAG
Defined Daily Dose
The DDD is the assumed average maintenance dose per day for a medicine used for its main indication in adults. The defined daily dose is a unit of measurement and does not necessarily reflect the recommended or prescribed daily dose. Doses for individual patients and patient groups will often differ from the DDD and will necessarily be based on individual characteristics (e.g., age and weight) and pharmacokinetic considerations.

Medicine consumption data presented in DDDs only give a rough estimate of consumption and not an exact picture of actual use. DDDs provide a fixed unit of measurement independent of price and formulation enabling the researcher to assess trends in medicine consumption and to perform comparisons between population groups.

The defined daily doses are from the WHO Collaborating Centre for Drug Statistics Methodology. They are illustrative defined daily doses, as recommended by the World Health Organization's Drug Utilization Research Group (DURG). Not all medicines listed in this price comparison guide have defined daily doses assigned by this method. A DDD will only be assigned for medicines that already have an ATC code.
The main use of the DDD is for estimating medicine consumption, based on inventory/distribution data. This can be combined with price information for budgeting purposes.

Note: The defined daily dose should not be used for dosing or therapeutic determinations. Refer to prescribing information for dosing schedules for specific indications.

WHO EML
The "WHO EML" column indicates whether the product is included on the 19th (2015) WHO Model List of Essential Medicines. We identify five categories in the International Medical Products Price Guide:
  • E = On the WHO main list in the same dosage form and strength

  • C = On the WHO complementary list in the same dosage form and strength

  • P = On the list but in a different presentation (different dosage form and/or strength)

  • T = Not on the WHO list, but can be an alternative for an item listed as a therapeutic group example

  • N = Not on the WHO model list

We also include WHO EML therapeutic class information for each product. For products not included on the latest WHO EML (i.e., those products with an "N" in the "WHO EML" column in this Guide), we have assigned a therapeutic class based on the WHO EML classification system. This is done when a non-EML product clearly falls within an EML therapeutic category, as determined by MSH staff.

This assignment does not reflect a decision by WHO Essential Drugs and Medicines Policy or MSH staff that the non-EML product is appropriate for inclusion in the WHO Model List of Essential Medicines. If an unambiguous assignment of an EML therapeutic category was not possible, we placed the product in the category of "UA – Agents Unclassified in WHO EML."

Median Price
When using the Guide for comparison with local prices, or for estimating the total value of a proposed procurement list, an average price can be helpful. There are basically two kinds of average prices that could be used: the mean price and the median price. The mean price is the simple average of all prices shown for a product; the values are added up and divided by the number of values.

However, there is a problem when one or two prices are much higher or lower than the rest for a certain product. These "outliers" skew the mean and make it less representative. For example, in a series of seven values such as $1, $2, $2, $3, $5, $16, $20, the total of all the values is $49, and dividing by seven gives a mean value of $7. For comparison or estimation purposes, it is likely that this average is too high, due to the two prices that are much higher than others in the series. To avoid this risk, we use the median price.

The median price is a type of average; it is the value that splits a series of values in half when the series is put in ascending order. This is likely to be a more valuable approach for estimating actual future prices (or for comparing with local prices) when there is a skewed distribution.

If there is an odd number of values in the series, as in the example above, the median value is the middle value in the series ($3 in the example). When there is an even number of values in a series, such as the series $1, $3, $4, $6, $14, $20, the median is calculated by averaging the two middle values. In this example, the median is the average of $4 and $6, which is $5. Again, this is likely to be closer to reality for comparison or estimation than the arithmetic mean of $8 ($48 divided by 6). (Adapted from Statistics without Tears-- Primer for Non-Mathematicians, by Derek Rowntree (New York: Charles Scribner's Sons, 1981), pp. 41–45.)

Unit Price (US$)
The unit used to compare prices varies with the type of pharmaceutical preparation as shown in the table below. This format facilitates the price comparison of different vendor pack sizes.
Pharmaceutical Dosage Form Comparison Unit (Code)
AmpouleMilliliter (ML)
Bottle Milliliter (ML)
CartridgeMilliliter (ML)
Condom Each (EACH)
CreamGram (G)
Disc for lab testingEach (EACH)
DisposableEach (EACH)
EachEach (EACH)
Ear dropsMilliliter (ML)
ElixirMilliliter (ML)
EnemaMilliliter (ML)
GasCubic meter (CUBMETER)
GelGram (G)
GranulesGram (G)
InhalerDose (DOSE)
IUDEach (EACH)
LiquidMilliliter (ML)
LotionMilliliter (ML)
Nasal dropsMilliliter (ML)
Nasal sprayMilliliter (ML)
NetEach (EACH)
OintmentGram (G)
Ophthalmic dropsMilliliter (ML)
Ophthalmic ointmentGram (G)
Ophthalmic stripsStrip (STRIP)
Oral dropsMilliliter (ML)
Oral gelGram (G)
PessaryPessary (PESS)
PowderGram (G)
Rectal tubeMilliliter (ML)
Respiratory solutionMilliliter (ML)
RodRod (ROD)
ShampooMilliliter (ML)
SolidKilogram (KG)
SolutionMilliliter (ML)
SprayMilliliter (ML)
SuppositorySuppository (SUPP)
SuspensionMilliliter (ML)
SyringeEach (EACH)
SyrupMilliliter (ML)
Tablet or capsuleTablet or Capsule (TAB-CAP)
TestTest (TEST)
TinctureMilliliter (ML)
Transdermal patchPatch (PATCH)
VialVial (VIAL)
High
Highest price from listed buyers and suppliers


Low
Lowest price from listed buyers and suppliers


High/Low Ratio
The High/Low ratio compares the highest unit price with the lowest unit price. For example, a High/Low ratio of 3 means that the highest unit price is three times greater than the lowest unit price.
ATC Code
The ATC code is the anatomical therapeutic chemical classification code assigned by the WHO Collaborating Centre for Drug Statistics Methodology. The purpose of the ATC/DDD system is to serve as a tool for medicine utilization research in order to improve quality of medicine use. One component of this is the presentation and comparison of medicine consumption statistics at international and other levels.

In the ATC classification system, the medicines are divided into different groups according to the organ or system on which they act and their chemical, pharmacological and therapeutic properties. Products are classified in groups at five different levels. The products are divided into fourteen main groups (1st level), with one pharmacological/therapeutic subgroup (2nd level). The 3rd and 4th levels are chemical/pharmacological/therapeutic subgroups and the 5th level is the chemical substance. The unit used to compare prices varies with the type of pharmaceutical preparation as shown in the table below. This format facilitates the price comparison of different vendor pack sizes.

Price Types (Incoterms)
Incoterms are a basic reference for sales contracts. They define the responsibilities of buyers and sellers. For more information, see the International Chamber of Commerce site. The terms used by suppliers and agencies in this Guide are:
  • CFR (cost and freight): includes transport charges up to the port of destination (sea shipments only)

  • CIF (cost, insurance, and freight): includes insurance and transport charges up to the port of destination

  • CIP (carriage and insurance paid): includes transport charges and insurance up to the place of destination

  • CPT (carriage paid to): includes transport charges up to the place of destination

  • DAP (delivered at place): seller pays for carriage to the named place, except for costs related to import clearance, and assumes all risks prior to the point that the goods are ready for unloading by the buyer

  • DDP (delivered duty paid): includes delivery and import duties and unloading costs

  • DDU (delivered duty unpaid): includes delivery, but not import duties or unloading costs

  • EXW (ex works): does not include loading, insurance, or freight

  • FCA (free carrier): includes transport and insurance until the goods are delivered to the carrier

  • FOB (free on board): the price of goods at the point of shipment, but does not include the cost of insurance and freight (transportation)