In the present sample of 23 countries in which patients are required to purchase medicines in
the public sector, prices paid for the lowest-priced generic medicines, on average, range from
1.9 times the international reference price (IRP) in the Eastern Mediterranean to 3.7 times
the IRP in Europe. In some individual countries, local prices for generics exceed the interna-
tional reference prices by a factor of four and above: examples include, Ukraine (MPR, 4.0),
Sudan (MPR, 4.4), Kazakhstan (MPR, 4.8) and the Philippines (MPR, 6.4).