Broadening commercial sector participation in reproductive health : the role of public sector prices on markets for oral contraceptives

This paper focuses on oral contraceptives and addresses whether the commercial sector would be capable of serving some of the users currently receiving their supplies from the public sector. A variety of published reports and data sources are examined, including national demographic surveys and commercial pharmaceutical market surveys.

It concludes that:

• Outside of South America, the market for OCs is dominated by donated orsubsidized product distributed through public outlets
• Experience from South America shows that introducing or promoting free products into an established commercial market induces users to abandon the commercial sector forthese free products without increasing overall use.
• Market segmentation analyses demonstrate that many users of public sources for OCs could afford to pay for a commercial brand in the commercial sector
• Most developing countries have at least an incipient commercial presence. Even in these poor countries, major pharmaceutical laboratories and/or subsidiaries have alreadymade the initial investment to formally register and manufacture or import low-to-moderately priced OC brands

Taken together, these findings suggest that many developing countries have two of the basic conditions needed for increased commercial sector provision of oral contraceptives:

• consumers who can afford to pay but who are currently using public sector products
• moderately-priced commercial products legallyregistered and in the marketplace.

The single policy step of introducing small user fees in public systems which currently provide untargeted free commodities could have significant ramifications in increasing commercial provision of oralcontraceptives. [author]