Abstract
This paper highlights the availability, pricing and affordability of popular medicines in Comoros. We used the standardized survey methodology developed by the World Health Organization and Health Action International to conduct a cross sectional survey for collecting data on availability and patient prices of medicines in public, private and mission sector medicines outlets from April 1 to June 30, 2014. Median availability of medicines in Comoros across all sectors was particularly low at 31.11% for all product types. The median price ratios of procurement prices for original brands, most sold generics and lowest-priced generics in the public sector, were 11.60, 4.74 and 3, respectively. These were 83 times higher than the international reference prices; and the median price ratios of retail prices to patients for lowest priced generics in the private sector were 29.49% higher than those in the public sector. For most of the population, the medicine prices are unaffordable particularly in the islands Ndzuwani and Mwali, where many people earn less 1$ per day. The survey revealed higher procurement prices and poor availability in the public sector. Various policy adjustments could increase the availability of essential medicines and reduce their prices for the low income population. Key words: Affordability, availability, Comoros, islands, prices.
Highlights
Medicines accessibility and affordability depends on various factors that include purchaser variables such as individual, household, community, private insurer, national health system or international donor and even product specificities
lowest priced generics (LPGs) of Metformin had a median availability that was lower in Comoros than in Sudan and Mauritius and higher than in Mongolia and Burundi
In Comoros, the lowest paid government worker would need to spend 0.73 or 0.78 days wages to purchase the LPGs in both sectors, which shows a better affordability compared with Burundi but less affordability with other countries
Summary
Medicines accessibility and affordability depends on various factors that include purchaser variables such as individual, household, community, private insurer, national health system or international donor and even product specificities. Different approaches have been employed to measure accessibility and affordability including benchmarking medicine prices against per capita gross national income (GNI), setting prices against “catastrophic” household health expenditure levels, or converting prices to working days based on government salaries as a proxy for average income
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