Abstract
Background: Non communicable diseases (NCDs) are spreading like an epidemic worldwide. Essential medicines are crucial for prevention and control of NCDs. World Health Organization (WHO) has set a benchmark of 80% availability of essential medicines in public and private facilities. Availability being a predictor of access to medicines is low in Low and Middle income countries (LMICs). The objective of this study is to determine price, availability and affordability of essential medicines for NCDs in District Abbottabad. Methods: This study was based on the standardized protocol provided by WHO and Health Action International (HAI) for determination of availability, prices and affordability of medicines. A total of 50 medicines for NCDs that were enlisted in Essential Medicine List of district Khyber Pakhtun Khawa were selected for the study. Twenty seven medicine dispensing facilities belonging to public, private and other basic health units (BHUs) (managed by PPHI) sectors were surveyed in the district. Simple random sampling was employed to select facilities. Results: The mean overall percentage availability of essential medicines for NCDs was 0.1% for original brand and 1.9% for low price generic in public sector. Overall availability was better in private and other sectors (32.9% for OB and 13.8% for LPGs and 5.3% for OB and 11.1% for LPG respectively). The prices in public procurement sector were competitive. The median price ratio (MPR) in public procurement sector was 0.56. Prices were higher comparatively in private sector with MPR 2.83. Most of the medicines require less than a day wage to buy 30 days treatment. Conclusions: The availability of essential medicines for NCDs was poor in District Abbottabad. None of the sectors reached the benchmark of 80% with regard to availability of medicines. LPGs were not frequently available in the private sector. However, prices were reasonable in public sector and acceptable in private sector. Medicines were found to be affordable but affordability may differ for people living below poverty line of US $1.
Highlights
Non- communicable diseases (NCDs) are killing more people worldwide than any communicable disease
The study results revealed that the mean overall percentage availability of essential medicines for NCDs was 0.1% for original brand and 1.9% for low price generic in public sector
Low availability of medicines for NCDs has been reported for many other Low and Middle income countries (LMICs) especially in public sector [8]
Summary
Non- communicable diseases (NCDs) are killing more people worldwide than any communicable disease. According to World Health Organization (WHO) almost 38 million people lose their lives each year globally due to one or more non-communicable diseases. NCDs are not curable and require lifelong treatment and care. These characters of NCDs tend to drain household resources especially in low resource settings mainly due to the continuous purchase of medicines. The medicines for chronic diseases in 6 LMICs including Pakistan were reported as less than 8% in public sector except in Brazil where it was 30%. In Pakistan public health facilities were reported to have extremely low median availability of low price generics (LPGs) (3.3%). Objective of this study was to determine price, availability and affordability of essential medicines for NCDs in District Abbottabad
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