Abstract
BackgroundLimited availability of medicines in public facilities and unaffordable prices in the private sector act as barriers to medicines’ access. Patients in Eswatini may be forced to buy medicine from the private sector resulting from chronic medicines’ shortages in public health facilities. The extent to which they can afford to do so is unknown.AimTo determine the availability, price and affordability of medicines in the retail pharmacies in Eswatini, and to compare the results regionally and internationally.SettingRetail pharmacy sector in the four administrative regions of Eswatini.MethodsData on availability, price and affordability to patients for 50 medicines in the originator brand (OB) and the lowest priced generic (LPG) equivalent, were collated using the standardised World Health Organization/Health Action International methodology from 32 retail pharmacies in the four regions of Eswatini. Prices were then compared with selected countries.ResultsThe overall mean availability of all medicines in selected retail pharmacies was 38.5%; standard deviation [s.d.] = 20.4% for OBs and 80.9%; s.d. = 19.0% for LPGs. The overall median price ratio (MPR) in the surveyed pharmacies was 18.61 for the OBs and 4.67 for LPGs. Most standard treatments with LPGs cost less than a day’s wages whilst for OBs cost more than a day’s wages. The differences between Eswatini and South African prices were statistically significant.ConclusionDrug pricing policies and price monitoring tools are needed for the whole pharmaceutical chain in Eswatini to monitor availability, affordability and accessibility of medicines to the general populace.
Highlights
Medicines are crucial in the healthcare system, they are generally not affordable to people globally
The aim of this study was to investigate the availability, affordability and prices that people pay for medicines in different parts of Eswatini
A total number of 32 pharmacies were included in the study
Summary
Medicines are crucial in the healthcare system, they are generally not affordable to people globally. It is well documented in literature that prohibitive pricing is one of the major barriers to essential medicines’ access.[1,2,3] There is significant underuse of costly medicines in populations that do not have any medical insurance, and even the smallest price changes in drugs will impact adherence significantly amongst the poor.[4]. Unavailability and/or low availability of essential medicines in the public health outlets may become a major barrier to medicines’ access, especially when coupled with high unaffordable prices in the private sector.[6] It is imperative that prices in the private sector be affordable to ensure equitable access.[7,8]. Limited availability of medicines in public facilities and unaffordable prices in the private sector act as barriers to medicines’ access. Patients in Eswatini may be forced to buy medicine from the private sector resulting from chronic medicines’ shortages in public health facilities. The extent to which they can afford to do so is unknown
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