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[e-drug] Research paper on prices & availability of essential medicines from India

E-DRUG: Research paper on prices & availability of essential medicines from 
India
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Dear all,

A paper entitled,"Where are we now: assessing the price, availability and 
affordability of essential medicines in Delhi as India plans free 
medicine for all" by Anita Kotwani is published in BMC Health Services 
Research. The full paper can be downloaded from

URL: http://www.biomedcentral.com/1472-6963/13/285

Abstract of the article

Where are we now: assessing the price, availability and 
affordability of essential medicines in Delhi as India plans free 
medicine for all

Background
Inequitable access to medicines is a major weakness in the Indian health care 
system. Baseline data needed to develop effective public health policy and 
provide equitable access to essential medicines. The present survey was 
conducted to investigate the price, availability, and affordability of fifty 
essential medicines in the public and private sector in Delhi, India using 
standardized WHO/HAI methodology. 

Methods
Data on procurement price and availability was collected (July-October 2011) 
from three public healthcare providers: the federal (central) government, state 
government and Municipal Corporation of Delhi (MCD). Data on price and 
availability of medicines was collected from private retail and chain 
pharmacies of a leading corporate house. Prices were compared to an 
international reference price (expressed as median price ratio-MPR). 

Results
The procurement price of surveyed medicines was 0.53-0.82 times the 
international reference price-IRP. However, the overall mean availability of 
surveyed medicines in facilities under state government and MCD was 41.3% and 
23.2%, respectively. The overall mean availability of medicines in three 
tertiary care facilities operated by the federal government was 49.3%. 
Availability of generic medicines was much higher in the private sector. 

Off-patented medicines, like diazepam, diclofenac, and doxycycline had the 
highest MPRs. The price ratio between procurement and retail was as high as 28 
(range 11–28) for certain medicines. Seven-day treatment with a popular brand 
of amoxicillin+clavulanic acid or one inhaler each of budesonide and salbutamol 
cost 2.3 and 1.4 days wages for the lowest paid government worker. A majority 
of India's population cannot afford these prices. 

Conclusions
This study revealed that procurement prices of surveyed medicines were 
reasonable in comparison to IRP. However, variation in procurement prices of 
certain medicines by different public procurement agencies was noted. 
Availability of medicines was very poor in public sector facilities, which are 
the primary source of free medicines for a majority of India's low-income 
population. Availability of medicines is better in private retail pharmacies 
but affordability remains a big challenge for a majority of the population. 
These data have significant policy implications that could help in amending 
policies to increase the access to essential medicines for India's population. 

Anita Kotwani
Associate Professor
Department of Pharmacology
Vallabhbhai Patel Chest Institute
University of Delhi
Delhi 110007
India
anitakotwani@yahoo.com
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