Access to essential medicines for diabetes care: availability, price, and affordability in central Ethiopia
Abstract Background Diabetes is a major global public health burden. Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines (EMs) which is a challenge especially in low-and-middle-income countries such as Ethiopia. This study aimed...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | Global Health Research and Policy |
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| Online Access: | https://doi.org/10.1186/s41256-024-00352-3 |
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| author | Hachalu Dugasa Deressa Habtamu Abuye Alemayehu Adinew Mohammed K. Ali Tedla Kebede Bruck Messele Habte |
| author_facet | Hachalu Dugasa Deressa Habtamu Abuye Alemayehu Adinew Mohammed K. Ali Tedla Kebede Bruck Messele Habte |
| author_sort | Hachalu Dugasa Deressa |
| collection | DOAJ |
| description | Abstract Background Diabetes is a major global public health burden. Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines (EMs) which is a challenge especially in low-and-middle-income countries such as Ethiopia. This study aimed to assess the accessibility of EMs used for diabetes care in central Ethiopia’s public and private medicine outlets with respect to availability and affordability parameters. Methods A cross-sectional study was conducted in 60 selected public and private medicine outlets in central Ethiopia from January to February 2022 using the World Health Organization/Health Action International (WHO/HAI) standard tool to assess access to EMs. We included EMs that lower glucose, blood pressure, and cholesterol as these are all critical for diabetes care. Availability was determined as the percentage of surveyed outlets per sector in which the selected lowest-priced generic (LPG) and originator brand (OB) products were found. The number of days’ wages required by the lowest paid government worker (LPGW) to purchase a one month’s supply of medicines was used to measure affordability while median price was determined to assess patient price and price markup difference between public procurement and retail prices. Results Across all facilities, availability of LPG and OB medicines were 34.6% and 2.5% respectively. Only two glucose-lowering (glibenclamide 5 mg and metformin 500 mg) and two blood pressure-lowering medications (nifedipine 20 mg and hydrochlorothiazide 25 mg) surpassed the WHO’s target of 80% availability. The median price based on the least measurable unit of LPG diabetes EMs was 1.6 ETB (0.033 USD) in public and 4.65 ETB (0.095 USD) in private outlets. The cost of one month’s supply of diabetes EMs was equivalent to 0.3 to 3.1 days wages in public and 1.0 to 11.0 days wages in private outlets, respectively, for a typical LPGW. Thus, 58.8% and 84.6% of LPG diabetes EMs included in the price analysis were unaffordable in private and public outlets, respectively. Conclusions There are big gaps in availability and affordability of EMs used for diabetes in central Ethiopia. Policy makers should work to improve access to diabetes EMs. It is recommended to increase government attention to availing affordable EMs for diabetes care including at the primary healthcare levels which are more accessible to the majority of the population. Similar studies are also recommended to be conducted in different parts of Ethiopia. |
| first_indexed | 2024-04-24T12:44:01Z |
| format | Article |
| id | doaj.art-ca71679fccf64f72beb709c27035c245 |
| institution | Directory Open Access Journal |
| issn | 2397-0642 |
| language | English |
| last_indexed | 2024-04-24T12:44:01Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Global Health Research and Policy |
| spelling | doaj.art-ca71679fccf64f72beb709c27035c2452024-04-07T11:06:56ZengBMCGlobal Health Research and Policy2397-06422024-04-019111210.1186/s41256-024-00352-3Access to essential medicines for diabetes care: availability, price, and affordability in central EthiopiaHachalu Dugasa Deressa0Habtamu Abuye1Alemayehu Adinew2Mohammed K. Ali3Tedla Kebede4Bruck Messele Habte5School of Pharmacy, College of Health Sciences, Addis Ababa UniversityDepartment of Pharmacy, College of Medicine and Health Sciences, Wachemo UniversitySchool of Pharmacy, College of Health Sciences, Addis Ababa UniversityDepartment of Family and Preventive Medicine, School of Medicine, Emory UniversitySchool of Medicine, College of Health Sciences, Addis Ababa UniversitySchool of Pharmacy, College of Health Sciences, Addis Ababa UniversityAbstract Background Diabetes is a major global public health burden. Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines (EMs) which is a challenge especially in low-and-middle-income countries such as Ethiopia. This study aimed to assess the accessibility of EMs used for diabetes care in central Ethiopia’s public and private medicine outlets with respect to availability and affordability parameters. Methods A cross-sectional study was conducted in 60 selected public and private medicine outlets in central Ethiopia from January to February 2022 using the World Health Organization/Health Action International (WHO/HAI) standard tool to assess access to EMs. We included EMs that lower glucose, blood pressure, and cholesterol as these are all critical for diabetes care. Availability was determined as the percentage of surveyed outlets per sector in which the selected lowest-priced generic (LPG) and originator brand (OB) products were found. The number of days’ wages required by the lowest paid government worker (LPGW) to purchase a one month’s supply of medicines was used to measure affordability while median price was determined to assess patient price and price markup difference between public procurement and retail prices. Results Across all facilities, availability of LPG and OB medicines were 34.6% and 2.5% respectively. Only two glucose-lowering (glibenclamide 5 mg and metformin 500 mg) and two blood pressure-lowering medications (nifedipine 20 mg and hydrochlorothiazide 25 mg) surpassed the WHO’s target of 80% availability. The median price based on the least measurable unit of LPG diabetes EMs was 1.6 ETB (0.033 USD) in public and 4.65 ETB (0.095 USD) in private outlets. The cost of one month’s supply of diabetes EMs was equivalent to 0.3 to 3.1 days wages in public and 1.0 to 11.0 days wages in private outlets, respectively, for a typical LPGW. Thus, 58.8% and 84.6% of LPG diabetes EMs included in the price analysis were unaffordable in private and public outlets, respectively. Conclusions There are big gaps in availability and affordability of EMs used for diabetes in central Ethiopia. Policy makers should work to improve access to diabetes EMs. It is recommended to increase government attention to availing affordable EMs for diabetes care including at the primary healthcare levels which are more accessible to the majority of the population. Similar studies are also recommended to be conducted in different parts of Ethiopia.https://doi.org/10.1186/s41256-024-00352-3AccessAvailabilityAffordabilityDiabetesEssential medicinesNon-communicable diseases |
| spellingShingle | Hachalu Dugasa Deressa Habtamu Abuye Alemayehu Adinew Mohammed K. Ali Tedla Kebede Bruck Messele Habte Access to essential medicines for diabetes care: availability, price, and affordability in central Ethiopia Global Health Research and Policy Access Availability Affordability Diabetes Essential medicines Non-communicable diseases |
| title | Access to essential medicines for diabetes care: availability, price, and affordability in central Ethiopia |
| title_full | Access to essential medicines for diabetes care: availability, price, and affordability in central Ethiopia |
| title_fullStr | Access to essential medicines for diabetes care: availability, price, and affordability in central Ethiopia |
| title_full_unstemmed | Access to essential medicines for diabetes care: availability, price, and affordability in central Ethiopia |
| title_short | Access to essential medicines for diabetes care: availability, price, and affordability in central Ethiopia |
| title_sort | access to essential medicines for diabetes care availability price and affordability in central ethiopia |
| topic | Access Availability Affordability Diabetes Essential medicines Non-communicable diseases |
| url | https://doi.org/10.1186/s41256-024-00352-3 |
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