The Access of Essential Medicines for Non Communicable Diseases in Private Sector of Sri Lanka

Abstract

Non communicable diseases (NCDs) are major health challenges for low and middle income countries. There were 38 million deaths (68%) from world population due to NCDs. Access to medicines is a universal human right where availability and affordability of medicines are preconditions. Both public and private sectors contribute to the healthcare of the people of Sri Lanka. The objective of the present study was to determine the availability and affordability of essential medicines (EM) prescribed to treat selected common NCDs in private health sector of Sri Lanka. Methodology was based on 2nd edition of WHO/HAI manual. Data were collected from a representative sample involving all 9 provinces and consisted of Rajya Osusalas, private pharmacies and private hospital pharmacies. Availability and prices of EMs commonly prescribed for hypertension, acute coronary syndrome, asthma and diabetes were collected. Percentage availability, median price of originator brand (OB) and lowest priced generic (LPG), median price ratio (MPR) to the International Reference Price (IRP) and median price ratio of OB to LPG were calculated. Affordability was determined using the daily income of the lowest -paid unskilled government worker and calculated according to basket method. Availability of assessed EMs was >50% as lowest priced generics in private pharmacies. However availability of OB in private sector was less than 50%. Price of one unit dosage form of all the LPG medicines surveyed was less than ten rupees. Price of unit dosage form of 50% of OB medicines surveyed was >50 rupees. Price of seven originator brands was five times higher than International Reference Price. Price of all originator brands of medicines was always higher than that of lowest priced generic. Single and multiple medicines for hypertension and oral medicines for diabetes were affordable if LPGs are purchased. Inhalers for asthma were not affordable to the lowest paid government worker. Medicines from OB for treatment of hypertension, asthma and diabetes for a month were not affordable to the lowest paid government worker. The EMs in lowest priced generics are available in Sri Lanka. The medicines for hypertension and diabetes are affordable to most if LPGs are purchased.