Prices, availability and affordability of medicines in Rwanda

Bizimana, Thomas; Kayumba, Pierre Claver; Heide, Lutz

doi:10.1371/journal.pone.0236411

Cited by 33 publications

(34 citation statements)

References 6 publications

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“…Most previous studies of this type have been in developing countries. Comparatively, the availability of LPGs in our study was similar to the results in Pakistan (Saeed et al, 2019) and Philippines (Lambojon et al, 2020) but lower than those in Bangladesh (Kasonde et al, 2019), Malawi (Khuluza and Haefele-Abah, 2019), Jordan (Alefan et al, 2018), and Rwanda (Bizimana et al, 2020), where the availability of LPGs was fairly high; however, the availability of OBs in those countries was similar. Comparing with the price in other developing countries, LPGs in our study had November 2020 | Volume 11 | Article 602421 similar or a little higher price, while OBs had a much higher price.…”

Section: Discussionsupporting

confidence: 79%

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Yang

et al. 2020

Front. Pharmacol.

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Objectives: To evaluate the price and availability of medicines in China.Methods: A standard methodology developed by WHO and Health Action International was used to collect medicine price and availability data. We obtained cross-sectional data for 48 medicines from 519 facilities (280 public hospitals and 239 private retail pharmacies) in five provinces in China in 2018. We also collected longitudinal data for 31 medicines in Shaanxi Province in 2010, 2012, 2014, and 2018. Medicine price was compared with the international reference price to obtain a median price ratio (MPR). The availability and price in five provinces were compared in matched sets. We used general estimating equations to calculate differences in availability and median prices from 2010 to 2018.Findings: Mean availability of surveyed medicines in five provinces was low in both public (4.29–32.87%) and private sectors (13.50–43.75%). The MPR for lowest priced generics (LPGs) was acceptable (1.80–3.02) and for originator brands (OBs) was much higher (9.14–12.65). The variation was significant for both availability and price of medicines across provinces. In Shaanxi Province, the availability of medicines decreased between 2010 and 2018, but this was not significant in the public or private sector. Compared with 2010, the median adjusted patient price was significantly lower in 2018 for nine OBs (difference −22.4%; p = 0.005) and 20 LPGs (−20.5%; p = 0.046) in the public sector and 10 OBs (−10.2%; p = 0.047) in the private sector.Conclusion: Access to medicines was found to be poor and unequal across China in 2018. Future interventions are needed, and possible strategies include effective and efficient procurement, promoting the development of retail pharmacies and increasing medicine price transparency.

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Section: Discussionsupporting

confidence: 79%

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Yang

et al. 2020

Front. Pharmacol.

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“…The prices of essential medicines and drugs in public sectors are lower compared to the international procurement prices. In private sectors, the prices are double, but still it is 30% below the international reference prices [ 8 ]. During the pandemic, the country faced an increase in drug and health commodities demand with limited importations, and this resulted in some prices of the pharmaceutical products being raised above the normal range.…”

Section: Price Controlmentioning

confidence: 99%

Drug supply situation in Rwanda during COVID-19: issues, efforts and challenges

Uwizeyimana

Hashim

Kabakambira

et al. 2021

J of Pharm Policy and Pract

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COVID-19 is a threat to health systems around the world and Rwanda is not an exception. The impact of the pandemic is far-reaching and access to health commodities is not spared. Proper drug supply is critical for a robust healthcare system. It determines the extent at which the population are likely to have access to essential medicines and treatments. In Rwanda, the pharmaceutical sector heavily relies on imports. With the emergence of COVID-19 pandemic, the drug supply system was interrupted leaving many stores from small local pharmacies to the big medical stores running out of stock. The reasons were limited importation of goods from abroad, and the panic buying practice among the customers and some institutions when responding to the pandemic. Drug and medicines accessibility, availability and affordability should be the core of any drug management policy. It is with no doubt that, Rwanda has made a tremendous work to mitigate the effect of COVID-19 on the country’s drug supply; however, efforts are still needed to invest in local pharmaceutical production as a way to minimize import expenses in the country. Good policy on drug importation, production and distribution should be enforced to avoid any drug shortage that may be encountered in the Rwandan drug market.

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“…Unlike high-income countries, low- and middle-income countries usually have poor regulation of pharmaceutical markets and often lack feasible purchasing and pricing strategies [ 36 ]. Country specific studies indicated that better availability and more affordable generic versions were reported from Rwanda [ 37 ] and Nepal [ 38 ]. Relatively higher availability of OBs in both public (6.8%) and private (55.0%) facilities were also observed in Pakistan whereas the availability of generic versions was lower in public (35.3%) and private (20.3%) facilities [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Availability, pricing and affordability of essential medicines in Eastern Ethiopia: a comprehensive analysis using WHO/HAI methodology

Sisay

Amare

Hagos

et al. 2021

J of Pharm Policy and Pract

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Background Access to essential medicines is a universal human right and availability and affordability are the preconditions for it. In line with the sustainable development goals, World Health Organization (WHO) has outlined a framework that assists the policy makers to improve access to essential medicines for universal health coverage by 2030. However, the availability and affordability of essential medicines remains suboptimal in several low-income countries. Therefore, this study was designed to investigate the availability, pricing and affordability of essential medicines in eastern Ethiopia. Methods A cross-sectional study design was employed to conduct this study. Public and private health facilities found in Eastern Ethiopia and which fulfilled criteria set forth by WHO/Health Action International (HAI) guideline and essential medicines listed on WHO/HAI guideline and essential medicine list of Ethiopia were included. Accordingly, 60 medicine outlets were selected based on the WHO/HAI standardized sampling methodology. A standardized data collection tools developed by WHO/HAI, with necessary modifications, was employed to collect the data. Median Price Ratio (MPR) was computed as a ratio of median local buyers’ price to international buyers’ reference price. The Mann–Whitney U test was employed to compare the median buyers’ price between public and private health facilities. Kruskal–Wallis test was also run to explore the median price difference among all facilities. Treatment affordability was calculated based on the number of days of wage of the lowest-paid government employee of Ethiopia required to purchase the prescribed regimen. Results The overall percent availability of originator brand (OB) versions of essential medicines was found to be 3.6% (range: 0.0–31.7%), with the public and private sectors contributing 1.43% and 5.50%, respectively. The overall percent availability of lowest price generics (LPGs) was 46.97% (range: 1.7–93.3%) (Public: 42.5%; private: 50.8%). Only eight LPGs (16.0%) met the WHO target of 80%. The Mann–Whitney U test indicated that 64% drugs showed statistically significant median price difference between public and private settings (p < 0.05). The MPR value indicated that the median buyers’ price of drugs in private sector were more than four times the international reference price in 30% of drugs. The percentage of unaffordable medicine were 72.09 and 91.84% for public and private facilities, respectively, with 79.17% of the medicines were unaffordable when both settings were combined. Conclusion Only 16% of the surveyed medicines surpassed the WHO cut-off point of 80%. Nearly one-third of drugs in the private sector had a price of more than four times compared to the international reference prices. Moreover, four out of five drugs were found unaffordable when both settings were combined, demanded several days of wage of lowest paid government employee. This finding calls a prompt action from stakeholders to devise a strategy that help promote the access of essential medicines and rescue the struggling healthcare system of Ethiopia.

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Prices, availability and affordability of medicines in Rwanda

Cited by 33 publications

References 6 publications

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Drug supply situation in Rwanda during COVID-19: issues, efforts and challenges

Availability, pricing and affordability of essential medicines in Eastern Ethiopia: a comprehensive analysis using WHO/HAI methodology

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