Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Availability, prices and affordability of essential medicines for treatment of diabetes and hypertension in private pharmacies in Zambia

Kaiser, Andrea Hannah LU ; Hehman, Lindsey ; Forsberg, Birger Carl ; Simangolwa, Warren Mukelabai and Sundewall, Jesper LU (2019) In PLoS ONE 14(12).
Abstract
Objectives: To explore availability, prices and affordability of essential medicines for diabetes and hypertension treatment in private pharmacies in three provinces of Zambia. Methods: A cross-sectional survey was conducted in 99 pharmacies across three Zambian provinces. Methods were based on a standardized methodology by the World Health Organization and Health Action International. Availability was analysed as mean availability per pharmacy and individual medicine. Median prices were compared to international reference prices and differences in price between medicine forms (original brand or generic product) were computed. Affordability was assessed as number of days' salaries required to purchase a standard treatment course using the... (More)
Objectives: To explore availability, prices and affordability of essential medicines for diabetes and hypertension treatment in private pharmacies in three provinces of Zambia. Methods: A cross-sectional survey was conducted in 99 pharmacies across three Zambian provinces. Methods were based on a standardized methodology by the World Health Organization and Health Action International. Availability was analysed as mean availability per pharmacy and individual medicine. Median prices were compared to international reference prices and differences in price between medicine forms (original brand or generic product) were computed. Affordability was assessed as number of days' salaries required to purchase a standard treatment course using the absolute poverty line and mean per capita provincial household income as standard. An analysis identifying medicines considered both available and affordable was conducted. Results: Two antidiabetics and nine antihypertensives had high-level availability (≥80%) in all provinces; availability levels for the remaining surveyed antidiabetics and antihypertensives were largely found below 50%. Availability further varied markedly across medicines and medicine forms. Prices for most medicines were higher than international reference prices and great price variations were found between pharmacies, medicines and medicine forms. Compared to original brand products, purchase of generics was associated with price savings for patients between 21.54% and 96.47%. No medicine was affordable against the absolute poverty line and only between four and eleven using mean per capita provincial incomes. Seven generics in Copperbelt/Lusaka and two in Central province were highly available and affordable. Conclusions: The study showed that the majority of surveyed antidiabetic and antihypertensive medicines was inadequately available (<80%). In addition, most prices were higher than their international reference prices and that treatment with these medicines was largely unaffordable against the set affordability thresholds. Underlying reasons for the findings should be explored as a basis for targeted policy initiatives. (Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
14
issue
12
article number
e0226169
publisher
Public Library of Science (PLoS)
external identifiers
  • scopus:85076410122
  • pmid:31834889
ISSN
1932-6203
DOI
10.1371/journal.pone.0226169
language
English
LU publication?
yes
id
497487f6-edd1-4d98-b649-ccf78af3b274
date added to LUP
2020-01-10 12:29:29
date last changed
2024-06-27 11:39:44
@article{497487f6-edd1-4d98-b649-ccf78af3b274,
  abstract     = {{Objectives: To explore availability, prices and affordability of essential medicines for diabetes and hypertension treatment in private pharmacies in three provinces of Zambia. Methods: A cross-sectional survey was conducted in 99 pharmacies across three Zambian provinces. Methods were based on a standardized methodology by the World Health Organization and Health Action International. Availability was analysed as mean availability per pharmacy and individual medicine. Median prices were compared to international reference prices and differences in price between medicine forms (original brand or generic product) were computed. Affordability was assessed as number of days' salaries required to purchase a standard treatment course using the absolute poverty line and mean per capita provincial household income as standard. An analysis identifying medicines considered both available and affordable was conducted. Results: Two antidiabetics and nine antihypertensives had high-level availability (≥80%) in all provinces; availability levels for the remaining surveyed antidiabetics and antihypertensives were largely found below 50%. Availability further varied markedly across medicines and medicine forms. Prices for most medicines were higher than international reference prices and great price variations were found between pharmacies, medicines and medicine forms. Compared to original brand products, purchase of generics was associated with price savings for patients between 21.54% and 96.47%. No medicine was affordable against the absolute poverty line and only between four and eleven using mean per capita provincial incomes. Seven generics in Copperbelt/Lusaka and two in Central province were highly available and affordable. Conclusions: The study showed that the majority of surveyed antidiabetic and antihypertensive medicines was inadequately available (&lt;80%). In addition, most prices were higher than their international reference prices and that treatment with these medicines was largely unaffordable against the set affordability thresholds. Underlying reasons for the findings should be explored as a basis for targeted policy initiatives.}},
  author       = {{Kaiser, Andrea Hannah and Hehman, Lindsey and Forsberg, Birger Carl and Simangolwa, Warren Mukelabai and Sundewall, Jesper}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{12}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Availability, prices and affordability of essential medicines for treatment of diabetes and hypertension in private pharmacies in Zambia}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0226169}},
  doi          = {{10.1371/journal.pone.0226169}},
  volume       = {{14}},
  year         = {{2019}},
}