Objectives During the past decade, the health system in Syria has been devastated due to the ongoing conflict which affected the production of pharmaceuticals as well. Patients of chronic diseases, such as diabetes mellitus, were significantly affected by the shortages of oral anti-diabetic medications, especially those of lower socioeconomic status. The objective of this paper is to study the causes and effects of the shortage of oral anti-diabetic agents in the Syrian market on patients with low socioeconomic status who find difficulties in accessing these medications. Methods The methodology of the study includes determining the availability of nationally produced oral anti-diabetic agents in different local pharmacies. Then, it studied the effects of this availability on low socioeconomic status patients whose prescriptions were registered in a local NGO and analysed using Microsoft Excel (Microsoft, USA). Key findings The study shows that many of the anti-diabetic medications included in the study have less than 50% availability in the pharmacies. Metformin, which is considered as a first-line treatment in diabetes has 40% availability. In addition, metformin was the most prescribed medication with about 57% frequency followed by gliclazide with 37% prescription frequency. Conclusion This study raises concerns about the continuity of supply of some of the oral anti-diabetic agents in the Syrian market. This can impact patient commitment to treatment, where patients from low socioeconomic status can be most affected by medication unavailability in nearby pharmacies or increased pricing due to high demand with low supply.

Background During the past decade, the health system in Syria has been devastated due to the ongoing conflict which affected the production of pharmaceuticals as well. Patients of chronic diseases, such as Diabetes Mellitus, were significantly affected by the shortages of oral anti-diabetic medications, especially those of lower socioeconomic status. Aims The aim of this paper is to study the causes and effects of the shortage in oral anti-diabetic agents in the Syrian market on patients with low socioeconomic status who find difficulties in accessing these medications. Methods The methodology of the study includes determining the availability of nationally produced oral anti diabetic agents in different local pharmacies. Then, it studied the effects of this availability on low socioeconomic status patients whom prescriptions were registered in a local NGO and analysed using Excel (Microsoft, USA). Results The study shows that many of the anti-diabetic medications included in the study have less than 50% availability in the pharmacies. Metformin, which is considered as a first-line treatment in diabetes has 40% availability. In addition, Metformin was the most prescribed medication with about 57% frequency followed by Gliclazide with 37% prescription’s frequency. Conclusion This study examines the availability of the most prescribed anti-diabetic medications in the Syrian market and highlights the most common challenges in the supply chain of medications due to sanction.