Availability, prices and affordability of essential medicines in Zhejiang Province, China

Abstract

Objective To evaluate the availability, prices, and affordability of essential medicines in Zhejiang Province, China. Methods The survey was carried out in Zhejiang Province in 2018 following the methodology of the World Health Organization (WHO) and Health Action International (HAI). This method is an international standard method.Data on 50 medicines were collected from public health facilities and private pharmacies. Medication prices were compared with international reference prices to obtain a median price ratio. The affordability of medicines was measured based on the daily wage of the lowest-paid unskilled government worker. In private pharmacies, the mean availability of Originator Brands (OBs) and Lowest-priced Generics (LPGs) was 36.7% and 40.3%, respectively. Findings The effects of the mean availability of OBs and LPGs were seen in private pharmacies. Correspondingly, the average availability of OBs and LPGs was 41.8% and 35.1% in the public sector, respectively. In the public sector, the median price ratios (MPRs) were 5.21 for generics and 13.49 for OBs. In the private sector, the MPRs were 4.94 for generics and 14.75 for OBs. Treating common diseases with LPGs was generally affordable, while treatment with OBs was less affordable. Conclusions In Zhejiang Province, low availability was observed for medicines surveyed in the public and private sectors. Price differences between originator brands and generics in both sectors are apparent. OBs were more expensive than LPGs in both the public and private sectors. Low availability affects access to essential medicines. Policy measures should be taken to improve the availability of essential medicines.

Access to essential medicines for children: a cross-sectional survey measuring medicine prices, availability and affordability in Hanam province, Vietnam

“…The availability of these two medicines was extremely low in the private Open access sector, similar to the results of Shaanxi, China (2012) 10 ; Iran (2014) 32 and Zhejiang, China (2018). 33 Besides, phenobarbital was unavailable in both sectors, which is in line with the result of Mongolia (2016). 15 The rationale for these results is that narcotic and psychotropic medicines are restricted in use in Vietnam, and only few drugstores with special permission are eligible to sell these medicines.…”

Availability, prices and affordability of essential medicines: A cross-sectional survey in Hanam province, Vietnam

“…In Hanam, the prices of LPGs in the public sector were acceptable with median MPRs = 0.95, compatible with findings in Jordan (1.16) [25], Rwanda (1.0) [28], Shaanxi, China (1.49) [35] but far lower than the result from Zhejiang, China (5.21) [27]. In the private medicine outlets of Hanam, OBs and LPGs were sold at 6.24 and 1.65 times their IRPs which were lower than the findings in Jordan (2016): 9.7 and 7.5 [25] and Zhejiang, China (2018): 14.75 and 4.94 [27], respectively for OBs and LPGs. OBs cost 351.34% more than LPGs in Hanam, lower than the result from Kenya (2016): innovator brands were 13.8 times more expensive than generic medicines [36].…”

“…In addition, the mean availability of LPGs in Hanam was fairly high in the public sector (63.2%) but still low in the private sector (47.9%). These results were lower than findings from Iran (2014): 75.5% and 83.3% [ 30 ], Malaysia (2017): 74.8% and 49.1% [ 31 ]; higher than results of Lahore Division, Pakistan (2016–2017): 35.3% and 20.3% [ 26 ], and Zhejiang, China (2018): 35.1% and 40.3% [ 27 ], respectively for the public sector and the private sector.…”

“…Due to the variation in the list of surveyed medicines, there are difficulties in equal comparing our results to previous studies. However, in Hanam, the mean availability of OBs in both public and private sector was respectively lower than that in Jordan (2016): 9% and 57% [ 25 ]; Lahore Division, Pakistan (2016–2017): 6.8% and 55.0% [ 26 ]; Zhejiang, China (2018): 41.8% and 35.1% [ 27 ]; Rwanda (2019): 11.7% and 29.2% [ 28 ]; higher than results from a study conducted in Bangladesh (2015): 0% and 4% [ 29 ]. In addition, the mean availability of LPGs in Hanam was fairly high in the public sector (63.2%) but still low in the private sector (47.9%).…”

“…and 57% [25]; Lahore Division, Pakistan (2016-2017): 6.8% and 55.0% [26]; Zhejiang, China (2018): 41.8% and 35.1% [27]; Rwanda (2019): 11.7% and 29.2% [28]; higher than results from a study conducted in Bangladesh (2015): 0% and 4% [29]. In addition, the mean availability of LPGs in Hanam was fairly high in the public sector (63.2%) but still low in the private sector (47.9%).…”