WHO key access antibiotics price, availability and affordability in private sector pharmacies in Pakistan

Cost Effectiveness and Resource Allocation

Amna Saeed¹  Zikria Saleem²  Zaheer-Ud-Din Babar³  Huma Rasheed⁴  Zunaira Akbar⁵  Mohamed Azmi Hassali⁶  Saleha Khalid⁷  Aleena Irfan⁷  Hamid Saeed⁷  Laiba Farrukh⁷  Azka Anam⁷ 

[1] Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Jiaotong University, Xi’an, Shaanxi, China;Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi’an, Shaanxi, China;The Global Health Institute, Xi’an Jiaotong University, Xi’an, Shaanxi, China;Shaanxi Centre for Health Reform and Development Research, Xi’an, China;Department of Pharmacy Practice, Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan;Department of Pharmacy, University of Huddersfield, HD1 3DH, Queensgate, Huddersfield, UK;Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan;Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Pakistan;School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town, Malaysia;University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore, Pakistan;

关键词: Key access antibiotics;    Price;    Availability;    Affordability;   

DOI  :  10.1186/s12962-021-00263-x

来源: Springer

【 摘 要 】

BackgroundPoor availability and unaffordability of key access antibiotics may increase antimicrobial resistance in the community by promoting inappropriate antibiotic selection and abridged therapy compliance.ObjectiveTo check the prices, availability, and affordability of the World Health Organization (WHO) key access antibiotics in private sector pharmacies of Lahore, Pakistan.MethodologyA survey of WHO key access antibiotics from WHO essential medicine list 2017 was conducted in private sector pharmacies of 4 different regions of Lahore employing adapted WHO/HAI methodology. The comparison of prices and availability between originator brands (OB) and lowest price generics (LPG) were conducted followed by the effect of medicine price differences on patient’s affordability. The data were analyzed using a preprogrammed WHO Microsoft excel workbook.ResultsThe mean availability of OB products was 45.20% and the availability of LPGs was 40.40%. The OBs of co-amoxiclav, clarithromycin and metronidazole and LPGs of azithromycin and ciprofloxacin were easily available (100%) in all private sector pharmacies. Whereas, antibiotics like chloramphenicol, cloxacillin, nitrofurantoin, spectinomycin, and cefazolin were totally unavailable in all the surveyed pharmacies. The OBs and LPGs with high MPRs were ceftriaxone (OB; 15.31, LPG; 6.38) and ciprofloxacin (OB; 12.42, LPG; 5.77). The median of brand premium obtained was 38.7%, which varied between the lowest brand premium of 3.97% for metronidazole and highest for ceftriaxone i.e. 140%. The cost of standard treatment was 0.5 day’s wage (median) if using OB and 0.4 day’s wage (median) for LPG, for a lowest paid unskilled government worker. Treatment with OB and LPG was unaffordable for ciprofloxacin (OB; 2.4, LPG; 1.1) & cefotaxime (OB; 12.7, LPG; 8.1).ConclusionThere is dire need to properly implement price control policies to better regulate fragile antibiotic supply system so that the availability of both OB and LPG of key access antibiotics should be increased. The prices could be reduced by improving purchasing efficiency, excluding taxes and regulating mark-ups. This could increase the affordability of patients to complete their antibiotic therapy with subsequent reduction in antimicrobial resistance.

【 授权许可】

CC BY