Availability, price and affordability of essential medicines for managing cardiovascular disease in Addis Ababa, Ethiopia

Abstract

Access to health care is a fundamental human right. However, nearly one-third of the global population have no access to it. This magnitude is even much worse in low- and middle-income countries. A cross-sectional study was conducted from April 12 to June 5, 2024 to determine availability, price and affordability of essential medicines for managing cardiovascular diseases using WHO/HAI methodology in Addis Ababa, Ethiopia. Data on the availability and price of the lowest priced generic medicines were collected from five public, ten private and eight other sectors in Addis Ababa, Ethiopia. The availability was assessed as the percentage of health facilities that stocked the listed medicines. The prices of these medicines were evaluated across all sectors. Price variations were calculated to identify differences among these settings. Additionally, medicine prices were compared against the management sciences for health (MSH) International Reference Prices to calculate the Median Price Ratio (MPR), providing a standardized measure of price affordability and accessibility. The data was analyzed using WHO/HAI work book Excel sheet V 15. The overall availability of generic drugs in all sectors was found to be 34.52%. The availability was 33.73, 40.58, 29.8 and 33.99% in Public, Private, Kenema and Red Cross pharmacies, respectively. The median price ratios for the medications used to treat cardiovascular disease were 3.49, 7.24, 2.84 and 5.2 at Public, Private, Kenema, and Red Cross Pharmacies, respectively. Majority of the medicines were found to be unaffordable, costing up to 352.44 days' wage of the lowest paid government employee to cover a one-month standard treatment. In conclusion, the study underscores significant challenges in the availability, pricing, and affordability of LPG medications to treat CVDs in Ethiopia.

Keywords: Access to medicine in Ethiopia; Affordability of drugs; Availability of drugs; Essential medicine; Medicine for cardiovascular diseases; Price of drugs.