The prices, availability and affordability of essential medicines in Sudan

Abstract

This study aims to analyze the prices, availability and affordability of selected essential medicines (EM) in Sudan in 2013. It also analyzes factors affecting medicines prices variation between the Capital and other states. The methodology developed by World Health Organization (WHO) and Health Action International (HAI) is used to assess medicine prices, availability and affordability, while Ordinary Lease Squire (OLS) is used to estimate factors affecting price variation. Primary data of 50 essential medicines were collected from 99 outlets in six geographical states, of which 35, 36 and 28 pharmacies were public, private and Revolving Drug Fund (RDF) respectively. Medicine prices were compared with international reference prices (IRPs) to obtain a median price ratio. The daily wage of lowest paid unskilled government worker was used to gauge the affordability of medicines. Innovator brand (IB) prices in private pharmacies were 4.24 times higher than the International References Prices (IRPs), while generics were 2.9 times higher. In the public pharmacies, IB and generic medicine prices were 2.67 and 2.98 times higher than IRPs, while in RDF, IB and generic medicine prices were 1.88 and 2.7 times higher than their IRPs respectively. The prices of RDF pharmacies was 41.9% higher than government procurement prices, while in the public and private pharmacies the prices were higher by 62.4% and 53.5% respectively. Prices in the public sector were found to be higher than the private and RDF sectors. The availability of essential medicines in the public sector was 68.1% for the generics and 3.7% for IBs. While in the private, the availability was 83.9% and 14.4% respectively. The availability in RDF sector was 4.3% for IB and 53.4% for the generic. In addition, most of essential medicines were less affordable since the treatment cost was greater than one day wage of lowest paid government workers. Regression results show that drug prices were higher in remote states and also in private pharmacies when compared to the prices in the capital.