Retail pharmacy prescription medicines availability, prices, and affordability in Eswatini.

Abstract

Background: The low availability of medicines in public health outlets coupled with unaffordable prices in the private sector can be a major barrier to medicines’ access. Patients in Eswatini may be forced to buy medicines from the private sector due to the chronic medicines shortages in Eswatini public health facilities. The extent to which they can afford to do so is unknown. Aim: To determine the availability, prices paid by patients and affordability of medicines, in the retail pharmacies in Eswatini and to compare the results regionally. Setting: Retail pharmacy sector in the 4 administrative regions of Eswatini. Methods: Data on availability, prices and affordability to patients for two products namely the originator brand (OB) and the lowest-priced generic equivalent (LPG) for 50 medicines were collected using the standardised World Health Organization/ Health Action International methodology. The data collection was conducted in 32 retail pharmacies in the 4 regions of Eswatini. Prices for each medicine were compared with South Africa. Results: The overall mean availability of all medicines in selected retail pharmacy outlets was (38.5%; SD=20.4%) for OBs and (80.9%; SD=19.0%) for LPGs. The overall median price ratio (MPR) in the surveyed pharmacies was 18.61 for the OBs and 4.67 for LPGs. Most standard treatments with LPGs cost less than a day’s wage whilst OB’s cost more than a day’s wages. The differences between Eswatini and South African prices were statistically significant. Conclusion: There is a need to develop medicines pricing policies and price monitoring tools in the whole pharmaceutical chain in Eswatini to measure and monitor availability, affordability, and accessibility of medicines to the general populace.