Medicine Pricing, Availability and Affordability. Report of Four Regions, Maharashtra, India
(2005; 60 pages)

Availability and affordability are key components in equitable access to essential medicines. This was a survey to measure prices of medicines and their availability using WHO - HAI methodology published in the manual, “Medicine prices: a new approach to measurement”, 2003. We surveyed the price and availability of innovator brand (IB), most sold generic (MSG; generic product with the highest sales nationally) and lowest priced generic (LPG; generic product with the lowest price at each facility) equivalents of a core list of drugs in this manual, and, 8 supplementary medicines commonly used. Price results of the three types (IB, MSG, LPG) for each medicine are presented in terms of automatically computer generated Median Price Ratio (MPR), which is the ratio of the median price for each medicine across facilities divided by an international reference price converted into local currency (Madden, 2003). The international reference price or MSH (the Management Sciences for Health (MSH), International Drug Price Indicator Guide, 2003) was median prices from not-for-profit wholesalers to developing countries.

Affordability calculations were based on simple model treatments and the minimum daily wages of the lowest paid unskilled worker in government service (Indian rupees 120/-). Our findings indicate that availability of medicines in the public procurement sector was low and ranged between 8 to 45% with median availability of 15.8%. This includes common antibacterials, antihypertensive, antidiabetic and anticonvulsant medications, indicating a poor stocking of essential medicines in government hospitals. The essential drug list of the procurement sectors contained 50% of those in the core list surveyed resulting in underreporting of availability of medicines.

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