Objective: To examine gender differences in access to prescribed medicines in 15 lower and middle income countries.

Methods: The proportion of consultations with at least one prescription for women in three age groups (<15, 15–59, 60+ years) with acute respiratory infections (ARI), depression and diabetes in routine audits was compared to the expected proportion calculated from WHO Global Burden of Disease estimates. Newer oral hypoglycaemic medication prescribing was also analysed. Differences reported by country, age group, and condition.

Findings: 487,841 consultations examined between January 2007 and September 2010 in low (n = 1), lower middle (6), and upper middle income (8) countries. No country favoured one gender exclusively, but gender differences were common. Taking the 15 countries together, only diabetes treatment revealed a significant difference, with women being treated less often than expected (p = 0.02). No consistent differences found across countries grouped by World Bank income category, WHO region or Global Gender Gap Index. Overall, women had equal access to newer oral hypoglycaemics.

Conclusion: Gender differences in access to prescribed medicines for three common conditions are common, but favour neither gender consistently. This challenges prevailing hypotheses of systematic disparities in access to care for women. Evidence about gender disparities should influence policy design.