Background & objectives: The price and availability of medicines are key
components in determining access to effective treatment. Data on prices and availability of common
medicines in public and private sector in different States of India are scarce. Hence, surveys were
undertaken in different States of India to evaluate these metrics.
Methods: During October 2004 to January 2005, six surveys were undertaken
simultaneously in five States of India to assess medicine prices and availability of essential
medicines (n = 21-28) using the World Health Organization and Health Action International methodology.
Surveys were conducted at Chennai, Haryana, Karnataka, West Bengal, and at two sites in
Maharashtra. For each medicine, data were collected for the Innovator Brand (IB), Most Sold
Generic (MSG), and Lowest Priced Generic (LPG) at randomly selected public and private facilities
in each site surveyed. Prices were compared to an international reference benchmark (expressed as
median price ratio - MPR).
Results: The procurement price of medicines in the public sector was 0.27 to
0.48 times the international reference price. However, these medicines were inadequately
available and the median availability in the public sector ranged from 0 to 30 per cent. The median
prices of medicines in the private sector were less than twice the IRP, although a few innovator brands
were more expensive. No difference was observed between the prices of the most sold generic (MSG) and
the lowest priced generic (LPG) available at the facilities. Interestingly, price variation
was observed among different generic equivalents of ciprofloxacin in each region. The price of LPG
diazepam in the private sector was thirty three times its procurement price in the public
Interpretation & conclusion: The survey revealed low procurement prices and
poor availability in the public sector. Thus, the majority of the population purchased medicines from
private pharmacies, where generics were usually available although prices of certain
medicines were high. Various policy measures could increase the availability and accessibility of
medicines for the population.