Determine the Price, Availability and Affordability of Selected Essential Medicines to Treat Diabetes Mellitus in Private Market in Gampaha District, Sri Lanka.

Abstract

Background: Availability, affordability and price are important factors for medicines, especially for diseases requiring lifelong treatments such as Diabetes Mellitus (DM). The COVID-19 pandemic affected many aspects of countries, making it crucial to study these factors in Sri Lanka post-COVID period. Objective: To describe the availability and analyze the affordability and pricing of selected essential medicines (EDM) for treating DM in the Gampaha district, Sri Lanka Methods: A descriptive quantitative study was conducted based on the World Health Organization and Health Action International (WHO/HAI) Manual, 2nd edition. The EDM list for Sri Lanka, published by the Ministry of Health, was used to select the oral drugs and insulin used for treating DM. Data were collected from May to July 2023 from all State Pharmaceuticals Corporation (SPC) outlets, 5 outdoor pharmacies of private hospitals (POPD), and 32 registered private pharmacies (RPP) in the Gampaha district to check the availability of the selected drugs. POPD were selected based on convenience, and RPP were selected randomly from the list of registered pharmacies in Gampaha district. The median price ratio (MPR) was calculated using the International Reference Price (IRP) for Innovator Products (IP) and Lowest Priced Generics (LPG). Results: The average percentage availability of the selected essential medicines (7 products) for DM was 100% in SPC outlets, RPP, and POPD in the Gampaha district. However, the percentage availability of the LPG was low for some medicines, e.g., soluble insulin at 4%. All selected insulins, as well as the IPs of metformin 500 mg tablets and gliclazide 80 mg tablets, required more than one daily wage (1DW) of a lowest-paid unskilled government worker to buy a month’s supply. Among the selected medicines, only the IP and LPG of glibenclamide 5 mg tablets required less than 1DW to purchase a month’s supply. The MPR of IP and LPG for all products was between 1 and 5, indicating that they were 1 to 5 times higher than the IRP. Conclusions: The selected essential medicines for diabetes mellitus were available in GD; however, the availability of the cheapest options is not satisfactory. Furthermore, 6 out of 7 drugs are not affordable for the Sri Lankan community, and all drug prices are higher than the IRP.