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.
