Abstract:
Background: Cardiovascular diseases (CVDs) pose a substantial burden to the healthcare
system of Sri Lanka, requiring consistent access to essential medicines for effective
management. Disparities in the availability and affordability of these medicines between urban
and semi-urban regions may negatively impact healthcare equity. Identifying and addressing
these regional differences is vital for ensuring equitable access to cardiovascular care.
Objective: To compare the availability and pricing of essential cardiovascular medicines in
privately owned pharmacies and State Pharmaceutical Corporation (SPC) pharmacies located in
urban (Kandy, Kurunegala) and semi-urban areas (Nikaweratiya, Peradeniya) of Sri Lanka
Methods: A cross-sectional survey was conducted from June to October 2024 in four locations
within Kandy and Kurunegala districts, following the WHO/HAI standardized methodology.
Data were collected from 40 pharmacies; 36 privately owned and 4 SPC pharmacies, focusing on
13 essential cardiovascular medicines. The availability and prices of Originator Brands (OBs)
and Lowest Priced Generics (LPGs) were compared, and Median Price Ratios (MPRs) were
analysed.
Results: In privately owned pharmacies, OB availability was notably higher in urban areas;
Kandy and Kurunegala (4.75%), compared to semi-urban Nikaweratiya (1.58%). LPGs showed
greater accessibility in urban areas (Kandy: 79.83%, Kurunegala: 77.05%) compared to semi-
urban areas (Nikaweratiya: 63.84%, Peradeniya: 73.57%). LPG availability at SPC pharmacies
was also higher in urban areas (Kandy: 81.25%, Kurunegala: 75.62%) than in semi-urban
locations (Nikaweratiya: 75%, Peradeniya: 68.75%). Regarding pricing, the median MPR for
LPGs in privately owned pharmacies was uniform (0.27) across all areas, whereas Peradeniya
had the highest (0.19) and Nikaweratiya the lowest (0.15) in SPC pharmacies.
Conclusions: Availability of essential cardiovascular medicines was consistently higher in urban
than semi-urban areas. There was no significant price variation across regions in either sector.
Targeted improvements in medicine distribution and supply chain management are
recommended to promote equitable healthcare access across Sri Lanka.
