THE PRIVATE-PUBLIC-DIVIDE ON THE ECONOMICS OF ESSENTIAL MEDICINES IN MEKELLE, NORTHERN ETHIOPIA: A CRITICAL ANALYSIS ON THE NATIONAL DRUG POLICY OUTCOMES

摘要

Essential medicines (EMs) save lives and improve health. But still, lack of access to EMs remains to be one of the most serious global public health problems. This study evaluates patient price, availability and affordability of essential medicines in Mekelle, and compares the private and public health care facilities with respect to these parameters. A cross-sectional prospective survey was conducted using WHO/HAI standardized methods for surveying medicines' prices, availability, affordability, and price components in low-income countries with the necessary adjustments in line with local situations. The patient price of lowest price generic (LPGs) products in private pharmacies and drug shops were 1.90 and 1.62 times patient price in public Health care facilities (PHCFs), respectively. The overall % availability of the selected EMs in PHCFs, private drug shops (PDSs) and private pharmacies (PPs) were found to be 81.25%, 86.25% and 90%, respectively. There were no innovator brand products in PHCFs and their overall availability were 16.67% in PPs and 11.11% in PDSs. In PHCFs and private drug retail outlets (PDROs), treatment costs of combination of diseases were found to consume more than 1 day's wage of lowest paid unskilled Ethiopian government worker. The patient prices of EMs in PHCFs were more affordable as compared to private ventures. There was a better availability of EMs in private health care facilities. In both private and public health facilities, most of the treatment costs of preselected disease conditions appeared to be unaffordable suggesting the need to devise appropriate pricing policy options.