A preliminary assessment of availability and pricing of children’s medicines in government hospitals and private retail pharmacies in a district of West Bengal in India

ABSTRACT

Background: A lack of availability of suitable pediatric formulation and high price are often the major hindrance to the better access of the essential treatment to the children. In the backdrop of paucity of literature addressing this problem in India and in particular West Bengal, the present work was planned. Aim and Objectives: This study has been a maiden approach to generate data regarding this issue in small scale and in an inexpensive way after conducting a survey in different government and private facilities in a district of West Bengal, India. Materials and Methods: This cross-sectional study used “WHO Children’s Medicines Survey Form” to make a rapid assessment of availability and pricing of 20 core children’s medicine formulations among ten government hospitals and nine private retail pharmacies in the district of Burdwan in West Bengal during September-October 2009. In retail pharmacies, the actual price to the patient of the cheapest brand was documented. In public health facilities, procurement prices for medicines were obtained from state government’s Central Medical Stores (CMS) listing. Results: Overall, the availability was sub-optimal in all levels of public health facilities-30% in medical college pharmacy, 33% in the district reserve stores, 33.75% in sub-divisional hospitals, 32.25% in primary health centers, and in retail pharmacies was only 45%. Out of the 20 formulations, only two (ORS, paracetamol) were available in all the public and private retail pharmacies. Availability of anti-infectives was better than other medicines in both types of facilities. The variation of prices among different brands was wide. The cost of even the cheapest brand was much higher than corresponding government procurement price. Conclusion: This maiden effort reveals sub-optimal availability of core essential medicines for children in both public facilities and private retail pharmacies. However, medicines available in private pharmacies were much costlier compared to CMS procurement price. This is a matter of concern. A larger nation-wide study is the need of the hour with a greater focus on affordability and prescribing behavior.