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Abstract

Assessment Of Availability, Accessibility And Affordability Of Medicines In A South Indian Hospital

Author(s): Shobha Churi, B. G Nagavi

A study was initiated with the development and collection of background, structural, process and outcome indicators for a South lndian Jagadguru Sri Shivarathreeshwara Hospital as suggested in the WHO manual, which focuses on the availability, accessibility, and affordability of essential medicines. The information on diseases that are commonly treated in the hospital (key diseases) and medicines that are used to treat such diseases (key medicines) were collected and the availability of these key medicines was assessed. Based on this study it was found that, excess numbers of analgesics, antipyretics, and non-steroidal antiinflammatory drugs (367% more), antiallergics (340% more), anti-bacterials (80% more), antimigraine medicines (75% more), cardiovascular medicines (135% more), dermatological medicines (59% more), diuretics (75% more), gastrointestinal medicines (157% more), psychotherapeutic medicines (322% more), and hormones and other endocrine medicines (58% more) were available in drug store of the hospital. Medicines such as antidotes (64% less), antiinfective (40% less), antiviral (62% less) and immunologicals (50% less) were not available in adequate numbers. However, the availability of key medicines was good (94%). Comparison of affordability of the treatment of enteric fever was performed between ceftriaxone and ciprofloxacin drugs, and basket of food. The cost of treatment using ceftriaxone (Rs.65.4) was 2.1 fold more where as it was 2.3 fold less for cost of treatment using ciprofloxacin (Rs.13.83) when compared to the cost of basket of food (Rs.30.87). In addition to the availability, accessibility and affordability study, cost minimisation and cost effectiveness study was also performed between three medicines viz., atenolol, amlodipine and enalapril which are used in the treatment of hypertension. It was found that atenolol was found to be cost effective drug when compared to amlodipine and enalapril for hypertension.