Availability and price of respiratory medications vary in low- and middle-income settings




Robertson N, et al. Quality of care, health disparities, and health care utilization among patients with asthma or COPD. Presented at: American Thoracic Society International Conference; May 13-18, 2022; San Francisco (hybrid meeting).

Disclosures: Robertson does not report any relevant financial information.

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SAN FRANCISCO — The availability and price of asthma and COPD medications vary by setting, with greater availability in urban and high-income settings compared to rural and low-income settings, the researchers reported.

“The burden of chronic respiratory disease is increasing globally, with the highest disease-related morbidity and mortality concentrated in…low- and middle-income countries,” NOTschool Robertson, MPH, from the University of Kentucky College of Medicine, said during a presentation at the American Thoracic Society’s international conference. “Therefore, the World Health Organization has established an Essential Medicines List, which includes many chronic respiratory medicines and considers these medicines as a minimum medical need for a basic health care system.”

Source: Helio.

Researchers conducted a cross-sectional survey of 63 pharmacies in Nepal (95.2% private), 104 pharmacies in Peru (94.2% private) and 53 pharmacies in Uganda (98.1% private) from 2017 to 2019. researchers collected data on the availability and prices of COPD. and asthma medications and determined affordability based on a ratio of the cost of one month’s standard treatment to the daily salary of the lowest-paid civil servant.

Salbutamol, a WHO essential medicine, was the most commonly used respiratory medicine in all settings (95.2% in Nepal, 85.7% in Peru, 79.2% in Uganda). Ipratropium bromide inhalers were not available in Uganda. Beclomethasone and fluticasone were largely unavailable in Peru (33.7% and 5.8%, respectively) and Nepal (30% and 6.1%, respectively) and were not available in Uganda. Salmeterol was only available in 30.3% of pharmacies in Nepal, most of which were public (66.6%). Tiotropium monotherapy was also only available in 77.8% of pharmacies in Nepal, most of which were private (78.3%).

The researchers reported the lowest monthly retail price for all respiratory medicines in Nepal as well as the lowest daily wages required to pay for these treatments. Robertson said there was a wide disparity in the cost of treating mild and intermittent asthma between private pharmacies, ranging from half a day’s salary in Peru to 54 days’ salary in Uganda.

“WHO is currently targeting 80% availability of these essential medicines by 2025 and there is wide variability in access and affordability of respiratory medicines across different geographic settings,” Robertson said. “We call for policies to reduce value added taxes, promote generic drugs and standardize procurement to increase the availability and affordability of these drugs.”


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