Prices, availability and affordability of essential medicines in rural areas of Hubei Province, China.

OBJECTIVE To investigate the availability of essential medicines and their prices in Hubei province. METHODS The survey assessed the prices and availability of essential medicines using the World Health Organization and Health Action International methodology. Data were collected from 18 public hospitals and 18 private pharmacies. At each facility the availability and prices of 39 innovator brand medicines and lowest-price generic equivalent medicines were collected. Medicine prices were compared with international reference prices to obtain a median price ratio (MPR). Daily incomes of low and average levels were used to assess the affordability of the medicines. FINDINGS Median availability in the public and private sectors was low (38.9% and 44.4% for lowest-price generics, respectively). The median MPRs of procurement prices for innovator brands and lowest-price generics in the public sector were 9.78 and 0.74 times the international reference prices; and the median MPRs of retail prices to patients for lowest-price generics in the public sector (1.04) were higher than those in the private sector (0.68). For most of the population, the medicine prices are affordable, but for those of low income they are not. CONCLUSIONS The survey revealed low procurement prices but poor availability in the public sector. Various policy adjustments could increase the availability of essential medicines and reduce their prices for the low income population.