Essential medicines are more available than other medicines around the globe

• Published in: PloS one Vol. 9; no. 2; p. e87576
• Main Authors: Bazargani, Yaser T, Ewen, Margaret, de Boer, Anthonius, Leufkens, Hubert G M, Mantel-Teeuwisse, Aukje K
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 12-02-2014; Public Library of Science (PLoS)
• Subjects: Availability; Comparative analysis; Developing countries; Drugs, Essential - classification; Drugs, Essential - economics; Drugs, Essential - supply & distribution; Generic drugs; Global Health; Health care; Health care reform; Health Services Accessibility; Health Services Needs and Demand - organization & administration; Health Services Needs and Demand - statistics & numerical data; Humans; Income; LDCs; Lists; Low income groups; Mathematical analysis; Medicine; Pharmaceutical sciences; Pharmacology; Polls & surveys; Prescription Drugs - classification; Prescription Drugs - economics; Prescription Drugs - supply & distribution; Prices; Private Sector; Public health; Public Sector; Social and Behavioral Sciences; Studies; Surveys; World Health Organization
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0087576

The World Health Organization (WHO) promotes the development of national Essential Medicines Lists (EMLs) in order to improve the availability and use of medicines considered essential within health care systems. However, despite over 3 decades of international efforts, studies show an inconsistent pattern in the availability of essential medicines. We evaluated and compared the availability of essential medicines, and medicines not included in national EMLs, at global and regional levels.
Medicine availability in the public and private sector were calculated based on data obtained from national and provincial facility-based surveys undertaken in 23 countries using the WHO/HAI methodology. The medicines were grouped according to their inclusion ('essential') or exclusion (termed 'non-essential') in each country's EML current at the time of the survey. Availability was calculated for originator brands, generics and any product type (originator brands or generics) and compared between the two groups. Results were aggregated by WHO regions, World Bank country income groups, a wealth inequality measure, and therapeutic groups.
Across all sectors and any product type, the median availability of essential medicines was suboptimal at 61·5% (IQR 20·6%-86·7%) but significantly higher than non-essential medicines at 27·3% (IQR 3·6%-70·0%). The median availability of essential medicines was 40·0% in the public sector and 78·1% in the private sector; compared to 6·6% and 57·1% for non-essential medicines respectively. A reverse trend between national income level categories and the availability of essential medicines was identified in the public sector.
EMLs have influenced the provision of medicines and have resulted in higher availability of essential medicines compared to non-essential medicines particularly in the public sector and in low and lower middle income countries. However, the availability of essential medicines, especially in the public sector does not ensure equitable access.