Objective: Since the 1970s, one of the smallest Indian States, Kerala, has been internationally applauded for its excellent performance in its health indicators. Even if mortality is low, the morbidity (those suffering from chronic/non-communicable diseases) levels in urban and rural is high in Kerala compared to other Indian states. Gradually, the public sector becomes incapable to convene the demands for health care and people have responded to this meagerness by increasing the use of an emerging private sector. To overcome this scenario, Kerala government established KMSCL for promoting access to medicines to the patients approaching the public hospitals in Kerala by making available selected essential medicines at free of cost. The present study was conducted to evaluate the availability, cost and affordability of anti-hypertensive medicines in Kerala.
Methods: This prospective, observational study was conducted in Trivandrum district in Kerala, from June 2013 to November 2013. Three types of medication prices were taken into contemplation with the intension for calculation purposes, the highest and the lowest branded medication costs in private pharmacy and Karunya Community Pharmacy (KCP) prices. Affordability was calculated for the different level of skilled workers and through the wages fixed by the government of Kerala for these categories, who were consuming the medications at the time. A comparison was also done between various treatment guidelines of hypertension.
Results: There was 15.5% to 230% price variation between the highest and lowest price of branded anti-hypertensive medicines respectively. For treating Stage 3 of hypertension; unskilled and highly skilled workers had to spend a minimum of 1.22 and 0.84 wage days respectively and a maximum of 5.23 and 4.34 wage days respectively in private pharmacies. All the medicines required for the treatments of hypertension were available in both private and KCP.
Conclusion: The study revealed that there was an average availability at of antihypertensive medicines in public health facilities. The availability of all medicines at KCP in low price shows the good impact of KMSCL for promoting access of medicines to the poor
