title: Assessing the global availability of misoprostol.
abstract: OBJECTIVE
  To assess the worldwide availability of misoprostol. Documenting the extent of misoprostol use in obstetrics-gynecology is difficult because the drug typically is unregistered for such indications.
  
  
  METHODS
  Data for 2002-2007 on annual sales (measured in weight) to hospitals and retail pharmacies, plus manufacturer prices per 200-microg misoprostol, were analyzed for medications containing misoprostol alone or combined with a nonsteroidal anti-inflammatory drug (NSAID); regional and country-specific trends were identified. Consumer prices per pill are documented for all formulations of registered medications.
  
  
  RESULTS
  Of the misoprostol sold worldwide, 70% was misoprostol-NSAID-combination drugs; of this, 91% was sold in North America and Western Europe. Asia sold the most misoprostol-only drugs; sales increased dramatically in Bangladesh (by 128%) and India (646%), where various low-price brands are sold. Misoprostol sales decreased in Latin America but increased in the Middle East-North Africa and Sub-Saharan Africa; these regions generally had low amounts sold per population.
  
  
  CONCLUSIONS
  Availability is improving in some low-income regions where misoprostol could significantly reduce maternal deaths due to postpartum hemorrhage and unsafe abortion.
authors.affiliation: Product Promotion and Distribution Unit, Ipas, Chapel Hill, North Carolina, USA. fernandezm@ipas.org
authors.forename: Maria M
authors.initials: MM
authors.lastname: Fernandez
authors.forename: Francine
authors.initials: F
authors.lastname: Coeytaux
authors.forename: Rodolfo Gomez Ponce
authors.initials: RG
authors.lastname: de León
authors.forename: Denise L
authors.initials: DL
authors.lastname: Harrison
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000191:economics / Q000600:supply & distribution*; D006297:Health Services Accessibility / Q000639:trends*; D038622:Internationality; D016595:Misoprostol / Q000191:economics / Q000600:supply & distribution*; D009774:Obstetrics / Q000639:trends*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol