Assessing the global availability of misoprostol.
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.
Fernandez
Maria M
MM
Product Promotion and Distribution Unit, Ipas, Chapel Hill, North Carolina, USA. fernandezm@ipas.org
Coeytaux
Francine
F
de León
Rodolfo Gomez Ponce
RG
Harrison
Denise L
DL
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*
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol