Availability, price and affordability of asthma medicines in five Indian states.
METHODS
States of Haryana, Karnataka, Maharashtra and Rajasthan, and Chennai (capital of Tamil Nadu State), India.


OBJECTIVE
To assess the availability, price and affordability of beclomethasone and salbutamol inhalers in five Indian states using a standardised methodology.


METHODS
Data on the availability and price of two essential medicines for asthma, beclomethasone (50 microg/dose) and salbutamol (0.1 mg/dose) inhalers, were collated from five medicine price studies on essential medicines.


RESULTS
Beclomethasone and salbutamol inhalers were available in 25% and 30% of public facilities in Rajasthan State only. The procurement price for beclomethasone and salbutamol was respectively 0.74 and 0.56 times the international reference price (IRP). The availability of beclomethasone inhalers was poor in the private sector (10-65%) in four states. The availability of salbutamol inhalers ranged from 20% to 95% as an innovator brand and 83% to 100% as the generic. The price of beclomethasone was 0.87-1.49 times the IRP, while salbutamol cost 0.82-1.12 times the IRP. Purchasing one inhaler each of salbutamol and beclomethasone cost between 1.6 and 2.3 days' wages for the lowest paid government worker. Eighty per cent of the population earn less than this wage.


CONCLUSIONS
Essential inhalation medicines for asthma were not available in the public sector where low-income populations receive treatment. Steroid inhalers were not readily available in the private sector. Essential inhalation medicines for asthma are not affordable for the majority of the population.
Kotwani
A
A
Department of Pharmacology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India. anitakotwani@yahoo.com
D018927:Anti-Asthmatic Agents / Q000191:economics* / Q000600:supply & distribution*; D001249:Asthma / Q000188:drug therapy* / Q000191:economics; D016527:Drug Costs; D018954:Drugs, Essential / Q000191:economics / Q000600:supply & distribution; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D007194:India; D011159:Population Surveillance; D017149:Private Sector / Q000191:economics; D017150:Public Sector / Q000191:economics; D012189:Retrospective Studies
D018927:Anti-Asthmatic Agents; D018954:Drugs, Essential