title: A national survey of price and affordability of key essential medicines for children in Sri Lanka.
abstract: OBJECTIVE
  To investigate the price and affordability of key essential medicines for children in Sri Lanka.
  
  
  METHODS
  This national survey investigated the prices and affordability of 25 key essential medicines for children in private sector pharmacies using the WHO/Health Action International (HAI) medicine price methodology. Data were collected from a representative sample of 48 private sector pharmacies selected from 8 Provinces using a multistage clustered approach. At each pharmacy prices of originator brand (OB) and lowest priced generics (LPG) of the selected medicines were collected. Medicine prices were compared with international reference prices to obtain a median price ratio (MPR). Income of the lowest paid unskilled government worker was used to establish the affordability.
  
  
  RESULTS
  The median MPR of retail prices to patients was 3.7 for OB (range 0.23-20) and 1.35 for LPG (range 0.05-3.75). MPR >5 was observed for OBs of 5 medicines: ceftriaxone injection, diazepam injection, mebendazole syrup, mebendazole chewable tablet and metronidazole tablet whereas MPR >2.5 was observed only for LPGs of 3 medicines: chlorphenamine syrup, clotrimazole topical cream, and paracetamol syrup. Mean percent difference in price between OB and LPG products was 365 % (range -21, 2343). Rational treatment for acute infections such as mild lower respiratory tract infections and acute gastroenteritis seems to be affordable but treatment for chronic illnesses requiring liquid or inhaled dosage forms were largely unaffordable.
  
  
  CONCLUSIONS
  Intervention is needed to improve the economic access to key essential medicines for children indicated in the treatment of chronic diseases.
authors: Department of Pharmacology, Faculty of Medicine, University of Colombo, PO Box 271, Colombo 8, Sri Lanka.
authors: R
authors: R
authors: Balasubramaniam
authors: B V S H
authors: BV
authors: Benaragama
authors: Shalini
authors: S
authors: Sri Ranganathan
mesh_terms: D002648:Child; D003132:Commerce; D003625:Data Collection; D006297:Health Services Accessibility / Q000639:trends; D006801:Humans; D004364:Pharmaceutical Preparations / Q000191:economics*; D013188:Sri Lanka
chemical_list: D004364:Pharmaceutical Preparations
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