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Geographic Regions Surveyed

Medicine Availability, Prices and Affordability in West Bengal, India (2004) DALIA DEY CUTS & CDMU. Geographic Regions Surveyed. indicates surveyed districts. Population of West Bengal: 80 million Source: 2001 Census Report. Survey Details. Sectors Surveyed Public Sector

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Geographic Regions Surveyed

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  1. Medicine Availability, Prices and Affordability inWest Bengal, India(2004)DALIA DEYCUTS & CDMU

  2. Geographic Regions Surveyed indicates surveyed districts Population of West Bengal: 80 million Source: 2001 Census Report

  3. Survey Details Sectors Surveyed • Public Sector • Private retail sector Products Selected (Core & Supplementary) • Originator Brand • Most sold generics • Lowest priced generics Analysed • Prices • Availability • Affordability

  4. Affordability Baseline • Daily salary of lowest paid unskilled government worker = INR 131.73 ($2.86US) • Estimated proportion of population on less than this salary1 = 79.9% live on less than $2US per day. 1 Source = WB Development Report, 2004

  5. Public Sector Procurement Prices (measured as Median Price Ratios) IB LPG Median MPR for all 32 medicines -- 0.75 MPR for Amoxicillin -- 0.93 MPR for Ceftriaxone -- 0.16 MPR for Omeprazole -- 0.09 -- 1.44 MPR for Doxycycline

  6. Availability: Public vs. Private Retail Sectors

  7. Median Price Ratios in the Private Retail Pharmacy Sector

  8. Affordability in the Private Retail Pharmacy Sector

  9. Availability and Affordability of Lowest Price Generics – Acute and Chronic Conditions Condition Medicine Availability in Public Sector (no. of facilities out of 26 surveyed) Affordability in Private Sector (# days work for unskilled government worker) Diabetes Glibenclamide 1 / 26 (3.8%) 0.3 Hypertension Hydrochloro-thiazide 0 / 26 0.3 Hypertension Atenolol 4 / 26 (15.4%) 0.5 Adult ARI Amoxicillin 25 / 26 (96.2%) 1.3 Pediatric ARI Co-trimoxazole suspension 1 / 26 (3.8%) 0.1

  10. Conclusions - 1 1. Availability situation in the public sector is far from satisfactory, with 19 of the 32 medicines (59.4%) not being available 2. Procurement in the public sector is quite efficient with the median MPR (in comparison with MSH 2003 median prices) for all medicines being 0.75 3. Availability is better in the private retail sector, with the median availability of all the 32 medicines being 77.1% for generic products

  11. Conclusions - 2 4. The median MPR of generics (2.17 for all 32 medicines) in the private sector indicate that medicines are costlier than the international reference prices 5. Most standard treatments are likely to be affordable to individuals who draw at least the minimum daily wages

  12. Policy Implications With the government committed to providing universal access to essential medicines, serious investigation is needed into the causes of the low availability in the public sector. Government of West Bengal should establish a monitoring authority to continuously monitor prices, availability and affordability of medicines, with transparent publication to their citizens, and act when prices are high, availability low and treatment affordability poor.

  13. Policy Advocacy • The medicine pricing survey report “Medicine Prices and Affordability in West Bengal” was released by Dr. Jayashree Mitra, Director of Medical Education, Government of West Bengal on October 1, 2005. • The report has already been shared with the Department of Health and Family Welfare, Government of West Bengal and tried to draw their attention on the concerns. • CUTS is going to hold an advocacy workshop involving relevant state government officials to take action to improve medicine availability. • Both national and local newspapers highlighted the abysmal availability situation of medicines in the public sector and insisted that the state government should find out the exact reason and improve the system.

  14. Press Coverage Survey

  15. Thank you

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