Background
Methods
Selection of medicine to be surveyed
Selection of medicine outlets
Data collection
Data entry
Data analysis
Medicine prices
-
Procurement prices in the public sector MPR ≤ 1
-
Patient prices in the public sector MPR ≤ 1.5
-
Patient prices in private pharmacies MPR ≤ 2
Medicine availability
Medicine affordability
Results
Availability of medicines in the public and private sectors
Public | Private | |||
---|---|---|---|---|
Type of medicine | OBs | LPGs | OBs | LPGs |
Availability | 9% | 72% | 57% | 76% |
Availability | Range | Public sector (n = 30 outlets) | Private Sector (n = 30 outlets) | ||
---|---|---|---|---|---|
OB | LPG | OB | LPG | ||
Absent | 0% | The rest of brands surveyed | Phenytoin, Valproic Acid | Chloramphenicol eye drops Enalapril Nifedipine Retard Paracetamol suspension Propranolol | Phenytoin |
Low | < 50% | Acyclovir, Carbamazepine, Diazepam, Isosorbide dinitrate Methyldopa, Salbutamol inhaler | Acetylsalicylic acid, Amitriptyline, Diclofenac Sodium, Diazepam, Fluoxetine, Gliclazide, Lisinopril, Metformin, Ranitidine | Ceftriaxone injection Dexamethasone injection Fluoxetine Hydrochlorothiazide Gliclazide | Isosorbide dinitrate Methyldopa |
Fairly High | 50–80% | Phenytoin | Acyclovir, Captopril, Dexamethasone injection, Dilitiazm, Hydrochlorothiazide, Isosorbide dinitrate, Methyldopa, Salbutamol inhaler, Simvastatin, Spironolactone, | Acyclovir, Allopurinol Amitriptyline, Amoxicillin Amlodipine, Amoxicillin suspension, Amoxicillin+Clavulanic acid, Atorvastatin Azithromycin, Beclometasone inhaler Bisoprolol, Captopril Carbamazepine Ciprofloxacin Co-trimoxazole suspension Diazepam, Diclofenac Sodium, Dilitiazm Doxycycline, Fluconazole Glibenclamide, Isosorbide dinitrate, Ibuprofen Lisinopril, Loratadine Mebendazole, Methyldopa Metoclopramide Metronidazole, Omeprazole, Ranitidine Salbutamol inhaler Simvastatin, Spironolactone Valproic Acid | Acyclovir Amitriptyline Amlodipine Amoxicillin Amoxicillin suspension Amoxicillin+Clavulanic acid Beclometasone inhaler Bisoprolol Diazepam Diclofenac Sodium Dilitiazm Fluoxetine Gliclazide Hydrochlorothiazide Ibuprofen Levothyroxine Lisinopril Loratadine Propranolol Salbutamol inhaler Simvastatin Spironolactone Valproic Acid |
High | > 80% | Acetylsalicylic acid, Mebendazole, Valproic Acid | Allopurinol, Amlodipine, Amoxicillin, Amoxicillin+Clavulanic acid, Amoxicillin suspension, Bisoprolol, Beclometasone inhaler, Azithromycin, Atorvastatin, Carbamazepine, Ceftriaxone injection, Chloramphenicol eye drops, Ciprofloxacin, Co-trimoxazole suspension, Doxycycline, Fluconazole, Glibenclamide, Furosemide, Enalapril, Ibuprofen, Levothyroxine, Loratadine, Metoclopramide, Nifedipine Retard, Omeprazole, Metronidazole, Paracetamol suspension, Valproic Acid. | Acetylsalicylic acid Furosemide Levothyroxine Metformin Phenytoin | Acetylsalicylic acid Allopurinol Amoxicillin+Clavulanic acid Atorvastatin Azithromycin Captopril Ceftriaxone injection Carbamazepine Chloramphenicol eye drops Ciprofloxacin Dexamethasone injection Co-trimoxazole suspension Diazepam Doxycycline Enalapril Fluconazole Glibenclamide Ibuprofen Metformin Mebendazole Metoclopramide Metronidazole Nifedipine Retard Paracetamol suspension Ranitidine |
Prices of medicines in the public and private sectors
Procurement prices in public sector
Type and number of medicines | Median MPR | 25th percentile MPR | 75th percentile MPR | Minimum MPR | Maximum MPR |
---|---|---|---|---|---|
OBs (n = 3) | 5.55 | 3.04 | 6.71 | 0.53 | 7.87 |
LPGs (n = 45) | 1.13 | 0.65 | 1.56 | 0.15 | 9.06 |
Patient prices in public sector (co-payment of patients)
Type and number of medicines | Median MPR | 25th percentile MPR | 75th percentile MPR | Minimum MPR | Maximum MPR |
---|---|---|---|---|---|
OB (n = 3b) | 5.8 | 3.2 | 7.0 | 0.56 | 8.3 |
LPG (n = 42) | 1.16 | 0.5 | 1.5 | 0.06 | 5.3 |
Patient prices in private sector (co-payment of patients)
Type and number of medicines | Median MPR | 25th percentile MPR | 75th percentile MPR | Minimum MPR | Maximum MPR |
---|---|---|---|---|---|
OB (n = 45) | 9.7 | 4.0 | 28 | 0.64 | 146.9 |
LPG (n = 49) | 7.5 | 3.0 | 16 | 0.8 | 73.8 |
Type of medicines (n = 44) | Median MPR | 25th percentile MPR | 75th percentile MPR | Minimum MPR | Maximum MPR |
---|---|---|---|---|---|
OB | 8.8 | 3.7 | 28.0 | 0.64 | 146.9 |
LPG | 7.5 | 3.2 | 17.0 | 0.8 | 73.8 |
Patient prices in public and private sectors
Type and number of medicines in both sectors | Median MPR public sector patient prices | Median MPR private sector patient prices | % Difference private to public |
---|---|---|---|
OB (n = 3) | 5.8 | 9.7 | 68% |
LPG (n = 42) | 1.16 | 7.6 | 554% |
Affordability of standard treatment regimens
Condition | Drug name | Dosage and Duration | Day’s wages to pay for treatment | ||
---|---|---|---|---|---|
LPG public sector | LPG private sector | OB private sector | |||
Asthma | Salbutamol Inhaler | 1 inhaler (200 doses) As needed | 0.3 | 0.3 | 0.6 |
Diabetes | Metformin | 500 mg three times daily X 30 days | Not found | 0.6 | 0.7 |
Hypertension | Bisoprolol | 5 mg twice daily X 30 days | 0.1 | 1.6 | 1.5 |
Hypertension | Captopril | 25 mg twice daily X 30 days | 0.1 | 1.6 | 2.3 |
Hypercholesterolemia | Simvastatin | 20 mg once daily X 30 days | 0.1 | 1.2 | 1.5 |
Depression | Amitriptyline | 25 mg three times daily X 30 days | 0.3 | 0.5 | 1.0 |
Arthritis | Diclofenac | 50 mg twice daily X 30 days | 0.1 | 1.1 | 1.5 |
Ulcer (duodenal) | Omeprazole | 20 mg once daily X 30 days | 0.1 | 4.0 | 1.9 |
Ulcer (peptic) | Ranitidine | 150 mg twice daily x 30 days | Not found | 1.2 | 1.5 |
Adult respiratory infection | Amoxicillin | 500 mg three times daily ×7 days | 0.1 | 0.6 | 0.8 |
Pediatric respiratory infection | Co-trimoxazole suspension | 8 + 40 mg/ml 5 mL twice daily × 7 days | 0.0 | 0.1 | 0.3 |
Adult respiratory infection | Ciprofloxacin | 500 mg twice daily × 7 days | 0.1 | 1.4 | 4.4 |
Adult respiratory infection | Ceftriaxone injection | 1 g/vial 1vial × 1 day | 0.1 | 2.2 | 3.3 |
Anxiety | Diazepam | 5 mg daily ×7 days | Not found | 0.2 | 0.0 |
Pain/ inflammation children | Paracetamol suspension | 24 mg/ml 5 mL three times daily × 7 days | 0.0 | 0. | Not found |
Epilepsy | Carbamazepine | 200 mg twice daily x 30 days | 0.2 | 0.7 | 0.9 |
International prices comparisons
Procurement prices in public sector
Medicine name | Jordan | Egypt | Saudi | Sudan | Lebanon | Oman | India | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
OB | LPG | OB | LPG | OB | LPG | OB | LPG | OB | LPG | OB | LPG | OB | LPG | |
Amoxicillin | 0.98 | 1.50 | 1.40 | 1.10 | ||||||||||
Amitriptyline | 3.17 | 2.08 | 2.58 | 1.80 | 3.6 | 0.09 | ||||||||
Captopril | 0.65 | 0.79 | 11.9 | 0.58 | 3.60 | 2.08 | 0.50 | |||||||
Diclofenac Na | 1.48 | 3.30 | 19.4 | 7.90 | 1.00 | 0.29 | ||||||||
Diazepam | 3.62 | 2.30 | 6.80 | |||||||||||
Salbutamol inhaler | 1.08 | 0.76 | 0.48 | 0.67 | 1.00 | 0.86 | 5.70 | 0.57 | ||||||
Metformin | 0.89 | 0.41 | 3.3 | 1.00 | 1.50 | 0.40 | 0.29 |
Patient prices in private sector
Medicine name | Jordan | Egypt | Saudi | Sudan | Lebanon | Oman | India | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
OB | LPG | OB | LPG | OB | LPG | OB | LPG | OB | LPG | OB | LPG | OB | LPG | |
Amoxicillin | 9.8 | 7.5 | 3.09 | 14 | 5.4 | 11 | 4.9 | 6.7 | ||||||
Amitriptyline | 12.1 | 6.2 | 2.4 | 6.38 | 8.75 | 17.9 | 10.4 | 5.8 | ||||||
Captopril | 22.4 | 15.9 | 5.3 | 3.3 | 17.9 | 12.9 | 7.2 | 22.6 | 11.9 | 7.2 | ||||
Diclofenac Na | 29.9 | 23 | 65.7 | 20.4 | 22.4 | 74.5 | 1.6 | 11.3 | 16.4 | 10.6 | 5.2 | |||
Diazepam | 5.98 | 23.8 | 5.1 | 4.7 | 25.8 | 24 | ||||||||
Salbutamol inhaler | 2.35 | 1.2 | 0.9 | 0.85 | 2 | 1.6 | 2 | 1.2 | 2.6 | 1.2 | 5.8 | 4.8 | 1 | 1 |
Metformin | 3.87 | 3.2 | 2.6 | 1.7 | 5.2 | 2 | 5 | 2.7 | 4.4 | 2.6 | 1.5 |
Discussion
Availability of surveyed medicines
Prices of surveyed medicines
Affordability of surveyed medicines
Limitations of the study
Conclusions
Acknowledgements
Funding
Availability of data and materials
Authors’ information
-
Dr. Qais Alefan
-
(PhD) Associate Professor, Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology (JUST), Irbid, Jordan
-
Rawan Amairi
-
(MSc) Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology (JUST), Irbid, Jordan
-
Dr. Shoroq Tawalbeh
-
(PhD) Assistant Professor, Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology (JUST), Irbid, Jordan