Abstract

Background: The corona virus disease (COVID-19) pandemic has presented a serious disruption in essential health services because of pandemic related impacts worldwide. In addition to the shortage of essential medicines due to the pandemic, high medicine prices have become significant impediments to better health by limitingthe population's access to medicines.

Objective:This study aimed to determine the availability, price and affordability of essential medicines during the COVID-19 pandemic among public and private drug retail outlets (DROs) in Addis Ababa, Ethiopia.

Methods: An explanatory sequential mixed methods approach was used in this study. Both quantitative and qualitative data were collected from July 1, 2021 to March 30, 2022 G.C. using the World Health Organization/Health Action International (WHO/HAI) data collection form and a semi structured interview guide, respectively. For the quantitative part, data entry and analysis were carried out using the WHO/HAI workbook and SPSS version 23whereas thematic analysis was used for the qualitative finding.

Findings: The overall percent availability of essential medicinesin DROs in Addis Ababa was found to be 5.75% and 53.9% for originator brands (OBs) and lowest priced generics (LPGs) respectively. The Mann–Whitney U test indicated that 94.7% of LPGs show a statistically significant (p<0.05) median unit price difference between public and private DROs. The cost of standard treatment using median unit price of LPGs varied from 0.4–6.1day’s wages in public and 0.8-22.9 days in private DROs for the lowest-paid government worker to buy a month's supply. Contributing factors for this result were related to the data reporting trend of public health facilities (PHFs), issues related to pharmaceuticals logistics, change in the demand pattern for pharmaceuticals, and the global pharmaceutical supply chain disruption due to the COVID-19 pandemic.

Conclusion:The current study found that essential medicines were poorly available with unaffordable price in Addis Ababa due to different reasons related to demand and supply imbalance due to the COVID-19 pandemic and other factors. The different stakeholders should work together to improve availability and to make the price of medicines affordable.