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Skip to content. Facebook Twitter Linkedin. What are the requirements and procedures to import and distribute drugs? Obtain certificate of competence from the Authority Register the drugs, or medical supplies or instruments through the Authority Purchase order of products to be imported should be approved by the Authority Port-clearance permit should be obtained to clear imported product from port of entry Drug products should only distributed to authorized institutions and according to their level.

Prevalence of Substance Use in University Students, Ethiopia

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Official websites use. Share sensitive information only on official, secure websites. Email: habtefikreselam gmail. The purpose of this study was to assess the availability, price, and affordability of antiseizure medicines in Addis Ababa, Ethiopia. Descriptive results were reported in text and table format. All the medications were unaffordable. The overall availability of antiseizure medicines was lower than the WHO target for noncommunicable diseases. All the available medicines were unaffordable. The availability of antiseizure medicines is short of the WHO target for noncommunicable disease. Epilepsy is one of the most common neurological diseases globally. Epilepsy accounts for more than 0. In many parts of the world, people with epilepsy and their families suffer from stigma and discrimination. The stigma and discrimination that surround epilepsy worldwide are often more difficult to overcome than the seizures themselves. However, the fundamental right to health cannot be realized without fair access to necessary medicines. World Health Organization WHO has established a framework to assist policymakers in improving access to essential medications for universal health coverage by To develop strategies and policies, there should be an adequate study about the current situation of the problems. The purpose of this study was to assess the availability, pricing, and affordability of antiseizure medicines in Addis Ababa, Ethiopia. In Addis Ababa, there are 13 public hospitals, among them six hospitals are owned by the Federal Minister of Health the other seven hospitals are owned by Addis Ababa City Administration. These hospitals provide service for patients referred from all over the country. AMSH is the oldest and only mental specialized hospital in Ethiopia established in AMSH has around beds for admitted patients. It provides services with beds. In addition to outpatient pharmacies, there is a special community pharmacy within the two mental hospitals, which is also included in the study. The other hospitals primarily provide outpatient services for neurology patients. Other than those three excluded medicines, all the other medicines with commonly used doses from EEML were included in the study. The five hospitals were selected to represent both Federal and city administration and these hospitals provide epileptic treatment service for many patients from the city and referred patients from all corners of the country. Five private pharmacies around the hospitals were selected randomly after listing all the private pharmacies around the hospitals. Also, five Kenema Public Community Pharmacies and two Red Cross Pharmacies were selected for the study based on proximity from the hospitals. The two special community pharmacies within the two hospitals were included in the public sector. The data regarding the availability and price of antiseizure medicines were collected from each selected pharmacy. Pretesting was carried out at one private pharmacy to guarantee the clarity of the questionnaire and the data obtained. At the end of each data collection date, the supervisor checked the data collected for completeness. The supervisor called four randomly chosen pharmacies to collect the same data in order to verify the accuracy of the data gathered previously. It was calculated as outlets with the medication divided by the number of outlets included in the sector. Percent availability was calculated as:. In Ethiopia, most patients acquire medicine by purchasing out of pocket. Only few patients who are very poor have free healthcare coverage. Recently, the healthcare financing system have been started in some segments of the population. The price of the medicine was obtained from the price list in the pharmacy outlet. Pharmacies in private mostly write the local price on the medicine package. The local price was changed to the US dollar using the exchange rate on the first day of the data collection. The median price ratio MPR of the medicine was calculated as the median price of the medicine in each sector divided by the International reference price of the medicine. Confidentiality of the outlet was kept. Affordability: It is calculated as the price of the medication for a month period divided by the lowest paid government worker wage. If the result is less than one it is affordable, if greater than one it is unaffordable. The availability of LPGs was On the contrary, Clonazepam was not available in any strength. Carbamazepine syrup was the only available Originator Brand OBs product. Also, the 25th and 75th quartile was 0. The range was wider because of the extreme value Lamotrigine and Diazepam injection Tabl e 2. The 25th and 75th percent quartile was 2. The 25th and 75th percent quartile was 0. The interquartile range was narrow relative to the range which indicates there were no extreme values Table 2. The 25th and 75th percent quartile was 1. The number of days' wage needed to purchase medicine used for a month was higher in the private sector Table 3. Medication switches or changes in epilepsy patients may result in relapse of seizure episodes. There are many reasons for the unavailability of the medicine. Civil war in Ethiopia, higher inflation rate, inadequate foreign currency for the importation of medications and poorly organized supply chain management system may be some of the reasons for unavailability of the essential antiseizure medicines. Additionally, less prioritization given to this disorder, insufficient health financing, inadequate skilled manpower, poor information generation and use on the disease and medicines need assessment, stigma from the disease, and poor patient treatment seeking may be some of the reasons for lower availability. The availability of LPG antiseizure medicines was The results showed that antiseizure medicines were more available in the public sector. This was similar with Zambia 16 and Cambodia 20 but different from Madagascar. Unlike this finding, many studies indicated that there was better availability in the private sector than in the public sector. EPSA primarily supplies to public hospitals which is why it is better available in the public sector. Private sectors are not as such involved in the supply of antiseizure medications, this could be because of inadequate foreign currency and information on the amount of the medication needed. Private companies do not have adequate data on the real need for those medications. There is no clear source of information, especially for private suppliers, on the actual amount of the medicines needed in the country. If private companies feel the medication is not used by many patients they do not prefer to supply such type of medications. Unlike the private sector, other sectors are allowed to purchase medicines from EPSA, which may be the reason for better availability in other sectors than in private sectors. The findings of the current study also indicated that generic versions of the drugs are more available than originator brands. The availability of OB antiseizure medicine was very low. Addis Ababa is the capital city of Ethiopia, where many health facilities and specialized health services are provided. Also, many patients are sent to Addis Ababa for better management from all corners of the country. If at least essential antiseizure medicines are not adequately available, the patients may not have other options to access the medication anywhere in the country. In this study, the median price of antiseizure medication in private sectors was twice higher than in the public and other sectors. This is also the case at global levels, the price of medicine in private sectors is almost always higher than public sector. When diazepam injection was not available in the public sector, patients may be forced to pay more than seven times Some of the reasons for the variation between public and private sectors could be that Ethiopia has a policy on the margin of price for medication, especially for public sectors, but this is not adequately implemented especially in private sectors 30 ; also running cost for private pharmacies is higher than public and other sectors; above all private sector are primarily established for profit generation but public and other sectors are established to serve the population with lower profit margin. Despite this MPR of carbamazepine and phenytoin tablets was lower than the MPR of those medications in 46 countries public and private sector. The cost of logistics is added to the Ethiopian price relative to those countries. The study also assessed the affordability of antiseizure medications in public, private, and other sectors in Addis Ababa, Ethiopia. Unlike most other studies, 19 , 20 , 24 , 28 , 31 , 33 , 34 , 35 , 36 antiseizure medications assessed in this study were unaffordable. Unaffordability was much higher in the private sector than in public and other sectors. Similar to Madagascar, 17 sodium valproate is the most available but very expensive medication. The unaffordability was increased even more when a combination of medication was used for a specific disease which is commonly seen in epilepsy treatment services. A patient with epilepsy required Even though the price of the medications was lower or similar to the price in many countries, the purchasing power of the population in Ethiopia is very low. Relatively, the affordability of phenobarbitone and phenytoin was better than sodium valproate and carbamazepine Table 3 , According to WHO, essential medications should be available in a price that the community and individuals are able to afford. The high unemployment rate in Ethiopia may also result in the increased rate of CHE. In Ethiopia there are many different barriers that hinder patients from using Epilepsy treatment services, these include socioeconomic issues, cultural factors, negative attitudes to the disease, fear, and unfamiliarity with the service. Health insurance should be a decisive priority in Ethiopia. The public health insurance system is also a promising program for universal health coverage in Ethiopia. Publicly financed treatment of epilepsy could have the advantage of increasing patient productivity, and progressive health benefit and could help to resolve concerns related to equity in accessing health services. Many studies indicated that switching antiseizure from brand to generic or from one generic to another may result in a relapse of the seizure, 14 interrupted supply, and unaffordability of antiseizure medication may require to switch the medication and could result in a relapse of the seizure episode. By increasing the availability and affordability of antiseizure medicines, a number of people seeking treatment could be increased, and associated morbidity and mortality from the disease could be reduced significantly. Good availability and affordability are also associated with better adherence to antiseizure medications. The limitation of this study was difficult to get full data from the Public procurement agency, EPSA about the procurement price of the medications, so it was excluded from the analysis. The other limitation was the study was done only in Addis Ababa, the capital city of Ethiopia, the result may be worse if it included the whole country. The availability of most antiseizure medicines was low in all sectors in comparison to WHO targets. Public pharmacies had better availability for LPG than Private sector. The patient price of the antiseizure medicines was not as different from international reference prices; however, most of the medications were unaffordable. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. All data are found in the manuscript, if additional is needed it can be accessed from the corresponding author on request. We would like to acknowledge Universal Medical and Business College for supporting us by reviewing the protocol and approving a letter to undertake the study. Also, we would like to thank data collectors, owners, and heads of the health facility. Availability, price, and affordability of antiseizure medicines in Addis Ababa, Ethiopia. Epilepsia Open. 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