Senior Director, Gynuity Health Projects, New York, NY, USA. Correspondence:
Senior Programme Adviser, International Planned Parenthood Federation, London, UK.
Sex Reprod Health Matters. 2021 Dec;29(1):1982460. doi: 10.1080/26410397.2021.1982460.
Pharmacies in low- and middle-income countries play an important role in increasing the availability of medical abortion to individuals for self-use. We aimed to document the costs to users of medical abortion products at outlets across geographies and understand the diversity of available products, primarily in low- and middle-income countries or in places where access to abortion is restricted. A descriptive analysis of price data was completed for identified medical abortion products at retail outlets visited in 44 countries from November 2017 to February 2018. Median prices and ranges are reported in $US for mifepristone 200 mg tablets, misoprostol 200 mcg tablets, and combipacks. Misoprostol, mifepristone, and combipacks were found in 44, 19, and 16 countries, respectively. Nearly two-thirds of products (321/508) required a prescription. The median price of misoprostol was $0.63 per tablet (range $0.09-$27.63) based on 304 price points. Mifepristone and combipacks had fewer price points available ( = 59 and = 44, respectively). Median prices were $11.78 per mifepristone tablet (range $1.77-$37.83) and $11.18 per combipack (range $3.50-$35.86). Overall, prices were highest in Latin America and lowest in South/Southeast Asia. Only 11.5% (7/61) of the total unique misoprostol brands were quality-assured (i.e. approved by a stringent regulatory authority or pre-qualified by the World Health Organization), compared to 25.0% (4/16) of unique combipack products. There was wide variation in product pricing and availability across settings. The infrequent availability of mifepristone and combipacks, in addition to the limited availability of quality-assured medicines and high cost of abortion medications, are important factors affecting access to high-quality abortion care.
在中低收入国家，药店在增加个人自行使用医疗流产的可用性方面发挥着重要作用。我们旨在记录在 2017 年 11 月至 2018 年 2 月期间在 44 个国家的零售网点购买医疗流产产品的用户成本，并了解主要在中低收入国家或堕胎服务受限的地方的可用产品的多样性。对在 44 个国家的 508 种零售网点购买的已识别医疗流产产品进行了价格数据的描述性分析。报告了米非司酮 200mg 片剂、米索前列醇 200mcg 片剂和组合包装在美元中的中位数价格和范围。在 19 个国家发现了米索前列醇、米非司酮和组合包装，分别为 44、19 和 16 个国家。近三分之二的产品（321/508）需要处方。基于 304 个价格点，米索前列醇片剂的中位数价格为每片 0.63 美元（范围为 0.09-27.63 美元）。米非司酮和组合包装的价格点较少（分别为 59 和 44）。米非司酮片剂的中位数价格为每片 11.78 美元（范围为 1.77-37.83 美元），组合包装的中位数价格为每包 11.18 美元（范围为 3.50-35.86 美元）。总体而言，价格在拉丁美洲最高，在南亚/东南亚最低。只有 11.5%（7/61）的总独特米索前列醇品牌是质量保证的（即获得严格监管机构的批准或世界卫生组织的预认证），而独特组合包装产品的比例为 25.0%（4/16）。不同设置的产品定价和供应情况存在很大差异。米非司酮和组合包装的供应不频繁，加上质量保证药物的供应有限和堕胎药物成本高昂，是影响获得高质量堕胎服务的重要因素。
