Access to essential medicines in Albania: a cross-sectional survey of availability, prices and affordability using the WHO/Health Action International (HAI) Global Core List
Eriona Petro, Aukje K Mantel-Teeuwisse, Iris Rebecca Joosse, Arthur C M Siebers, Fatima Suleman, Hendrika Annie van den HamObjectives
To assess the availability, prices and affordability of essential medicines in Albania, focusing on a standardised set of medicines from the Global Core List (GCL), using an adapted WHO/Health Action International (WHO/HAI) methodology.
Design
Cross-sectional survey.
Setting
30 private community pharmacies across six urban areas in Albania (Tirana, Durrës, Fier, Vlorë, Kavajë and Lushnjë).
Participants
Licensed private community pharmacies, including both contracted and non-contracted pharmacies under the national health insurance scheme.
Outcomes
Availability, patient prices and affordability of 14 medicines from the GCL. Affordability was assessed using the daily wage of the lowest-paid government worker (LPGW), and prices were evaluated using the median price ratio (MPR) compared with international reference prices.
Results
The mean availability of WHO/HAI GCL medicines was 79.8%, slightly below the WHO target of 80%. In a secondary analysis that included therapeutically equivalent alternative formulations availability increased to 83.3%. Ceftriaxone, amoxicillin and salbutamol were among the least available medicines and were frequently out of stock. All medicines, except ceftriaxone, met affordability criteria based on LPGW. MPR analysis showed that while most medicines were priced competitively, some, including diclofenac and ceftriaxone, were substantially higher than international reference prices, with five medicines exceeding an MPR of 4.0. Overall, 64% of medicines met both availability and affordability thresholds.
Conclusions
Access to essential medicines in Albania appears to be primarily constrained by availability rather than affordability. Gaps in the availability of key antibiotics and asthma medicines highlight the need for targeted policy interventions, including improved procurement, supply chain management and rational use strategies to strengthen equitable access to essential medicines.