Medicine Affordability, Accessibility, and Economic Burden: Patient Experiences From a Multi-Center Survey in Two Division of Bangladesh

OBJECTIVES: Access to essential medicine is the crucial component of effective healthcare delivery in low and middle income country like Bangladesh. The objective of the study was to evaluate the accessibility and affordability of medicine through a patient centered questionnaire survey.

METHODS: A structured questionnaire was administered to patients across government and non-government medical college hospitals in two division of Bangladesh from May, 2023 to April, 2024. This survey collected data on the economic burden of patients due to cost of medication, frequency of difficulty in affording and accessing essential medicine.

RESULTS: The survey interviewed 600 patients with selected communicable and non-communicable diseases experiences with medication affordability and accessibility in Bangladesh. The result showed that a significant percentage (41%) of patient found medication they needed somewhat affordable, while only 4.3% mentioned never having difficulties. The high cost of medicine enforced a very significant financial burden on 41% of patients. This financial burden contributes to adherence concerns, as almost half (48%) of patients skip medication due to cost, and more than a third (36.6%) report that the cost affects their treatment regimen. The majority (88.6%) of patients consider that government should provide more financial support to make medication easier to afford. Out-of-pocket expenses are widespread (37%), and more than one-third (36%) have chosen a less appropriate medication owing to affordability. Accessibility also poses issues, with more than half (54%) reported that it somewhat hard to access medication.

CONCLUSIONS: The findings highlight that significant barriers to the affordability and accessibility of medicine in Bangladesh. A considerable portion of the patients struggles with the high price, resulting in frequent treatment disruptions. Addressing these concerns is crucial for enhancing patient outcome and ensuring equitable healthcare in Bangladesh.