OBJECTIVES: Cardiovascular diseases are the leading cause of death in Armenia; and access to appropriate medicines is vital for patients. The objective of this work was to study the situation with availability and affordability of cardiovascular medicines on pharmaceutical market in Armenia.

METHODS: Lists of medicines registered in Armenia (April, 2023), price-lists of 2 main wholesalers and 2 on-line pharmacies were analyzed. The number of registered generics for 12 tracer medicines was identified for 2023 and 2018. Affordability of 14 essential medicines (2 from each subgroup) was calculated using methodology adjusted from the method developed by World Health Organization (WHO) and Health Action International (cost of treatment is less than money that a worker with the official minimal salary receive for 1 day).

RESULTS: Only 24 of cardiovascular medicines and therapeutic equivalents listed in the WHO Model List of Essential Medicines (WHO EML) of 2021 are authorized in Armenia. Some essential medicines / equivalents, such as glyceryl trinitrate, dopamine, isosorbide dinitrate, hydralazine and others, are not registered in the country. Furthermore, some dosage forms and strengths of medicines included in WHO EML are also not in the List of Medicines registered in Armenia. The number of registered generic products for 8 of 12 tracer medicines is decreased from 2018 to 2023. Some of studied essential cardiovascular medicines are affordable; for some medicines only part of generic products are affordable; some medicines are affordable only if prescribed at low doses and unaffordable at higher doses.

CONCLUSIONS: Only part of essential cardiovascular medicines and their dosage forms are authorized in Armenia that restricts their import to the country. Low availability and unaffordability of some medicines can compromise access to treatment for patients with cardiovascular diseases. Policy recommendations aimed to increase access to cardiovascular medicines have been developed for submitting to decision-makers.