The association between price, competition, and demand factors on private sector anti-malarial stocking and sales in western Kenya: considerations for the AMFm subsidy

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  • O’Meara, Wendy
    • Other Affiliation: Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA; College of Health Sciences, Moi University School of Public Health, Eldoret, Kenya; Webuye Demographic Surveillance Site Scientific Steering Committee, Eldoret, Kenya
  • Obala, Andrew
    • Other Affiliation: Webuye Demographic Surveillance Site Scientific Steering Committee, Eldoret, Kenya; College of Health Sciences, Moi University School of Medicine, Eldoret, Kenya
  • Thirumurthy, Harsha
    • Affiliation: Gillings School of Global Public Health
  • Khwa-Otsyula, Barasa
    • Other Affiliation: Webuye Demographic Surveillance Site Scientific Steering Committee, Eldoret, Kenya; College of Health Sciences, Moi University School of Medicine, Eldoret, Kenya
Abstract
  • Background Households in sub-Saharan Africa are highly reliant on the retail sector for obtaining treatment for malaria fevers and other illnesses. As donors and governments seek to promote the use of artemisinin combination therapy in malaria-endemic areas through subsidized anti-malarials offered in the retail sector, understanding the stocking and pricing decisions of retail outlets is vital. Methods A survey of all medicine retailers serving Bungoma East District in western Kenya was conducted three months after the launch of the AMFm subsidy in Kenya. The survey obtained information on each anti-malarial in stock: brand name, price, sales volume, outlet characteristics and GPS co-ordinates. These data were matched to household-level data from the Webuye Health and Demographic Surveillance System, from which population density and fever prevalence near each shop were determined. Regression analysis was used to identify the factors associated with retailers’ likelihood of stocking subsidized artemether lumefantrine (AL) and the association between price and sales for AL, quinine and sulphadoxine-pyrimethamine (SP). Results Ninety-seven retail outlets in the study area were surveyed; 11% of outlets stocked subsidized AL. Size of the outlet and having a pharmacist on staff were associated with greater likelihood of stocking subsidized AL. In the multivariable model, total volume of anti-malarial sales was associated with greater likelihood of stocking subsidized AL and competition was important; likelihood of stocking subsidized AL was considerably higher if the nearest neighbour stocked subsidized AL. Price was a significant predictor of sales volume for all three types of anti-malarials but the relationship varied, with the largest price sensitivity found for SP drugs. Conclusion The results suggest that helping small outlets overcome the constraints to stocking subsidized AL should be a priority. Competition between retailers and prices can play an important role in greater adoption of AL.
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  • Article
Rights statement
  • In Copyright
Rights holder
  • Wendy O’Meara et al.; licensee BioMed Central Ltd.
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Journal title
  • Malaria Journal
Journal volume
  • 12
Journal issue
  • 1
Page start
  • 186
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1475-2875
Bibliographic citation
  • Malaria Journal. 2013 Jun 05;12(1):186
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • June 15, 2013

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