OBJECTIVES: World Health Organization Model List of Essential Medicines for Children (WHO EMLc) includes certain non-opioids and non-steroidal anti-inflammatory medicines and opioid analgesics intended for pain relief in children. The aim of this work was to evaluate availability of these medicines in supply system in Armenia.

METHODS: Inclusion of essential analgesics from WHO EMLc in the Armenian Essential Medicines List (AEML) was assessed by comparing medicines listed in these two documents. Lists of medicines authorized in Armenia and price-lists of 4 leading wholesalers were analyzed. Interview with representative of the main supplier of opioid analgesics was implemented. Data on availability of tracer medicines were collected from 20 pharmacy outlets in Yerevan.

RESULTS:: All 4 active ingredients recommended by WHO intended for pain relief are included in AEML, authorized in the country and available in pricelists of some wholesalers and at a specialized pharmacy that provides opioid analgesics to patients. However, some dosage forms and many formulations of these medicines included in WHO EMLc are not available. Only 9 (69.2%) of 13 dosage forms and 10 (45.5%) of 22 formulations were authorized in 2019; 61.5% of dosage forms and 36.4% of formulations - in 2020. Only 69.2% of dosage forms and 45.5% of formulations were available in the pharmaceutical market in 2019 and 2020. 3 of 5 formulations of paracetamol recommended by WHO and all 4 formulations recommended for ibuprofen were mainly available (55-100%) in community pharmacies studied. Only 1 of 5 dosage forms listed for morphine in WHO EMLc and AEML is available.

CONCLUSIONS:

Medicines supply system in Armenia provides only a part of dosage forms and formulations for analgesics recommended by WHO for pain relief in children. There is urgent need for improving availability of dosage forms and formulations of these medicines to improve access to treatment for children.