The Burden of Unavailable Drugs Cost to Patients Admitted to Internal Medicine Ward of Tikur Anbessa Specialized Hospital

To assess the burden of unavailable drugs cost to patients admitted to TikurAnbessa Specialized Hospital's internal medicine ward. Costs of medications obtained inside and outside the pharmacy and other burdens associated with drugs' unavailability are also estimated and explored. A facility-based cross-sectional study design was conducted from November 9 to November 23, 2020. Quantitative data on medication costs were collected from patients admitted to TikurAnbessa Specialized Hospital internal medicine ward B8. Qualitative information was collected from patients, caregivers, and health care professionals through interviews to assess the burdens of unavailability of pharmaceuticals on patients and the health care system. A total of 32 patients were enrolled in the study. Participants' age ranged from 14 to 92. Eighteen (56.25%) paid in cash for medications bought within the hospital pharmacy, while the remaining 14 (43.75%) were treated for free. A total of 68 medicines were prescribed during the study period. Of this, 33 (48.53%) medicines were not available in the hospital pharmacy. The total costs of patients were 78.07$ and 1530.84$ when purchased from inside and outside the hospital pharmacy, respectively. The average price of medications per patient ranged from 0.025 to 8.41$ inside the hospital pharmacy, where the average cost per patient outside the hospital pharmacy ran from 0.128 to 54.67$. For the qualitative part, four patients and/or caregivers and five health care professionals were interviewed, and three key themes emerged from the thematic analysis: (i) awareness of the availability of medication, (ii) management of the burden of stock out, and (iii) impact of the stock out. The study came up with a result that the hospital pharmacy has high unavailability of medication. Patients complain about unwanted and unreasonably expenditure to purchase pharmaceuticals from outside pharmacies and associated delayed treatment.