Affordability of inhaled corticosteroids as a potential barrier to treatment of asthma in some developing countries.

Setting: The cost and availability of the medications required for the treatment of asthma may represent potential barriers to effective management.

Method: A survey of prices and policies for components of asthma treatment in 1998, in Algeria, Burkina Faso, Ivory Coast, Guinea, Mali, Syria, Turkey and Vietnam.

Results: Medications were consistently available in only four of the eight countries studied. The cost of essential medications for standard case management varied by over five times for beclomethasone and by over three times for inhaled salbutamol. In all but two countries, the cost of one year of drugs for treatment of a moderate, persistent case exceeded the monthly salary of a nurse in that country. The essential drugs list included inhaled salbutamol in five of eight countries and beclomethasone in three of eight. The costs of medications were lower where generic preparations were available and, to a lesser extent, where the medications are on the essential drugs list.

Conclusions: The cost and availability of medications vary widely, and may represent an important barrier to effective management in some low and middle income countries.