Amidst millions of malarial cases w

Amidst millions of malarial cases witnessed in India every year, access to quality anti-malarial medications is a problem. The availability, price and affordability of medications are the three important determinants of patients receiving effective healthcare services. The present study was conducted to evaluate the availability, cost and affordability of anti-malarials in India. This prospective, observational study was conducted in Cuddalore district in Tamil Nadu, India from August to September 2011. Three types of medication costs were taken into consideration for calculation purposes, the highest and the cheapest branded medication costs in private pharmacy and the Jan-Aushadhi prices. Affordability was calculated for the agriculture workers and wages fixed by government of tamilnadu for different levels of skills categorized, who were consuming the medications at the time. Total six drugs included in the study according to new treatment guidelines of malaria. There was 15.5% to 230% price variation between minimum and maximum costs of branded anti-malarials respectively. For treating Plasmodium Vivax cases of malaria; unskilled and highly skilled workers had to spend a minimum of 0.32 and 0.28 wage days respectively and a maximum of 0.43 and 0.35 wage days respectively in private pharmacies. The ACT therapy required for treating severe malaria cases(Sulfadoxime+Pyrimethamine, Artemether, Arteether, Quinine) were unavailable in Jan-Aushadhi facilities. Challenges in improving access to essential anti-malarials persist mainly due to disparity in the prices of the branded and generic anti-malarials, lack of these medications in Janaushadhi stores which provide them lower cost to poor people and inability of Indians earning low wages to purchase them at high prices from private pharmacies who stockpile them.