The article provides a comprehensive systematic review and meta-analysis on the availability, pricing, and affordability of essential medicines in Ethiopia. Key findings include:

• The overall mean availability of essential medicines was 63.89%, below the WHO target of 80%. Availability was higher in public (64%) than private (54%) facilities. 

• The median price ratio (MPR) ranged from 0.55 to 5.21 in public facilities, and 0.88 to 11.17 in private facilities, indicating higher prices in the private sector. 

• Around 62% of the evaluated medicines were deemed unaffordable for the population. 

The review highlights the need for coordinated efforts to improve access to essential medicines in Ethiopia, including policy refinement, supply chain management, and context-specific interventions. The article discusses several strategies that can be implemented to improve access to essential medicines in low- and middle-income countries like Ethiopia:

Improve Availability:

• Implement policies that promote the use of generic medicines, such as mandatory generic prescribing and substitution. 
• Strengthen supply chain management to reduce stockouts and ensure consistent availability of essential medicines. 

Enhance Affordability:

• Introduce subsidies, reimbursement systems, and social health insurance to reduce the financial burden on patients. 
• Implement effective price regulation mechanisms, such as reference pricing and value-based pricing, to reduce medicine prices. 

Strengthen Regulatory Frameworks:

• Develop and enforce policies that promote generic competition and limit mark-ups along the supply chain. 
• Improve regulatory oversight to ensure quality, safety, and appropriate pricing of essential medicines. 

Address Socioeconomic Factors:

• Implement targeted interventions to improve access for vulnerable populations, such as children, the elderly, and low-income groups. 1
• Address cultural and socioeconomic barriers that may limit access to essential medicines. 1

By implementing a comprehensive approach addressing availability, pricing, affordability, and socioeconomic factors, countries can work towards improving equitable access to essential medicines for all populations. 

https://doi.org/10.1016/j.rcsop.2025.100674