{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:15:38Z","timestamp":1788509738774,"version":"build-2803163510"},"reference-count":46,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,22]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the availability, prices and affordability of essential medicines in Albania, focusing on a standardised set of medicines from the Global Core List (GCL), using an adapted WHO\/Health Action International (WHO\/HAI) methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>30 private community pharmacies across six urban areas in Albania (Tirana, Durr\u00ebs, Fier, Vlor\u00eb, Kavaj\u00eb and Lushnj\u00eb).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Licensed private community pharmacies, including both contracted and non-contracted pharmacies under the national health insurance scheme.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Availability, patient prices and affordability of 14 medicines from the GCL. Affordability was assessed using the daily wage of the lowest-paid government worker (LPGW), and prices were evaluated using the median price ratio (MPR) compared with international reference prices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean availability of WHO\/HAI GCL medicines was 79.8%, slightly below the WHO target of 80%. In a secondary analysis that included therapeutically equivalent alternative formulations availability increased to 83.3%. Ceftriaxone, amoxicillin and salbutamol were among the least available medicines and were frequently out of stock. All medicines, except ceftriaxone, met affordability criteria based on LPGW. MPR analysis showed that while most medicines were priced competitively, some, including diclofenac and ceftriaxone, were substantially higher than international reference prices, with five medicines exceeding an MPR of 4.0. Overall, 64% of medicines met both availability and affordability thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Access to essential medicines in Albania appears to be primarily constrained by availability rather than affordability. Gaps in the availability of key antibiotics and asthma medicines highlight the need for targeted policy interventions, including improved procurement, supply chain management and rational use strategies to strengthen equitable access to essential medicines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121273","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T11:10:32Z","timestamp":1786619432000},"page":"e121273","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Access to essential medicines in Albania: a cross-sectional survey of availability, prices and affordability using the WHO\/Health Action International (HAI) Global Core List"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1471-3861","authenticated-orcid":false,"given":"Eriona","family":"Petro","sequence":"first","affiliation":[{"name":"Pharmacoepidemiology and Clinical Pharmacology, Universiteit Utrecht, Utrecht, The Netherlands"},{"name":"Pharmacy, Western Balkans University, Tirana, Albania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8782-0698","authenticated-orcid":false,"given":"Aukje K","family":"Mantel-Teeuwisse","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology and Clinical Pharmacology, Universiteit Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7677-8589","authenticated-orcid":false,"given":"Iris Rebecca","family":"Joosse","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology and Clinical Pharmacology, Universiteit Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur C M","family":"Siebers","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology and Clinical Pharmacology, Universiteit Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Suleman","sequence":"additional","affiliation":[{"name":"Health Sciences, KwaZulu-Natal Department of Health, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrika Annie","family":"van den Ham","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology and Clinical Pharmacology, Universiteit Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"2026090400401638000_16.8.e121273.1","unstructured":"World Health Organization . 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