Rapid assessment of possible price instability and shortages of medicines and equipment during the COVID-19 pandemic across Asia and the public health implications

Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with some countries adopting preventative strategies earlier than others. There has been considerable controversy surrounding some treatments especially hydroxychloroquine with the initial hype and misinformation leading to shortages, price rises, and suicides. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, a need to investigate this further. Objective: Assess changes in utilisation, prices, and availability of relevant medicines and PPE during the pandemic among Asian countries. Method: Interviews among community pharmacists from beginning of March until end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: 308 pharmacists took part from 5 Asian countries. There was an appreciable increase in the utilisation of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, increased use of Vitamins/ immune boosters and PPE across the countries and limited price rises for antimicrobials in India, Malaysia and Vietnam. Appreciable price increases seen for PPE across some countries. Conclusion: Encouraging to see increases in utilisation of vitamins/ immune boosters and PPE. However, increases in the utilisation and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from lockdown measures. Community pharmacists can play key role in providing evidence-based advice, helping moderate price increases, reducing self-purchasing of antimicrobials, and addressing some of the unintended consequences of the pandemic.