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Assessing the global availability of misoprostol.

Maria M Fernandez1, Francine Coeytaux, Rodolfo Gomez Ponce de León

  • 1Product Promotion and Distribution Unit, Ipas, Chapel Hill, North Carolina, USA. fernandezm@ipas.org

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|March 17, 2009
PubMed
Summary

Misoprostol availability is increasing in low-income regions, offering potential to reduce maternal deaths from postpartum hemorrhage and unsafe abortions. Sales data reveal regional shifts in misoprostol and misoprostol-NSAID drug distribution.

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Area of Science:

  • Pharmacology
  • Global Health
  • Reproductive Medicine

Background:

  • Misoprostol is crucial for obstetric-gynecologic indications, yet often unregistered for these uses, complicating availability assessments.
  • Understanding global misoprostol distribution is vital for improving maternal health outcomes.

Purpose of the Study:

  • To evaluate the worldwide availability and sales trends of misoprostol from 2002 to 2007.
  • To identify regional disparities in misoprostol and misoprostol-NSAID combination drug distribution.

Main Methods:

  • Analysis of annual sales data (weight) and manufacturer prices for misoprostol and misoprostol-NSAID formulations.
  • Tracking regional and country-specific sales trends and consumer prices for registered medications.

Main Results:

  • Misoprostol-NSAID combinations dominated global sales (70%), primarily in North America and Western Europe (91%).
  • Asia showed significant growth in misoprostol-only drug sales, particularly in Bangladesh and India, with diverse low-price brands.
  • Sales decreased in Latin America but increased in the Middle East-North Africa and Sub-Saharan Africa, though per capita sales remained low.

Conclusions:

  • Misoprostol availability is improving in certain low-income regions.
  • Increased access to misoprostol holds significant potential for reducing maternal mortality, especially from postpartum hemorrhage and unsafe abortions.