On our last full day in Zambia (10-Jul-2023) we decided to clear the last thing on the MUST DO list and investigate retail prices for ORS, Zinc and co-packaged ORS and Zinc. As time was short, we decided to conduct an informal ‘Mystery Shopper’ exercise: as we drove from one commitment to another, we stopped at all the pharmacies we came across. So, this is not a Randomised Control Trial! We did, however, try to get a range of locations, to see if prices varied. They did!
We visited eight pharmacies in all. None stocked co-packaged ORS and Zinc although three were in the same shopping mall as a Shoprite store that did. Seven of the eight pharmacies had ORS in stock. Similarly seven of the eight had Zinc in stock, although only five had dispersible zinc sulphate tablets; the remaining 2 offered only Zync syrup – a more expensive option. All of the dispersible Zinc tablets offered were imported (‘PedZinc’), which is surprising as similar tablets are now made in Zambia by Pharmanova (NovaZinc). Similarly, all of the ORS was imported in spite of locally made ORS being available via Pharmanova. Six of the eight pharmacies (75%) had both ORS and Zinc (tablets or syrup) in stock.
Only one pharmacy had small ORS sachets – ie under 1 litre. These were the up-market REHIDRAT brand making up 250 mL and were priced at K40 (USD 2.15) each. REHIDRAT is considered to be a luxury product targeted at athletes and sports, rather than diarrhoea, although it was offered by that pharmacy for ‘a child with diarrhoea aged 5’. REHIDRAT was excluded from the price comparison below.
In all cases the cost of two 1 L sachets of ORS and 10 Zinc tablets bought separately was greater that the cost of the co-packaged ORS and Zinc product sold by Shoprite (Kit Yamoyo). The saving from buying the co-pack ranged from 20% to 52%.
The US Dollar prices are as follows:
When engaged in conversation, only one of the retailers volunteered that she had heard of Kit Yamoyo; mentioning the recent coverage on the radio during our visit. She was surprised to hear it was available in Shoprite – a few metres away – and was cheaper than the option she had in stock. She did not know why her pharmacist in charge did not order it. One of the independent out of town pharmacists volunteered an interest in Kit Yamoyo when it was mentioned, and offered to order it from his wholesaler in town in future.
This mini, unscientific survey confirms information from elsewhere that the cheapest way to deliver the WHO recommended treatment for diarrhoea (ORS and Zinc) is through a co-pack. It also reflects what seems to be a tendency from established pharmaceutical chains in Zambia to buy ‘what they know’, often from importers, rather than seeking local options.
