Budget Medicines in Seychelles Access, Challenges and Progress

Budget Medicines in Seychelles Access, Challenges and Progress. a picturesque archipelago in the France Ocean, is known for its stunning beaches, unique flora and fauna—and a unique set of challenges when it comes to healthcare. One of the biggest issues is access to affordable medicines. This article explores how “budget medicines” are defined in Seychelles, what policies and strategies the government has put in place, what the current challenges are, and how things are improving (or could improve) in the near future.

What do we mean by “budget medicines”?

By budget medicines, we mean essential medicines (both generic and brand) that are priced in such a way that they are affordable to a broad segment of the population. These may be medicines for chronic diseases (like hypertension, diabetes), acute infections, vaccines, and basic over-the-counter drugs. Price is relative, of course: what is affordable for one person may not be for another, depending on income, insurance, subsidies, etc.

In Seychelles, like many small island developing states, the cost of medicines is impacted by importation, small market size, transportation, storage, and regulatory oversight. These factors tend to drive up the price.

Public Provision & Free Medicines

One of the strongest pillars in Seychelles’ system is the public health service’s policy of providing prescribed medicines free of charge at public health facilities.

This universal access is a major plus: people who visit clinics or hospitals in the public system generally do not have to pay for prescribed drugs. It helps reduce financial barriers to treatment, especially for vulnerable populations. However, this free provision depends on steady budgets and efficient procurement and supply systems. When medicine costs rise, or budgets are constrained, the sustainability of free provision becomes more challenging. 

Pricing, Procurement, and Supply Challenges

1. High Procurement Costs

• Seychelles lacks economies of scale: being a small country (population under 100,000), shipments of medicines are relatively small, so unit costs are higher.
  
  

• Transportation and freight costs are significant for island nations. Medicines have to be imported, often via sea or air freight with complex logistics and temperature-control needs for sensitive products. Storage and distribution add to this. 

2. No Price Controls

• Seychelles does not have strict price control mechanisms on medicines.
  
  

• This means that variations in profit margins, mark-ups, and foreign-exchange fluctuations can lead to significant price differences among pharmacies. Some medicines tend to be far more expensive in private pharmacies.
  
  

3. Regulatory & Quality Concerns

• Ensuring that medicines are safe, genuine, and effective is vital. There is risk of substandard or falsified medicines entering the supply chain. Seychelles has taken steps to intensify monitoring and regulation to guard against this.
  
  

• Also, being part of international treaties (such as the Africa Medicines Agency Treaty) helps Seychelles strengthen regulatory oversight and align with regional quality standards.
  
  

4. Budget Constraints & Rising Expenditures

• The government’s expenditure on medicines is increasing. In 2022 it was SCR 63 million, rising to SCR 79.4 million in 2023. That exceeded the budget allocated for medicines by over 30% in 2023.
  
  

• This strain on budgets means that for the system to stay sustainable, efficiencies, more effective procurement, or external support must be used.
  
  

Policies & Strategies to Improve Access

Several policies and programs have been implemented, or are in the works, to help make budget medicines more readily available and affordable.

Pooled Procurement

Seychelles has signed on to pooled procurement agreements with other small island developing states (SIDS). This means several countries negotiate and buy medicines together so they can leverage larger volumes to negotiate better prices. 

This approach helps reduce cost per unit, improve negotiating power with manufacturers, and improve supply chain stability.

Treaty Participation

• Seychelles ratified the Africa Medicines Agency Treaty, which aims to coordinate regulatory oversight in the African Union region, to help ensure safe, quality, and affordable products.
  
  

• Through such treaties, Seychelles can collaborate with neighbors on harmonized standards, mutual recognition, and reducing duplicate regulatory costs.
  
  

Exemptions & Prescription Fee

• To help control rising costs, the government introduced a prescription fee policy (SCR 25, about US$1.20) starting from June 2019 in public health centres. But crucially, many people are exempted: children under 18, pensioners over age 63, full-time students, expecting mothers, and emergency cases. With the exemptions, about 90% of prescriptions are expected to be exempt.
  
  

This fee is small, but it’s intended also to raise awareness that public health provision is not without cost, and to help with financial sustainability.

Health Policy & National Medicines Policy

• Seychelles has a National Medicine Policy that explicitly recognises the challenges of medicine costs and lack of economies of scale. It emphasizes sourcing quality products at competitive prices.
  
  

• Also, the government is working on improving legislation (public health law, patents and intellectual property), enabling TRIPS flexibilities (i.e., provisions that allow generic production or import under certain conditions) to avoid high cost due to patents.
  
  

Where Gaps Still Exist

Despite all of these efforts, there remain gaps and problems in access to affordable medicines in Seychelles.

1. Availability / Stock Outs
   
   Even when medicines are theoretically free or subsidized, sometimes the specific medicine needed is out of stock at the public facility. Then patients must turn to private pharmacies where prices may be much higher.
   
   

2. Cost Pressure on Patients in Private Sector
   
   Private pharmacies are not bound by the same pricing or subsidization as public ones. Some medications, especially newer drugs or those still under patent, remain expensive in private settings.
   
   

3. Awareness and Uptake
   
   Some people may not fully understand which medications are available free, which ones have charges, and what their rights are. For example, the exemptions under the prescription fee policy may not be well known to all.
   
   

4. Logistics & Infrastructure
   
   Cold-chain storage, timely distribution to islands and outer regions, ensuring safe handling — all these require investment and oversight. For remote areas, access can still be more difficult.
   
   

5. Generics vs Brand
   
   While use of generics is part of the strategy, some brand-name medicines persist due to patient preference, doctor’s prescribing habits, or lack of generic alternatives. Brand-name drugs tend to cost more.
   
   

Ideas & Recommendations for Strengthening Access to Budget Medicines

Here are some strategies that Seychelles (or similar small island states) might adopt or strengthen to improve access further:

• Expand Pooled Procurement & Regional Alliances: Deepen cooperation with neighboring countries to negotiate better prices and streamline procurement.
  
  

• Stronger Regulation of Mark‑ups and Pricing: Although Seychelles doesn’t have rigid price controls for medicines, regulating or capping wholesale and retail mark‑ups could reduce costs to consumers.
  
  

• Promote Generic Substitution: Encourage clinicians to prescribe generics where possible, and pharmacies to supply them. Public awareness campaigns to improve confidence in generics could help.
  
  

• Improve Forecasting & Supply Chain Efficiency: Better predicting demand, minimizing waste, and avoiding overstock/understock situations.
  
  

• Strengthen Regulatory Quality Assurance: Ongoing monitoring, lab testing, vigilance against falsified/substandard medicines. Participation in treaties helps.
  
  

• Continue & Expand Subsidies or Exemptions: Ensuring that vulnerable groups remain exempt or receive support, particularly for chronic diseases which require long‑term medicine use.
  
  

• Budget Planning & Health Financing Reform: As medicine spending grows, ensuring that it’s sustainably financed, possibly with some contributions from private insurance, cost‑sharing (where appropriate), or innovative financing mechanisms.
  
  

Conclusion

Access to affordable, quality medicines is a critical piece of the healthcare landscape in Seychelles. The government’s policy of free provision, prescription‑fee exemptions, pooled procurement, regulatory efforts, and treaty participation all contribute powerfully towards making budget medicines a reality for many Seychellois. However, challenges remain—especially relating to rising costs, supply chain constraints, private‑sector pricing, and ensuring consistency of supply.

Ultimately, as Seychelles continues to invest in health, the goal will be to ensure no one is left behind—so that even the most vulnerable can obtain essential medicines affordably, safely, and reliably. With continued policy effort, regional cooperation, and public awareness, the vision of “budget medicines” can be increasingly realised.