scholarly journals Availability, pricing and affordability of essential medicines in Eastern Ethiopia: a comprehensive analysis using WHO/HAI methodology

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Mekonnen Sisay ◽  
Firehiwot Amare ◽  
Bisrat Hagos ◽  
Dumessa Edessa
Keyword(s):  
Private Sector ◽  
Reference Price ◽  
Health Facilities ◽  
Essential Medicines ◽  
Price Difference ◽  
Eastern Ethiopia ◽  
Public And Private ◽  
Government Employee ◽  
International Reference ◽  
Access To Essential Medicines

Abstract Background Access to essential medicines is a universal human right and availability and affordability are the preconditions for it. In line with the sustainable development goals, World Health Organization (WHO) has outlined a framework that assists the policy makers to improve access to essential medicines for universal health coverage by 2030. However, the availability and affordability of essential medicines remains suboptimal in several low-income countries. Therefore, this study was designed to investigate the availability, pricing and affordability of essential medicines in eastern Ethiopia. Methods A cross-sectional study design was employed to conduct this study. Public and private health facilities found in Eastern Ethiopia and which fulfilled criteria set forth by WHO/Health Action International (HAI) guideline and essential medicines listed on WHO/HAI guideline and essential medicine list of Ethiopia were included. Accordingly, 60 medicine outlets were selected based on the WHO/HAI standardized sampling methodology. A standardized data collection tools developed by WHO/HAI, with necessary modifications, was employed to collect the data. Median Price Ratio (MPR) was computed as a ratio of median local buyers’ price to international buyers’ reference price. The Mann–Whitney U test was employed to compare the median buyers’ price between public and private health facilities. Kruskal–Wallis test was also run to explore the median price difference among all facilities. Treatment affordability was calculated based on the number of days of wage of the lowest-paid government employee of Ethiopia required to purchase the prescribed regimen. Results The overall percent availability of originator brand (OB) versions of essential medicines was found to be 3.6% (range: 0.0–31.7%), with the public and private sectors contributing 1.43% and 5.50%, respectively. The overall percent availability of lowest price generics (LPGs) was 46.97% (range: 1.7–93.3%) (Public: 42.5%; private: 50.8%). Only eight LPGs (16.0%) met the WHO target of 80%. The Mann–Whitney U test indicated that 64% drugs showed statistically significant median price difference between public and private settings (p < 0.05). The MPR value indicated that the median buyers’ price of drugs in private sector were more than four times the international reference price in 30% of drugs. The percentage of unaffordable medicine were 72.09 and 91.84% for public and private facilities, respectively, with 79.17% of the medicines were unaffordable when both settings were combined. Conclusion Only 16% of the surveyed medicines surpassed the WHO cut-off point of 80%. Nearly one-third of drugs in the private sector had a price of more than four times compared to the international reference prices. Moreover, four out of five drugs were found unaffordable when both settings were combined, demanded several days of wage of lowest paid government employee. This finding calls a prompt action from stakeholders to devise a strategy that help promote the access of essential medicines and rescue the struggling healthcare system of Ethiopia.

scholarly journals Universal Access to Essential Medicines: An Evaluation of Nepal’s Free Health Care Scheme

2018 ◽  
Vol 16 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Shiva Raj Adhikari ◽  
Achyut Raj Pandey ◽  
Mamata Ghimire ◽  
Arjun Kumar Thapa ◽  
Dinesh Kumar Lamsal
Keyword(s):  
Public Health ◽  
Health Care ◽  
Service Providers ◽  
Universal Access ◽  
Health Facilities ◽  
Essential Medicines ◽  
Public Health Facilities ◽  
Free Health Care ◽  
Access To Essential Medicines ◽  
Expired Medicines

Background: Access to medicine for the poor is recognized to be difficult task and one of the major challenges in achieving universal health coverage, particularly in low-and- middle income countries. In order to ensure the availability of essential medicines free of cost in public health facilities, Nepal has also commenced Free Health Care Services (FHCS). So, this study aims to evaluate availability, expiry, and stock-out duration of essential medicines at front line service providers in Nepal.Methods: Cross-sectional survey was conducted 28 public health facilities, 7 district warehouses, and 14 private pharmacies in 7 districts of Nepal. The survey was conducted during the March and April 2014. Survey tools recommended by the WHO operational package for assessing, monitoring and evaluating country pharmaceutical situations was used with slight modification as per Nepal’s situation.Results: The availability of medicine was found to be 92.44% in this study. The percentage of expired medicines in district warehouse was found to be 8.40. The average stock-out duration in district warehouse was 0.324 days.Conclusions: Although the availability of essential medicines at peripheral health facilities was found to be satisfactory with lesser proportion of expired medicines, a strong monitoring and evaluation of expired and stock medicines are desirable to maintain and improve the access to essential medicines.

scholarly journals The role of the public and private health sectors on factors associated with early essential newborn care practices among institutional deliveries in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maxwell Tii Kumbeni ◽  
Paschal Awingura Apanga ◽  
Mary-Ann Wepiamo Chanase ◽  
John Ndebugri Alem ◽  
Nana Mireku-Gyimah
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Newborn Care ◽  
Health Facilities ◽  
Essential Newborn Care ◽  
Public And Private ◽  
The Public ◽  
Factors Associated ◽  
Public Sector Health

Abstract Background Early essential newborn care is one of the important interventions developed by the World Health Organization to reduce morbidities and mortalities in neonates. This study investigated the role of the public and private sector health facilities on factors associated with early essential newborn care practices following institutional delivery in Ghana. Methods We used data from the 2017/2018 multiple indicator cluster survey for our analysis. A total of 2749 mothers aged 15–49 years were included in the study. Logistic regression analysis was used to assess the factors associated with early essential newborn care in both public and private health sectors. Results The prevalence of good early essential newborn care in the public sector health facilities was 26.4 % (95 % CI: 23.55, 29.30) whiles that of the private sector health facilities was 19.9 % (95 % CI: 13.55, 26.30). Mothers who had a Caesarean section in the public sector health facilities had 67 % lower odds of early essential newborn care compared to mothers who had a vaginal delivery [adjusted prevalence odds ratios (aPOR) = 0.33, 95 % CI: 0.20, 0.53]. Mothers without a health insurance in the public sector health facilities had 26 % lower odds of early essential newborn care compared to mothers with a health insurance (aPOR = 0.74, 95 % CI: 0.56, 0.97). However, these associations were not observed in the private sector health facilities. Conclusions The findings suggest that the prevalence of good early essential newborn care in the public sector health facilities was higher than that reported in the private sector health facilities. Child health programs on early essential newborn care needs to be prioritized in the private healthcare sector. The Government of Ghana may also need to increase the coverage of the national health insurance scheme for women in reproductive age.

scholarly journals Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, India

2019 ◽  
Vol 4 (2) ◽  
pp. e001379 ◽  
Author(s):  
Neha Faruqui ◽  
Alexandra Martiniuk ◽  
Abhishek Sharma ◽  
Chanchal Sharma ◽  
Bhumika Rathore ◽  
...  
Keyword(s):  
Private Sector ◽  
Low Income ◽  
Essential Medicines ◽  
Local Context ◽  
New Delhi ◽  
Middle Income ◽  
Consumer Prices ◽  
Hospital Pharmacies ◽  
Health Action ◽  
Access To Essential Medicines

IntroductionLimited access to essential medicines (EMs) for treating chronic diseases is a major challenge in low-income and middle-income countries. Although India is the largest manufacturer of generic medicines, there is a paucity of information on availability, price and affordability of anti-neoplastic EMs, which this study evaluates.MethodsUsing a modified WHO/Health Action International methodology, data were collected on availability and price of 33 strength-specific anti-neoplastic EMs and 4 non-cancer EMs. Seven ‘survey anchor’ hospitals (4 public and 3 private) and 32 private-sector retail pharmacies were surveyed. Median price ratios (MPRs) were calculated by comparing consumer prices with international reference prices (IRPs).ResultsOn average, across survey anchor areas (hospital and private-sector retail pharmacies combined), the mean availability of anti-neoplastic EMs and non-cancer medicines was 70% and 100%, respectively. Mean availability of anti-neoplastic EMs was 38% in private-sector retail pharmacies, 43% in public hospital pharmacies and 71% in private hospital pharmacies. Median MPR of lowest-priced generic versions was 0.71 in retail pharmacies. The estimated cost of chemotherapy medicines needed for treating a 30 kg child with standard-risk leukaemia was INR 27 850 (US$442) and INR 17 500 (US$278) for Hodgkin’s lymphoma, requiring 88 and 55 days’ wages, respectively, for the lowest paid government worker.ConclusionMost anti-neoplastic EMs are found in survey anchor areas, however, mean availability was less than non-cancer medicines; not meeting the WHO target of 80%. Medicine prices were relatively low in New Delhi compared with IRPs. However, the cost of chemotherapy medicines seems unaffordable in the local context.

ANALYSIS OF SOME FACTORS AFFECTING ACCESS TO ESSENTIAL MEDICINES IN THE CITY AND SOME DISTRICTS OF THUA THIEN HUE PROVINCE

2018 ◽  
Vol 8 (4) ◽  
pp. 48-57
Author(s):  
Ngoc Nguyen Phuoc Bich ◽  
Phu Nguyen Quang
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Care Program ◽  
Essential Medicines ◽  
Price Ratio ◽  
Factors Affecting ◽  
The Public ◽  
Originator Brand ◽  
Access To Essential Medicines ◽  
The City

Background: Essential medicines play an important role in the primary health care program. At least one third of the world’s population has no regular access to these medicines. The availibility and price are two of factors affecting access to essential medicines. Objective: To analyse the availability and the price of essential medicines in the city and some districts of Thua Thien Hue Province. Methods: Using the WHO/ HAI methodology. Results: The originator brand drugs were less available as compared to the lowest price generics. Median availability of originator brand drugs and lowest price generics were 0.0% and 40.0% in public sector. Similarily, these values were respectively 20.0% and 53.3% in private sector, 0.0% and 50.0% in other sector. The median MPRs of innovator drugs was 9.26 and 14.00 for private and other sector respectively while that of generic equivalent versions was 0.68 for public sector, 1.88 for private sector and 1.54 for other sector. Conclusion: The avalibility of originator products was lower than that of lowest price generics. Although the median price of originator brand drugs was much higher than the international reference prices, generic price was almost reasonable. The availibilty as well as the median MPRs figure for the private sector was higher than that for the public sector and other sector. Key words: Medicine prices, availability, essential medicines, WHO/HAI methodology, median price ratio (MPR)

scholarly journals USING E-CATALOG SYSTEM TO REDUCE COST IN PROCUREMENT OF DRUGS

2016 ◽  
Vol 11 (2) ◽  
pp. 123
Author(s):  
Hery Suliantoro ◽  
Eldinda Sazida Permatsari ◽  
Naniek Utami Handayani
Keyword(s):  
Case Studies ◽  
Reference Price ◽  
Private Hospital ◽  
Generic Drugs ◽  
Price Difference ◽  
Pharmaceutical Factory ◽  
International Reference ◽  
Conventional Methods ◽  
The Government ◽  
Selection Of

The price of drugs in Indonesia is still relatively expensive in both the government and private sectors. A survey conducted in 2004 showed that the price of patented drugs in Indonesia is 22 to 26 times higher than the International Reference Price (IRP). As for generic drugs, though cheaper than patented drugs, the price is still nine times higher than the IRP. To overcome these problems, the government facilitated the procurement of generic drugs by using the e-Catalog. But not all hospitals can purchases drugs through the e-Catalog, some still use the conventional methods to supply the needs of medicine where the prices are more expensive than the prices of the e-Catalog. The case studies carry out in one of private hospital, and selection of items examined using Kraljic Portfolio Matrix. After doing research, the selected item that is on strategic items is Omeprazole. The price difference is due to different contract system. In the conventional way, the contract made between the Hospital and the main distributor. While,  the e-Catalog way, contracts made directly to the pharmaceutical factory through the framework contract with government (LKPP). In the future, the conventional way must be abandoned, because through the e-Catalog, procurement is more efficient, thereby reducing time and costs

scholarly journals Medicine prices in 2017 and 2018 as a reflection of the effectiveness of government measures to ­ensure access to medicines

2020 ◽  
Vol 101 (2) ◽  
pp. 256-263
Author(s):  
C M Razzakova ◽  
L E Ziganshina
Keyword(s):  
Comparative Analysis ◽  
Public Sector ◽  
Private Sector ◽  
Price Ratio ◽  
Generic Medicines ◽  
Public And Private ◽  
International Reference ◽  
The Public ◽  
Reference Prices ◽  
Medicine Prices

Aim. To conduct a comparative analysis of medicine prices in 2017 and 2018 years in Kazan (The Republic of Tatarstan, The Russian Federation) to assess the effectiveness of government measures to ensure the accessibility of medicines. Methods. We conducted a comparative analysis of medicine prices according to methodology developed by Health Action International and World Health Organization (WHO/HAI). The analysis included 30 medicines at a preselected dosage form. We studied the accessibility and prices of original brands and lowest priced generic of each medicine in the public and private pharmacies of Kazan in 2017 and 2018, and analyzed the procurement prices of the same medicines in inpatient hospitals. Medicine prices were compared with international reference prices (The Management Sciences for Health (MSH) reference prices) and expressed as median price ratio (MPR). Results. Prices for originator and generic medicines in the public and private sectors tended to decrease in 2018 compared to 2017, but statistically significant price reduction occurred only for generic medicines in the private sector. For example, the median price ratio for originator products changed from 6.86 to 2.97 in the public sector and from 11.1 to 5.36 in the private sector in 2018 compared to 2017, but the changes were not statistically significant (p 0.05). Prices for generics medicines in the public sector did not change in the studied years and remained at the level of international reference prices (the median price ratio were 1.3 in 2017 and 1.27 in 2018). In the private sector, we found a twofold decrease in the prices of generics medicines in 2018 compared to 2017 [the median price ratio decreased from 3.25 to 1.44 (p 0.05)]. Procurement prices for generics medicines in public hospitals in 2017 and 2018 years did not show statistically significant changes with the median price ratio equal to 1.34 and 0.8, respectively. Conclusion. Government price control measures of medicines contributed to maintaining the price of generic medicines at the reference prices level in the public sector and to halving the price of generic medicines in the private sector in 2018 compared to 2017.

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