scholarly journals Prices, Availability And Affordability Of Essential Medicines For Non-Communicable Diseases: A Facility Based Survey In District Abbotabad

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Khizran Mir ◽  
Hafsa Ayyub
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Public Procurement ◽  
Essential Medicine ◽  
Simple Random Sampling ◽  
Communicable Diseases ◽  
Essential Medicines ◽  
World Health ◽  
Price Ratio ◽  
Non Communicable Diseases

Background: Non communicable diseases (NCDs) are spreading like an epidemic worldwide. Essential medicines are crucial for prevention and control of NCDs. World Health Organization (WHO) has set a benchmark of 80% availability of essential medicines in public and private facilities. Availability being a predictor of access to medicines is low in Low and Middle income countries (LMICs). The objective of this study is to determine price, availability and affordability of essential medicines for NCDs in District Abbottabad. Methods: This study was based on the standardized protocol provided by WHO and Health Action International (HAI) for determination of availability, prices and affordability of medicines. A total of 50 medicines for NCDs that were enlisted in Essential Medicine List of district Khyber Pakhtun Khawa were selected for the study. Twenty seven medicine dispensing facilities belonging to public, private and other basic health units (BHUs) (managed by PPHI) sectors were surveyed in the district. Simple random sampling was employed to select facilities. Results: The mean overall percentage availability of essential medicines for NCDs was 0.1% for original brand and 1.9% for low price generic in public sector. Overall availability was better in private and other sectors (32.9% for OB and 13.8% for LPGs and 5.3% for OB and 11.1% for LPG respectively). The prices in public procurement sector were competitive. The median price ratio (MPR) in public procurement sector was 0.56. Prices were higher comparatively in private sector with MPR 2.83. Most of the medicines require less than a day wage to buy 30 days treatment. Conclusions: The availability of essential medicines for NCDs was poor in District Abbottabad. None of the sectors reached the benchmark of 80% with regard to availability of medicines. LPGs were not frequently available in the private sector. However, prices were reasonable in public sector and acceptable in private sector. Medicines were found to be affordable but affordability may differ for people living below poverty line of US $1.

P6147Access to essential cardiovascular medicines in Kerala, the state with the highest cardiovascular disease burden in India

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Satheesh ◽  
S Puthean ◽  
M Ansil ◽  
M K Unnikrishnan ◽  
A Sharma ◽  
...  
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Premature Mortality ◽  
Generic Medicine ◽  
Essential Medicines ◽  
World Health ◽  
Healthcare Needs ◽  
Consumer Prices ◽  
Majority Population ◽  
Government Worker

Abstract Introduction The 2030 Agenda for Sustainable Development has prioritized the reduction of premature mortality due to NCDs – including cardiovascular diseases (CVD) - by a third. To achieve this goal, countries must achieve 80% availability of affordable essential medicines. Essential medicines as identified by the World Health Organization are those that meet the priority healthcare needs of majority population. Globally, India has the second highest CVD burden with over 1.7 million deaths annually, with the highest CVD morbidity and mortality rate in Kerala. Purpose To evaluate the availability, prices and affordability of essential CVD medicines in Kerala state to facilitate implementation of informed public health policy. Methods Using WHO/HAI methodology, we obtained data on availability and prices for 25 essential CVD medicines in a representative sample of 7 public-sector hospitals (survey anchors) and 37 private retail pharmacies located near the survey anchors in four districts. Additionally, we obtained the data from 10 government-subsidized discount pharmacies. We report availability as percentage of surveyed facilities where a given medicine was found. Median prices ratios (MPRs) were calculated by comparing consumer prices to the MSH International Reference Prices (IRPs). Medicines were considered affordable if the monthly supply costs less than one-day's wage of the lowest paid government worker. Results In the public-sector facilities (hospital and discount pharmacies combined), the mean (SD) availability of the surveyed CVD medicines was 52% (35.3%) for generic and 35.3% (20.7%) for originator brand (OB) version. 28% of surveyed medicines (including amlodipine, clopidogrel, losartan, metformin) were available in over 80% pharmacies. 12% (captopril, streptokinase and glyceryl trinitrate) were not available in any of the facilities. In the private sector, mean (SD) availability of generic and OB versions was 64.4% (37.2%) and 43.7% (34.6%), respectively. MPR was 1.28 [range: 0.02 (insulin NPH) – 16.7 (simvastatin)] for both lowest-priced generics (LPG) and most-sold generics (MSG). The lowest paid government worker in Kerala would spend 0.06 - 3.48 days' wages for the monthly supply of essential CVD medicines in the private sector. In government-subsidized discount pharmacies, mean availability was 49.3%. The generic medicine prices were 74% lower than in the private sector. Conclusions Availability of essential CVD medications in both public and private sector pharmacies fall short of the 80% target. In the private-sector, many essential CVD medications seem unaffordable especially considering the polypharmacy among CVD patients. Introducing policies to improve medicine availability in government-subsidized discount pharmacies is crucial in tackling Kerala's ever-increasing CVD burden.

scholarly journals Availability and prices of medicines for non-communicable diseases at health facilities and retail drug outlets in Kenya: a cross-sectional survey in eight counties

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035132 ◽  
Author(s):  
Paul G Ashigbie ◽  
Peter C Rockers ◽  
Richard O Laing ◽  
Howard J Cabral ◽  
Monica A Onyango ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Essential Medicines ◽  
Price Ratio ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Non Profit ◽  
For Profit ◽  
The Mean

ObjectivesThe objective of this study was to determine the availability and prices of medicines for non-communicable diseases (NCDs) in health facilities and private for-profit drug outlets in Kenya.DesignCross-sectional study.MethodsAll public and non-profit health facilities in eight counties (Embu, Kakamega, Kwale, Makueni, Narok, Nyeri, Samburu and West Pokot) that purchased medicines from the Mission for Essential Drugs and Supplies, a major wholesaler, were surveyed in September 2016. For each health facility, one nearby private for-profit drug outlet was also surveyed. Data on availability and price were analysed for 24 NCD and 8 acute medicine formulations. Availability was analysed separately for medicines in the national Essential Medicines List (EML) and those in the Standard Treatment Guidelines (STGs). Median price ratios were estimated using the International Medical Products Price Guide as a reference.Results59 public and 78 non-profit facilities and 135 drug outlets were surveyed. Availability of NCD medicines was highest in private for-profit drug outlets (61.7% and 29.3% for medicines on the EML and STGs, respectively). Availability of STG medicines increased with increasing level of care of facilities: 16.1% at dispensaries to 31.7% at secondary referral facilities. The mean proportion of availability for NCD medicines listed in the STGs (0.25) was significantly lower than for acute medicines (0.61), p<0.0001. The proportion of public facilities giving medicines for free (0.47) was significantly higher than the proportion of private non-profit facilities giving medicines for free (0.09) (p<0.0001). The mean price ratio of NCD medicines was significantly higher than for acute medicines in non-profit facilities (4.1 vs 2.0, respectively; p=0.0076), and in private for-profit drug outlets (3.5 vs 1.7; p=0.0013).ConclusionPatients with NCDs in Kenya appear to have limited access to medicines. Increasing access should be a focus of efforts to achieve universal health coverage.

scholarly journals Availability, prices and affordability of essential medicines: A cross-sectional survey in Hanam province, Vietnam

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260142
Author(s):  
Huong Thi Thanh Nguyen ◽  
Dai Xuan Dinh ◽  
Trung Duc Nguyen ◽  
Van Minh Nguyen
Keyword(s):  
Public Sector ◽  
Urban Areas ◽  
Health Facilities ◽  
Essential Medicines ◽  
World Health ◽  
Price Ratio ◽  
The Public ◽  
Private Medicine ◽  
The Mean ◽  
Medicine Outlets

Objective To measure medicines’ prices, availability, and affordability in Hanam, Vietnam. Methods The standardized methodology developed by the World Health Organization (WHO) and Health Action International was used to survey 30 essential medicines (EMs) in 30 public health facilities and 35 private medicine outlets in 2020. The availability of medicine was computed as the percentage of health facilities in which this medicine was found on the data-collection day. International reference prices (IRPs) from Management Sciences for Health (2015) were used to compute Median Price Ratio (MPR). The affordability of treatments for common diseases was computed as the number of days’ wages of the lowest-paid unskilled government worker needed to purchase medicines prescribed at a standard dose. Statistic analysis was done using R software version 4.1.1. Results The mean availability of originator brands (OBs) and lowest-priced generics (LPGs) was 0.7%, 63.2% in the public sector, and 13.7%, 47.9% in the private sector, respectively. In private medicine outlets, the mean availability of both OBs and LPGs in urban areas was significantly higher than that in rural areas (p = 0.0013 and 0.0306, respectively). In the public sector, LPGs’ prices were nearly equal to their IRPs (median MPRs = 0.95). In the private medicine outlets, OBs were generally sold at 6.24 times their IRPs while this figure for LPGs was 1.65. The affordability of LPGs in both sectors was good for all conditions, with standard treatments costing a day’s wage or less. Conclusion In both sectors, generic medicines were the predominant product type available. The availability of EMs was fairly high but still lower than WHO’s benchmark. A national-scale study should be conducted to provide a comprehensive picture of the availability, prices, and affordability of EMs, thereby helping the government to identify the urgent priorities and improving access to EMs in Vietnam.

scholarly journals Out of pocket payment, affordability and availability of essential medicines in Africa: systematic review

2021 ◽  
Vol 10 (2) ◽  
pp. 58-63
Author(s):  
Getahun Asmamaw ◽  
Dinksew Tewuhibo ◽  
Nardos Asffaw
Keyword(s):  
Low Income ◽  
Communicable Disease ◽  
Essential Medicine ◽  
Communicable Diseases ◽  
Essential Medicines ◽  
Low Income Countries ◽  
Health Coverage ◽  
African Countries ◽  
Non Communicable Diseases ◽  
Private And Public

Background: Availability and affordability of medicines are key determinants of universal health coverage, yet achieving them presents a major challenge especially in low-income countries. This study aims to overview the evidence on the accessibility of essential medicines in the African continent. Methods: A quantitative literature search published in English since 2014 was held from valid databases; such as, Scholar, Economic Literature, Global Health, PAIS International, and African Index Medicus. The search was erperformed from September 16 to 20, 2019. Two authors (G.A and D.T) screened the titles, reviewed the articles for inclusion, extracted the data, and conducted a quality assessment of the literature. The third author (N.A) commented on the review. We have used the universal definition of OOP, availability, and affordability. Results: Of 34, 06 articles initially identified, 19 were eligible for inclusion. These were cross-sectional and case-control household and health facility studies published in 2014 in Africa. They demonstrated that the availability of some essential medicine (antibiotics) >80% met WHO’s target. However, drugs for non-communicable diseases show unavailable that range within 20.1% to 60.8%. Households access health services mainly through OOP. An item patients’ expense more for, was fees for drugs (62.3%) (Congo) and was an expensive component of expenditure in private and public health facilities with a mean of 16.7USD and 25.5USD, respectively (Burkina-Faso). Drugs for non-communicable diseases were the most expensive than drugs for infectious diseases (median = 0.62 USD) (Ethiopia). The majority of core essential medicines in private and public outlets are unaffordable. There was a considerable variation in the affordability of basic treatment for infectious and non-communicable diseases. Interestingly, the potential source of inadequate availability of essential medicines and the presence of unaffordability was not investigated in Africa. Conclusion: Evidence suggests that even though, African countries show progress in coverage and affordability for some core essential medicines, it tills needs an effort to convey the WHO’s goal particularly for drugs of non-communicable disease. Future studies need to explore reasons for the persistent unavailability, unaffordability as well as high OOPs for medicines.

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 Availability, prices and affordability of essential medicines in Zhejiang Province, China

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241761
Author(s):  
Zuojun Dong ◽  
Qiucheng Tao ◽  
Bobo Yan ◽  
Guojun Sun
Keyword(s):  
Public Sector ◽  
Zhejiang Province ◽  
Essential Medicines ◽  
World Health ◽  
Price Ratio ◽  
Public And Private ◽  
The Public ◽  
The Mean ◽  
Daily Wage ◽  
Health Organization

Objective To evaluate the availability, prices, and affordability of essential medicines in Zhejiang Province, China. Methods The survey was carried out in Zhejiang Province in 2018 following the methodology of the World Health Organization (WHO) and Health Action International (HAI). This method is an international standard method.Data on 50 medicines were collected from public health facilities and private pharmacies. Medication prices were compared with international reference prices to obtain a median price ratio. The affordability of medicines was measured based on the daily wage of the lowest-paid unskilled government worker. In private pharmacies, the mean availability of Originator Brands (OBs) and Lowest-priced Generics (LPGs) was 36.7% and 40.3%, respectively. Findings The effects of the mean availability of OBs and LPGs were seen in private pharmacies. Correspondingly, the average availability of OBs and LPGs was 41.8% and 35.1% in the public sector, respectively. In the public sector, the median price ratios (MPRs) were 5.21 for generics and 13.49 for OBs. In the private sector, the MPRs were 4.94 for generics and 14.75 for OBs. Treating common diseases with LPGs was generally affordable, while treatment with OBs was less affordable. Conclusions In Zhejiang Province, low availability was observed for medicines surveyed in the public and private sectors. Price differences between originator brands and generics in both sectors are apparent. OBs were more expensive than LPGs in both the public and private sectors. Low availability affects access to essential medicines. Policy measures should be taken to improve the availability of essential medicines.

Adipositasprävention und non-communicable diseases

2012 ◽  
Vol 06 (04) ◽  
pp. 249-251
Author(s):  
M. Braun ◽  
J. Ried
Keyword(s):  
Communicable Diseases ◽  
World Health ◽  
Sich Eine ◽  
Non Communicable Diseases ◽  
World Health Assembly

ZusammenfassungDie 65. World Health Assembly hat die Bekämpfung nicht-übertragbarer Krankheiten in den Mittelpunkt globaler Aufmerksamkeit und Aktivität gerückt. Da Übergewicht bzw. Adipositas wesentliche Risikofaktoren für einen erheblichen Teil dieser Erkrankungen darstellen, kommt damit der Prävention (aber auch der Therapie) erhöhten Körpergewichtes in der Programmatik der WHO besondere Bedeutung zu. Gleichzeitig führen die hochgesteckten Ziele der WHO in das fundamentale Dilemma, dass es keine Instrumente gibt, die angestrebten Prävalenz- und Reduktionsraten im vorgegebenen Zeitrahmen zu erreichen. Daraus ergeben sich eine Reihe ethischer und sozialer Fragen, unter anderem nach dem zu Grunde gelegten Modell der Adipositas und den impliziten und expliziten Verantwortlichkeiten für ihre Bekämpfung.

Non-Communicable Diseases and Global Health Politics

2019 ◽  
pp. 626-659
Author(s):  
Roger Magnusson
Keyword(s):  
Respiratory Diseases ◽  
Communicable Diseases ◽  
World Health ◽  
Global Response ◽  
Non Communicable Diseases ◽  
Health Politics ◽  
Chronic Respiratory Diseases ◽  
Health Organization ◽  
High Level ◽  
And Control

Non-communicable diseases (NCDs), including cardiovascular disease, cancer, chronic respiratory diseases, and diabetes, are responsible for around 70 percent of global deaths each year. This chapter describes how NCDs have become prevalent and critically evaluates global efforts to address NCDs and their risk factors, with a particular focus on the World Health Organization (WHO) and United Nations (UN) system. It explores the factors that have prevented those addressing NCDs from achieving access to resources and a priority commensurate with their impact on people’s lives. The chapter evaluates the global response to NCDs both prior to and since the UN High-Level Meeting on Prevention and Control of Non-communicable Diseases, held in 2011, and considers opportunities for strengthening that response in future.

scholarly journals A Study on Service Availability and Readiness Assessment of Non-Communicable Diseases Using the WHO Tool for Gazipur District in Bangladesh

2016 ◽  
Vol 7 (2) ◽  
pp. 1-13 ◽  
Author(s):  
Mohammad Rashemdul Islam ◽  
Shamima Parvin Laskar ◽  
Darryl Macer
Keyword(s):  
Respiratory Disease ◽  
Chronic Respiratory Disease ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Essential Medicines ◽  
Service Availability ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Service Readiness

Non-communicable diseases (NCDs) disproportionately affect low and middle-income countries where nearly three quarters of NCD deaths occur. Bangladesh is also in NCD burden. This cross-sectional study was done on 50 health facilities centres at Gazipur district in Bangladesh from July 2015 to December 2015 to introduce SARA for better monitoring and evaluation of non-communicable diseases health service delivery. The General Service readiness index score was 61.52% refers to the fact that about 62% of all the facilities were ready to provide general services like basic amenities, basic equipment, standard precautions for infection prevention, and diagnostic capacity and essential medicines to the patients. But in case of non-communicable diseases, among all the health facilities 40% had chronic respiratory disease and cardiovascular diseases diagnosis/ management and only 32% had availability of diabetes diagnosis/management. Overall readiness score was 52% in chronic respiratory disease, 73% in cardiovascular disease and 70% in diabetes. Therefore, service availability and readiness of the health facilities to provide NCD related health services were not up to the mark for facing future targets.  A full-scale census survey of all the facilities of the study area would give a better understanding of the availability and service readiness.

scholarly journals Physical activity as a global risk factor for non-communicable diseases: time for action, what, why, when, who and how?

2016 ◽  
Vol 24 (1) ◽  
Author(s):  
E V Lambert
Keyword(s):  
Physical Activity ◽  
Salt Intake ◽  
Communicable Diseases ◽  
World Health ◽  
Global Risk ◽  
Dietary Salt ◽  
Discussion Paper ◽  
Non Communicable Diseases ◽  
Dietary Salt Intake ◽  
Health Organization

Chronic, non-communicable diseases (NCDs) account for more than two-thirds of global mortality, at least 50% of which is preventable on the basis of modifiable lifestyle behaviours. In the wake of the UN Global Summit on NCDs, the World Health Organization produced a discussion paper that emphasised the need for a global monitoring framework and voluntary global targets for the prevention and control of NCDs.1 The WHO discussion paper presents 10 suggested voluntary targets including the reduction in deaths due to NCDs, cardiovascular disease and diabetes, an overall reduction in blood pressure and obesity, as well as reduced smoking, alcohol and dietary salt intake, increased screening for cervical cancer and the elimination of trans-fats from the food supply. Physical activity is notable by its absence from this critical list of voluntary global targets for preventing and controlling NCDs

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