نتائج البحث - "Drugs, Essential"

1

An Arm and a Leg: The Rising Cost of Cancer Drugs and Impact on Access

المؤلفون: Natasha B. Leighl, Doreen A. Ezeife, Sharon Nirmalakumar, Bishal Gyawali

المصدر: American Society of Clinical Oncology Educational Book. :e1-e12

الوصف: Increasing cancer drug prices present global challenges to treatment access and cancer outcomes. Substantial variability exists in drug pricing across countries. In countries without universal health care, patients are responsible for treatment costs. Low- or middle-income countries are heavily impacted, with limited patient access to novel cancer treatments. Financial toxicity is seen across cancer types, countries, and health care systems. Those at highest risk include younger patients, new immigrants, visible minority groups, and those without private health coverage. Currently, cancer drug pricing does not correlate with value or clinical benefit. Value-based pricing of oncology drugs may incentivize development of higher-value medicines and eliminate excess spending on drugs that yield little benefit. Generics and biosimilars in oncology can also improve affordability and patient access, offering dramatic reductions in drug spending while maintaining patient benefit. Oncologists can promote value-based care by following evidence-based clinical guidelines that avoid low-value treatments. Researchers can also engage in value-based research that critically explores optimal cancer drug dosing, schedules, and treatment duration and defines patient populations most likely to benefit (e.g., through biomarker selection). Cancer Groundshot proposes that we improve outcomes for today's patients with cancer, including broader global access for high-value treatments, promotion of affordable cancer control strategies, and reduction of cancer morbidity and mortality through low-cost prevention and screening initiatives. Moving forward, major oncology societies recommend promoting uniform global access to essential cancer medicines and avoiding financial harm for patients as key principles in addressing the affordability of cancer drugs.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a726e78780cb208a75fdbcbd8b98a758
https://doi.org/10.1200/edbk_100028

2

Forecasting essential childhood cancer drug need: An innovative model‐based approach

المؤلفون: Sumit Gupta, Anita K. Wagner, Brianna Empringham, Zachary J. Ward, A. Lindsay Frazier, Avram Denburg, Terence M. Hughes, Jennifer M. Yeh

المصدر: Cancer. 127:2990-3001

الوصف: Background Childhood cancer outcomes in low-income and middle-income countries have not kept pace with advances in care and survival in high-income countries. A contributing factor to this survival gap is unreliable access to essential drugs. Methods The authors created a tool (FORx ECAST) capable of predicting drug quantity and cost for 18 pediatric cancers. FORx ECAST enables users to estimate the quantity and cost of each drug based on local incidence, stage breakdown, treatment regimen, and price. Two country-specific examples are used to illustrate the capabilities of FORx ECAST to predict drug quantities. Results On the basis of domestic public-sector price data, the projected annual cost of drugs to treat childhood cancer cases is 0.8 million US dollars in Kenya and 3.0 million US dollars in China, with average median price ratios of 0.9 and 0.1, respectively, compared with costs sourced from the Management Sciences for Health (MSH) International Medical Products Price Guide. According to the cumulative chemotherapy cost, the most expensive disease to treat is acute lymphoblastic lymphoma in Kenya, but a higher relative unit cost of methotrexate makes osteosarcoma the most expensive diagnosis to treat in China. Conclusions FORx ECAST enables needs-based estimates of childhood cancer drug volumes to inform health system planning in a wide range of contexts. It is broadly adaptable, allowing decision makers to generate results specific to their needs. The resultant estimates of drug need can help equip policymakers and health governance institutions with evidence-informed data to advance innovative procurement strategies that drive global improvements in childhood cancer drug access.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b7afa304cc2882c8db747a643a288f7e
https://doi.org/10.1002/cncr.33568

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3

Access to essential anticancer medicines for children and adolescents in Europe

المؤلفون: Karsten Nysom, Pamela Kearns, S. Griskjane, Gilles Vassal, G. Bricalli, L. Kameric, F. Arnold, Anita Kienesberger, S. Kamal, Olga Kozhaeva, Nicola Jane Latino, N. Cherny, L. Basset

المصدر: RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
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مصطلحات موضوعية: Adult, 0301 basic medicine, MECANICA DE LOS MEDIOS CONTINUOS Y TEORIA DE ESTRUCTURAS, 10.- Reducir las desigualdades entre países y dentro de ellos, medicine.medical_specialty, Adolescent, Public policy, Organizational model, Pharmacist, Economic shortage, Medical Oncology, Health Services Accessibility, World health, Essential medicines, 03 medical and health sciences, 0302 clinical medicine, Neoplasms, Anticancer medication, 03.- Garantizar una vida saludable y promover el bienestar para todos y todas en todas las edades, Humans, Medicine, Child, Paediatric oncology, business.industry, Infant, Newborn, Infant, Out-of-pocket, Hematology, Pain management, Europe, 030104 developmental biology, Clinical research, Oncology, Child, Preschool, 030220 oncology & carcinogenesis, Family medicine, Health Expenditures, Medication shortage, Drugs, Essential, business

الوصف: [EN] Background: Essential anticancer medicines are an indispensable component of multidisciplinary treatment of paediatric malignancies. A European Society for Medical Oncology (ESMO) study reported inequalities in the availability of anticancer medicines for adult solid tumours and provided a model for the present survey. The aim of this survey was to assess the accessibility of essential medicines used in paediatric cancer patients aged 0 to 18 years across Europe from 2016 to 2018. Methods: A list of medicines was drawn with input from the European Society for Paediatric Oncology (SIOP Europe) Clinical Research Council referring to the World Health Organization Model List of Essential Medicines for Children (WHO EMLc) 2017. A survey was sent to nominated national clinician and pharmacist rapporteurs and parent associations in up to 37 countries; answers were obtained from 34 countries. Results: The full survey list contained 68 medicines, including 24 on the WHO EMLc 2017. Health professionals reported that 35% of all medicines were prescribed off-label in at least one country and that 44% were always available in >90% of countries. Only 63% of the EMLc 2017 medicines were reported as always available. The main determinant of unavailability was shortages, reported for 72% of medicines in at least one country. Out-of-pocket costs were reported in eight countries. Twenty-seven percent of orally administered medicines were never available in childfriendly formulations. Parents detailed individual efforts and challenges of facilitating ingestion of oral medicines as prescribed. Inequalities in access to pain control during procedures were reported by parents across Europe. Conclusions: Children and adolescents with cancer in Europe experience lack of access to essential medicines. Urgent actions are needed to address shortages, financial accessibility, availability of safe age-appropriate oral formulations, and pain management across Europe.
This work was supported by the EU Health Programme (2014-2020) in the framework of the Joint Action on Rare Cancers [grant number 724161/JARC].

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URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9f71b35b522b5be1e834fe003dd4d82e
https://doi.org/10.1016/j.annonc.2020.12.015

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Can we achieve affordable cancer medicine prices? Developing a pathway for change

المؤلفون: Sabine Vogler

المصدر: Expert Review of Pharmacoeconomics & Outcomes Research. 21:321-325

مصطلحات موضوعية: 030503 health policy & services, Health Policy, Antineoplastic Agents, Financial system, General Medicine, Transparency (behavior), Drug Costs, 03 medical and health sciences, 0302 clinical medicine, Cancer Medicine, Neoplasms, Sustainability, Costs and Cost Analysis, Humans, Pharmacology (medical), 030212 general & internal medicine, Business, Drugs, Essential, 0305 other medical science

الوصف: Cancer patients face high financial burden in many low- and middle-income countries but also in high-income countries such as the US [1]. Large price variations have been identified between countri...

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5eb7b9bf028b4c3f8f13e48b481cf735
https://doi.org/10.1080/14737167.2021.1898951

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Strategies to improve the availability of medicines in primary health care in Brazil: findings and implications

المؤلفون: Renata Crm Nascimento, Mariana Michel Barbosa, Juliana Alvares-Teodoro, Brian Godman, Augusto Afonso Guerra, Francisco de Assis Acurcio, Marina Morgado Garcia

المصدر: Journal of Comparative Effectiveness Research. 10:243-253

الوصف: Aim: Access to essential medicines is a key component of managing patients in ambulatory care. In 2008, the State of Minas Gerais, Brazil, created the Pharmacy Network of Minas (Rede Farmácia de Minas [RFM]) program to improve access to medicines, increasing availability and restructuring the infrastructures. The aim was to assess the current situation, comparing municipalities with and without RFM. Materials & methods: Descriptive survey study, data collected from 2014 July to May 2015. Availability was verified by stock levels. Results: The drug availability index was 61.0%, higher in municipalities with RFM. Most physicians considered the pharmaceutical services as good/very good. The main reasons for medicines shortage were ‘financial transference problems’, ‘insufficient financial resources’ and ‘budget’. Conclusion: Strategies, such as the RFM can promote improvements in medicine availability.

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URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2e134f26bb3d01bb09f7d028e7ed4da5
https://doi.org/10.2217/cer-2020-0125

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6

Availability of diagnostic services and essential medicines for non‐communicable respiratory diseases in African countries

المؤلفون: Karen Bissell, B O Ozoh, Kevin Mortimer, M Stolbrink, C Plum, L Zurba

المصدر: INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE

الوصف: BACKGROUND: The global burden of disease due to asthma and chronic obstructive pulmonary disease (COPD) is substantial and particularly great in low‐ and middle‐income countries, including many African countries. Management is affected by availability of diagnostic tests and essential medicines. The study aimed to explore the availability of spirometry services and essential medicines for asthma and COPD in African countries.METHOD: Questionnaires were delivered to healthcare workers at the annual meeting of the Pan African Thoracic Society Methods in Epidemiology and Clinical Research (PATS MECOR) and International Multidisciplinary Programme to Address Lung Health and TB in Africa (IMPALA). Data were analysed using simple descriptive statistics.RESULTS: A total of 37 questionnaires representing 13 African countries were returned. Spirometry availability was 73.0%. The most common reasons for non‐availability were lack of knowledge of the utility of the test. Within the study sample, 33.3% faced sporadic availability due to maintenance issues. Essential medicines availability ranged from 37.8% for inhaled corticosteroid‐long‐acting beta‐agonist inhalers to 100% for prednisolone 5 mg tablets, mainly due to supply chain problems.CONCLUSION: There is varied availability of spirometry and WHO essential medicines for COPD and asthma in African countries. Strategies are needed to improve access to basic effective care for people with non‐communicable lung disease in Africa.

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URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4f8a05da4b3ba9c8094c8682d40ea81d
https://doi.org/10.5588/ijtld.20.0762

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Effects of restrictive reimbursement on the prescribing and expenditures on non-essential lipid-lowering drugs

المؤلفون: Thananan Rattanachotphanit, Cheardchai Soontornpas, Chulaporn Limwattananon, Noppakun Thammatacharee, Onanong Waleekhachonloet

المصدر: Research in Social and Administrative Pharmacy. 16:1664-1669

الوصف: Background The rapid cost escalation of the government employee scheme in Thailand was driven by the overprescription of non-essential drugs (NEDs), which were not listed in the National Lists of Essential Medicines. A restrictive reimbursement policy implemented in October 2012 required prescribers to base the prescription of NEDs on six criteria, including A and B for safety, C for effectiveness, D for availability, and E and F for costs, hence known as the A-F policy. Objective The A-F policy was examined in terms of its outcomes regarding the prescription volume and reimbursement expenditure for lipid-lowering drugs (LLDs). Methods Data on LLD prescription in 2012–2015 from outpatient settings in 29 public hospitals were standardized using quantities based on the World Health Organization's Anatomical, Therapeutic and Chemical (ATC) classification and the defined daily dose (DDD) system. The policy effects were estimated using an interrupted time-series analysis. Results The restrictive reimbursement policy decreased both the prescription volume and the reimbursement value of non-essential LLDs. Within the first month of policy implementation, the percentage of NEDs, as defined by DDDs and reimbursement expenditure, immediately decreased by 15.1 and 15.2% points in provincial hospitals and by 8.3 and 4.4% points in military hospitals, respectively. The prescription of NEDs continued to decrease thereafter, despite there being no statistically significant changes in the trend of decreased prescribing compared with the prepolicy period. The decrease in the prescription of NEDs resulted in the declining reimbursed amount per day and stable expenditure of LLDs as a whole. Conclusion The effectiveness on the A-F restrictive reimbursement on NED prescribing helped stabilize the expenditure on LLDs.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fafba5de7666d3006d664a74fc82feaf
https://doi.org/10.1016/j.sapharm.2020.02.017

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Appropriate use of essential medicines in the elderly: a comparison of the WHO essential medicines list and PIM criteria

المؤلفون: Xuxu Yin, Meng Li, Wei Liu, Xin Ma, Yanwen Wang, Hongxia Xin

المصدر: European Journal of Clinical Pharmacology. 77:509-516

الوصف: The elderly are not only threatened by bad medicines (overtreatment) but also by undertreatment with “good” medicines. Symmetry is required in any patient-centred approach to properly treat older people. The purpose of this study was to perfect the development of an EML and criteria according to the advantages of each and promote the appropriate use of essential medicines in the elderly. We compared the EML with four PIM criteria and calculated the proportion of essential medicines included in the criteria. We also summarized the rationale for including medicines in each criterion and analysed higher risk drugs and drug risks. Of essential medicines, 26% are included in at least one criterion as PIM. In 11 drug categories of the EML, more than 50% of drugs of each category are included in at least one criterion, and in four categories, all drugs are included. The potentially inappropriate essential medicines (PIEMs) for the elderly focus on cardiovascular drugs and central nervous system drugs. Fifty-nine drugs have been explicitly identified as increasing the risk of falls, increasing mortality and/or having inappropriate long-term use, and the main risk of PIEMs is falls (30.3% of PIEMs). Additionally, 17.9% of essential medicines are labelled as positive drugs in START and/or FORTA (A/B). Improving medication information for the elderly in the EML and establishing an essential medicines list for the elderly will promote appropriate drug use in older people worldwide.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::513a94fb9c45d34df13d18594e9119e9
https://doi.org/10.1007/s00228-020-03038-0

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9

Availability, price and affordability of essential medicines for managing cardiovascular diseases and diabetes: a statewide survey in Kerala, India

المؤلفون: Sandra Puthean, Jereena E, Muhammed Ansil T P, Gautam Satheesh, Shiva Raj Mishra, Abhishek Sharma, Mazhuvancherry Kesavan Unnikrishnan

المصدر: Tropical Medicine & International Health. 25:1467-1479

الوصف: Limited access to essential medicines (EMs) for cardiovascular disease (CVD) and diabetes is a major concern in low- and middle-income countries. We aimed to generate data on availability, price and affordability of EMs for CVD and diabetes in India.Using WHO/HAI survey methodology, we evaluated availability and prices of 23 EMs in 30 public sector facilities (government hospitals and semi-public/government-subsidised-discount-pharmacies (GSDPs)) and 60 private retail pharmacies across six districts in Kerala state, India (November 2018 - May 2019). Median Price Ratios (MPRs) were calculated by comparing consumer prices with international reference prices. We also analysed data (collected in July 2020) on six anti-hypertensive fixed-dose-combinations (FDCs) that were designated as 'essential' by the WHO in 2019.Mean availability of surveyed generic EMs was 45.7% in government hospitals, 64.7% in GSDPs and 72.0% in private retail pharmacies. On average, the most-sold and highest-priced generics, respectively, were 6.6% and 8.9% costlier than the lowest-priced generics (LPG). Median MPR for LPG was 2.71 in private retail and 2.25 in GSDPs. Monthly supply of LPG would cost the lowest-paid worker 1.11 and 0.79 days' wages in private retail and GSDPs, respectively. Mean availability of the surveyed FDCs was poor (private retail: 15-85%; GSDPs: 8.3-66.7%), and the private retail prices of FDCs were comparable to the sum of corresponding constituent monotherapies.Availability of CVD and diabetes EMs fall short of WHO's 80% target in both sectors. Although availability in the private retail pharmacies was near-optimal, prices appear unaffordable compared to GSDPs. Initiatives such as mandating generic prescribing, adding the WHO-approved FDCs in local EM lists, improving price transparency, and streamlining medicine supply to ensure equitable access to EMs, especially in the public sector, are crucial in tackling Kerala's ever-increasing CVD burden.L'accès limité aux médicaments essentiels (ME) pour les maladies cardiovasculaires (MCV) et le diabète est une préoccupation majeure dans les pays à revenu faible et intermédiaire. Nous visions à générer des données sur la disponibilité, le prix et l'aspect abordable des ME pour les MCV et le diabète en Inde. MÉTHODES: En utilisant la méthodologie OMS/HAI, nous avons évalué la disponibilité et les prix de 23 ME dans 30 établissements du secteur public (hôpitaux publics et pharmacies semi-publiques/à discompte subventionnées par le gouvernement (GSDP)) et 60 pharmacies de détail privées dans 6 districts de l’Etat du Kerala, en Inde. Les ratios de prix médians (RPM) ont été calculés en comparant les prix des consommateurs aux prix de référence internationaux. Nous avons également analysé les données de six combinaisons à dose fixe (CDF) d’antihypertensives désignées ''essentielles'' par l'OMS en 2019. RÉSULTATS: La disponibilité moyenne des ME génériques étudiés était de 45,7% dans les hôpitaux publics, de 64,7% dans les GSDP et de 72,0% dans le commerce de détail privé. En moyenne, les génériques les plus vendus et les plus chers, respectivement, étaient de 6,6% et 8,9% plus chers que les génériques les moins chers (GMC). Le RPM pour les (GMC) était de 2,71 dans le secteur privé et de 2,25 dans les GSDP. L'approvisionnement mensuel en GMC coûterait au travailleur le moins payé le salaire de 1,11 et 0,79 jour de travail dans le secteur de la vente au détail privé et dans les GSDP, respectivement. La disponibilité moyenne des CDF était faible (vente au détail privée: 15% - 85%; GSDP: 8,3%-66,7%), avec des prix de détail privés comparables à la somme des monothérapies constituantes correspondantes.La disponibilité des ME pour les MCV et le diabète est inférieure à l'objectif de 80% de l'OMS dans les deux secteurs. Bien que la disponibilité dans les pharmacies de détail privées soit presque optimale, les prix semblent inabordables par rapport aux GSDP. Des initiatives telles que la prescription de médicaments génériques, l'inscription des CDF sous ME, l'amélioration de la transparence des prix, la rationalisation de l'approvisionnement en médicaments pour assurer un accès équitable aux ME, en particulier dans le secteur public, sont essentielles pour faire face à la charge toujours croissante des MCV dans le Kerala.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3453f4ca50acba71b362cfc4342461f4
https://doi.org/10.1111/tmi.13494

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10

Essential Diabetes Medicines and Health Outcomes in 127 Countries

المؤلفون: Darshanand Maraj, Nav Persaud, Dalton R. Budhram, Ri Wang, Krish Bilimoria, Simran Benipal

المصدر: Canadian Journal of Diabetes. 46:S4

الوصف: Aim Diabetes is the ninth leading cause of death. Improving access to diabetes medicines may decrease mortality. Diabetes medicines on national essential medicines lists (NEMLs) vary considerably. We examine the association between diabetes population health outcomes, relating to mortality, and the listing of diabetes medicines on national essential medicine lists for 127 countries. Materials and methods We conducted a cross-sectional study. We determined the number of diabetes medicines on NEMLs and used multiple linear regression to analyze the association between diabetes health outcomes and the number of medicines on NEMLs. We used linear regression to assess the association between diabetes health outcomes and the listing or not listing of medicines that were listed by 25% to 75% of countries. Diabetes prevalence, gross domestic product (GDP) per capita and mean expenditure per person with diabetes were controlled for in all analyses. Results The total number of diabetes medicines listed on NEMLs ranged from 0 to 16 (median: 4; interquartile range: 3 to 6). Diabetes health outcome scores were associated with the number of diabetes medicines on NEMLs (1·3-point increase [95% Confidence Interval, 95% CI 0·5-2·1] for every additional medicine on NEMLs; p = 0·002) and GDP per capita (19·5-point increase [95% CI 5·4 to 33·6] for every 10-fold increase in GDP; p = 0·003). Diabetes expenditure was not associated with health outcome scores (p = 0·23). Increases in diabetes health outcomes score were associated with the listing of glimepiride (7·9-point increase 95% CI 2·3-13·5, p = 0.006) and glipizide (5·8-point increase 95% CI 0·03-11·6, p = 0·049) on NEMLs. Conclusions Listing of diabetes medicines on NEMLs has the potential to improve population health outcomes related to mortality in countries with diverse incomes and diabetes prevalence without necessarily increasing diabetes health expenditure. This article is protected by copyright. All rights reserved.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f20ecac0459b26967b3c5616820f9892
https://doi.org/10.1016/j.jcjd.2022.09.011

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