دورية أكاديمية
أعرض في EDS

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

التفاصيل البيبلوغرافية
العنوان: Availability, price and affordability of essential medicines for managing cardiovascular diseases and diabetes: a statewide survey in Kerala, India.
المؤلفون: Satheesh G; Department of Pharmacy Practice, National College of Pharmacy, Kozhikode, India.; The George Institute for Global Health, Hyderabad, India., Sharma A; Department of Global Health, Boston University School of Public Health, Boston, MA, USA.; PRECISIONheor, Precision Value & Health, Boston, MA, USA.; World Heart Federation, Salim Yusuf Emerging Leaders Programme, Geneva, Switzerland., Puthean S; Department of Pharmacy Practice, National College of Pharmacy, Kozhikode, India., Ansil T P M; Department of Pharmacy Practice, National College of Pharmacy, Kozhikode, India., E J; Department of Pharmacy Practice, National College of Pharmacy, Kozhikode, India., Raj Mishra S; World Heart Federation, Salim Yusuf Emerging Leaders Programme, Geneva, Switzerland.; Nepal Development Society, Bharatpur, Nepal., Unnikrishnan MK; Department of Pharmacy Practice, National College of Pharmacy, Kozhikode, India.
المصدر: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2020 Dec; Vol. 25 (12), pp. 1467-1479. Date of Electronic Publication: 2020 Nov 03.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 9610576 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-3156 (Electronic) Linking ISSN: 13602276 NLM ISO Abbreviation: Trop Med Int Health Subsets: MEDLINE
أسماء مطبوعة: Publication: Oxford : Blackwell Scientific Publications
Original Publication: Oxford, UK : Blackwell Science Ltd, c1996-
مواضيع طبية MeSH: Cardiovascular Agents/*economics , Cardiovascular Diseases/*economics , Diabetes Mellitus/*economics , Drugs, Essential/*economics , Health Services Accessibility/*economics , Hypoglycemic Agents/*economics, Cardiovascular Agents/therapeutic use ; Cardiovascular Diseases/drug therapy ; Costs and Cost Analysis ; Cross-Sectional Studies ; Diabetes Mellitus/drug therapy ; Drugs, Generic/economics ; Hospitals, Public ; Humans ; Hypoglycemic Agents/therapeutic use ; India ; Pharmacies ; Private Sector ; Public Sector
مستخلص: Objective: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
(© 2020 John Wiley & Sons Ltd.)
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فهرسة مساهمة: Keywords: India; access to medicines; cardiovascular disease; diabetes; essential medicines
Local Abstract: [Publisher, French] 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. [Publisher, French] 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.
المشرفين على المادة: 0 (Cardiovascular Agents)
0 (Drugs, Essential)
0 (Drugs, Generic)
0 (Hypoglycemic Agents)
تواريخ الأحداث: Date Created: 20200922 Date Completed: 20210422 Latest Revision: 20210422
رمز التحديث: 20231215
DOI: 10.1111/tmi.13494
PMID: 32959441
قاعدة البيانات: MEDLINE
الوصف
تدمد:1365-3156
DOI:10.1111/tmi.13494