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.

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 Price, availability and affordability of medicines

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Brenda S. Mhlanga ◽  
Fatima Suleman
Keyword(s):  
Supply Chain ◽  
Public Sector ◽  
Low Income ◽  
Essential Medicines ◽  
World Health ◽  
Middle Income ◽  
Originator Brand ◽  
Private And Public ◽  
Daily Wage ◽  
Health Organization

Background: Medicines play an important role in healthcare, but prices can be a barrier to patient care. Few studies have looked at the prices of essential medicines in low- and middle-income countries in terms of patient affordability.Aim: To determine the prices, availability and affordability of medicines along the supply chain in Swaziland.Setting: Private- and public-sector facilities in Manzini, Swaziland.Methods: The standardised methodology designed by the World Health Organization and Health Action International was used to survey 16 chronic disease medicines. Data were collected in one administrative area in 10 private retail pharmacies and 10 public health facilities. Originator brand (OB) and lowest-priced generic equivalent (LPG) medicines were monitored and these prices were then compared with international reference prices (IRPs). Affordability was calculated in terms of the daily wage of the lowest-paid unskilled government worker.Results: Mean availability was 68% in the public sector. Private sector OB medicines were priced 32.4 times higher than IRPs, whilst LPGs were 7.32 times higher. OBs cost473% more than LPGs. The total cumulative mark-ups for individual medicines range from 190.99% – 440.27%. The largest contributor to add-on cost was the retail mark-up (31% – 53%). Standard treatment with originator brands cost more than a day’s wage.Conclusion: Various policy measures such as introducing price capping at all levels of the medicine supply chain, may increase the availability, whilst at the same time reducing the prices of essential medicines for the low income population.

scholarly journals Evaluating essential medicines for treating childhood cancers: availability, price and affordability study in Ghana

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kofi Boamah Mensah ◽  
Adwoa Bemah Boamah Mensah ◽  
Varsha Bangalee ◽  
Neelaveni Padayachee ◽  
Frasia Oosthuizen
Keyword(s):  
Low Income ◽  
Tertiary Hospital ◽  
Essential Medicines ◽  
World Health ◽  
Unskilled Worker ◽  
Price Ratio ◽  
Childhood Cancers ◽  
The Mean ◽  
The Government ◽  
Health Organization

Abstract Introduction Access to childhood cancer medicines is a critical global health challenge. There is a lack of sufficient context-specific data in Ghana on access to essential medicines for treating childhood cancers. Here, we present an analysis of essential cancer medicine availability, pricing, and affordability using the pediatric oncology unit of a tertiary hospital as the reference point. Method Data on prices and availability of 20 strength-specific essential cancer medicines and eight non-cancer medicines were evaluated using the modified World Health Organization (WHO)/Health Action International method. Two pharmacies in the hospital and four private pharmacies around the hospital were surveyed. We assessed their median price ratio using the WHO international reference price guide. The number of days wages per the government daily wage salary was used to calculate the affordability of medicines. Results The mean availability of essential cancer medicines and non-cancer medicines at the hospital pharmacies were 27 and 38% respectively, and 75 and 84% respectively for private pharmacies. The median price ratio of cancer medicines was 1.85, and non-cancer medicines was 3.75. The estimated cost of medicines for treating a 30 kg child with Acute lymphoblastic leukaemia was GHȻ 4928.04 (US$907.56) and GHȻ 4878.00 (US$902.62) for Retinoblastoma, requiring 417 and 413-days wages respectively for the lowest-paid unskilled worker in Ghana. Conclusion The mean availability of cancer medicines at the public and private pharmacies were less than the WHO target of 80%. The median price ratio for cancer and non-cancer medicines was less than 4, yet the cost of medicines appears unaffordable in the local setting. A review of policies and the establishment of price control could improve availability and reduce medicines prices for the low-income population.

scholarly journals Change in affordability of medications in Kazan in 2011 and 2015 as a reflection of state initiatives to regulate drug prices

2017 ◽  
Vol 98 (5) ◽  
pp. 822-826 ◽  
Author(s):  
Ch M Razzakova ◽  
L E Ziganshina
Keyword(s):  
Comparative Analysis ◽  
Generic Drugs ◽  
World Health ◽  
Price Ratio ◽  
Public And Private ◽  
Drug Prices ◽  
State Initiatives ◽  
Health Action ◽  
Medicine Prices ◽  
Health Organization

Aim. Performing comparative analysis of drug prices in 2011 and 2015 in Kazan to assess the effectiveness of state initiatives to ensure the affordability of medicines. Methods. The collection and processing of data was performed according to methodology developed by Health Action International and World Health Organization (WHO/HAI). We studied the availability and prices of 30 medicines in public and private pharmacies in Kazan in 2011 and 2015 and analyzed the procurement prices of the same medicines in inpatient hospitals. Recording and analysis were performed using standardized MS Excel WHO/HAI Workbook. Medicine prices were compared with international reference prices and were expressed as median price ratio. Results. The analysis showed a decrease in medicine prices in 2015 compared to 2011. In public and private sectors median price ratio of the originator brands reduced by about 3 times, and of the lowest price generics reduced by 1.5 times. A decrease in procurement prices by more than 2 times for generics and more than 6 times for the original brands was also revealed in 2015 in comparison with 2011. Conclusion. State initiatives to regulate drug prices contributed to the price reduction by 1.5-3 times in 2015 compared to 2011; changes in the procedures for the medicines procurement at the legislative level resulted in reduction of procurement prices by more than 2 times for generic drugs in 2015 compared to 2011.

scholarly journals Market penetration of Xpert MTB/RIF in high tuberculosis burden countries: A trend analysis from 2014 - 2016

2018 ◽  
Vol 2 ◽  
pp. 35 ◽  
Author(s):  
Danielle Cazabon ◽  
Tripti Pande ◽  
Sandra Kik ◽  
Wayne Van Gemert ◽  
Hojoon Sohn ◽  
...  
Keyword(s):  
Public Sector ◽  
World Health ◽  
Sputum Smear ◽  
Positive Trend ◽  
Market Penetration ◽  
The Public ◽  
Control Programs ◽  
Full Capacity ◽  
Health Organization ◽  
Roll Out

Background: Xpert® MTB/RIF, a rapid tuberculosis (TB) molecular test, was endorsed by the World Health Organization in 2010. Since then, 34.4 million cartridges have been procured under concessional pricing. Although the roll out of this diagnostic is promising, previous studies showed low market penetration. Methods: To assess 3-year trends of market penetration of Xpert MTB/RIF in the public sector, smear and Xpert MTB/RIF volumes for the year 2016 were assessed and policies from 2014-2016 within 22 high-burden countries (HBCs) were studied. A structured questionnaire was sent to representatives of 22 HBCs. The questionnaires assessed the total smear and Xpert MTB/RIF volumes, number of modules and days of operation of GeneXpert machines in National TB Programs (NTPs). Data regarding the use of NTP GeneXpert machines for other diseases and GeneXpert procurement by other disease control programs were collected. Market penetration was estimated by the ratio of total sputum smear volume for initial diagnosis divided by the number of Xpert MTB/RIF tests procured in the public sector. Results: The survey response rate was 21/22 (95%). Smear/Xpert ratios decreased in 17/21 countries and increased in four countries, since 2014. The median ratio decreased from 32.6 (Q1:14.3, Q3: 58.9) in 2014 to 6.0 (Q1: 1.6, Q3: 17.0) in 2016. Nineteen countries (19/19; 100%) were not using GeneXpert machines to their full capacity, however seven countries (7/19; 37%) were running tests for other diseases on their NTP-procured GeneXpert systems in 2017, such as HIV, hepatitis-C virus (HCV), Chlamydia trachomatis, and Neisseria gonorrhoeae. Five (5/15; 33%) countries reported GeneXpert procurement by HIV or HCV programs in 2016 and/or 2017. Conclusions: Our results show a positive trend for Xpert MTB/RIF market penetration in 21 HBC public sectors. However, GeneXpert machines were under-utilized for TB, and inadequately exploited as a multi disease technology.

scholarly journals Availability of WHO Essential Medicines for Cancer Treatment in Botswana

2018 ◽  
pp. 1-8
Author(s):  
Yehoda M. Martei ◽  
Sebathu Chiyapo ◽  
Surbhi Grover ◽  
Doreen Ramogola-Masire ◽  
Scott Dryden-Peterson ◽  
...  
Keyword(s):  
Public Sector ◽  
Treatment Guidelines ◽  
Essential Medicines ◽  
Price Ratio ◽  
Cancer Drugs ◽  
African Region ◽  
The Public ◽  
Essential Medicines List ◽  
Chemotherapy Drugs ◽  
Using Data

Purpose Stock outs of cancer drugs are potentially fatal but have not been systematically studied in low- and middle-income countries. The aim of this study was to determine the availability and alignment of the Botswana National Essential Medicines List (NEML) for cancer drugs with the WHO’s Essential Medicines List (EML). Methods The availability and cost of cancer drugs were analyzed using data from a weekly stock catalog sent by Botswana’s Central Medical Store to all pharmacy departments in government hospitals. Comparative data were extracted from the WHO EML and the “International Drug Price Indicator Guide-2014” from the Management Sciences for Health. Interviews with key informants were used to collect data on the Botswana NEML and the drug supply chain in the public sector. Results The 2015 Botswana NEML for cancer had 80.5% alignment with the WHO EML. At least 40% of essential drugs were out of stock for a median duration of 30 days in 2015. Stock outs affected chemotherapy drugs included in first-line regimens for treating potentially curable diseases such as cervical, breast, and colorectal cancer and were not associated with buyer price of therapy. Analyses showed that the median price ratio for procured drugs was greater than 1 for 61% of the NEML drugs, which suggests inefficiency in procurement in the public sector. Conclusions Botswana has one of the highest alignments of NEML to the WHO EML in the sub-Saharan African region, which is consistent with investment in the health care system evident in other clinical spheres. Better quantification of chemotherapy requirements using data from the National Cancer Registry and resource-sensitive treatment guidelines can help reduce stock outs and facilitate more effective and efficient procurement processes.

scholarly journals Availability of Essential Medicines in a Country in Conflict: A Quantitative Insight from Yemen

2020 ◽  
Vol 18 (1) ◽  
pp. 175
Author(s):  
Mohamed Izham Mohamed Ibrahim ◽  
Mohammed Alshakka ◽  
Nazeh Al-abd ◽  
Awsan Bahattab ◽  
Wafa Badulla
Keyword(s):  
Essential Medicines ◽  
World Health ◽  
Private Hospitals ◽  
Public And Private ◽  
Middle Income ◽  
Short Supply ◽  
Healthcare Facilities ◽  
Private Healthcare ◽  
Healthcare Settings ◽  
Health Organization

Background: Medicine and medical supplies are often in short supply in countries suffering from the scourge of conflict. Effective medicine supply policies are lacking in many low- and middle-income countries (LMICs), particularly during conflict. This study aimed to assess the availability of essential medicines in both the public and private healthcare sectors. Methods: The study was conducted by administering a survey from November 2017 to February 2018 using the World Health Organization/Health Action International (WHO/HAI) guidelines and methodology. Thirty healthcare facilities in thirteen districts from three governorates in Yemen were included in the assessment of thirty essential medicines. The results were reported as frequencies and percentages of outlets with available medicines on the day of data collection. Results: A set of 30 vital and essential medicines were selected from the list of essential medicines that are used in healthcare centers in Yemen to treat prevalent diseases. In general, only 52.8% of the selected medicines were available in public and private healthcare settings. The distribution and availability of medicines in the three governorates were approximately equal. The availability of medicines was better in the private healthcare settings, specifically 73.3% in private hospitals and approximately 79.7% in private pharmacies. Conclusions: The availability of essential medicines during this state of conflict in three governorates in Yemen is low, in both public and private hospitals and healthcare centers. Many of the medications that were not available are used to treat chronic illnesses.

scholarly journals Availability, prices, and affordability of selected essential cancer medicines in a middle-income country – the case of Mexico

2019 ◽  
Author(s):  
Daniela Moye-Holz ◽  
Margaret Ewen ◽  
Anahi Dreser ◽  
Sergio Bautista-Arredondo ◽  
Rene Soria-Saucedo ◽  
...  
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Public Hospitals ◽  
World Health ◽  
Public And Private ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Public And Private Sector

Abstract Background: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO’s Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People’s Health Insurance” were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization’s 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.

scholarly journals Market penetration of Xpert MTB/RIF in high tuberculosis burden countries: A trend analysis from 2014 - 2016

2018 ◽  
Vol 2 ◽  
pp. 35 ◽  
Author(s):  
Danielle Cazabon ◽  
Tripti Pande ◽  
Sandra Kik ◽  
Wayne Van Gemert ◽  
Hojoon Sohn ◽  
...  
Keyword(s):  
Public Sector ◽  
World Health ◽  
Sputum Smear ◽  
Positive Trend ◽  
Market Penetration ◽  
The Public ◽  
Control Programs ◽  
Health Organization ◽  
Roll Out ◽  
Structured Questionnaire

Background: Xpert® MTB/RIF, a rapid tuberculosis (TB) molecular test, was endorsed by the World Health Organization in 2010. Since then, 34.4 million cartridges have been procured under concessional pricing. Although the roll out of this diagnostic is promising, previous studies showed low market penetration. Methods: To assess 3-year trends of market penetration of Xpert MTB/RIF in the public sector, smear and Xpert MTB/RIF volumes for the year 2016 were evaluated and policies from 2014-2016 within 22 high-burden countries (HBCs) were studied. A structured questionnaire was sent to representatives of 22 HBCs. The questionnaires assessed the total smear and Xpert MTB/RIF volumes, number of modules and days of operation of GeneXpert machines in National TB Programs (NTPs). Data regarding the use of NTP GeneXpert machines for other diseases and GeneXpert procurement by other disease control programs were collected. Market penetration was estimated by the ratio of total sputum smear volume for initial diagnosis divided by the number of Xpert MTB/RIF tests procured in the public sector. Results: The survey response rate was 21/22 (95%). Smear/Xpert ratios decreased in 17/21 countries and increased in four countries, since 2014. The median ratio decreased from 32.6 (IQR: 44.6) in 2014 to 6.0 (IQR: 15.4) in 2016. In 2016, the median GeneXpert utilization was 20%, however seven countries (7/19; 37%) were running tests for other diseases on their NTP-procured GeneXpert systems in 2017, such as HIV, hepatitis-C virus (HCV), Chlamydia trachomatis, and Neisseria gonorrhoeae. Five (5/15; 33%) countries reported GeneXpert procurement by HIV or HCV programs in 2016 and/or 2017. Conclusions: Our results show a positive trend for Xpert MTB/RIF market penetration in 21 HBC public sectors. However, GeneXpert machines were under-utilized for TB, and inadequately exploited as a multi disease technology.

scholarly journals Barreras de acceso geográfico a los servicios de salud oral en el departamento del Tolima, Colombia.

Tequio ◽  
2021 ◽  
Vol 4 (12) ◽  
pp. 5-24
Author(s):  
John Harold Estrada Montoya ◽  
Laura Camila Reyes Cañón
Keyword(s):  
Public Sector ◽  
Public Transport ◽  
World Health ◽  
Dental Services ◽  
Cross Sectional ◽  
The Public ◽  
Geographical Access ◽  
General Dentists ◽  
Health Organization ◽  
Geographical Accessibility

Cross-sectional descriptive mixed study carried out for the 47 municipalities of the department of Tolima, Colombia, neighboring the department of Cundinamarca, where Bogota, the capital of the country, is located. The objective was to analyze the geographical access barriers and the inventory of human talent and dental services in this department. A distance and time measurement system was applied to identify the duration of travel from each municipality to Ibagué (departmental capital) by public transport. The geographical accessibility barrier determinant endorsed by the World Health Organization (W.H.O.) is a trip duration greater than four hours. It was found that the first level of care in the public sector is present in all municipalities, the second level is in six; the third only in Ibague. Displacement by public transport represents a geographical access barrier in six municipalities; the number of dentists in the public sector does not satisfactorily cover the needs of the population, since more than 50% of the municipalities have a deficit of more than four general dentists and there is a low presence of specialists. In the department of Tolima there are geographical accessibility barriers to health and, specifically, to oral health.

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