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 Graduate programs in education, exploring its meaning and significance of training

2017 ◽  
Author(s):  
María del Rosario Landín Miranda ◽  
Diana Ramírez Hernández ◽  
Félix Eduardo Núñez Olvera
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Symbolic Interactionism ◽  
Social Representations ◽  
Graduate Programs ◽  
Educational Policies ◽  
The Public ◽  
Inductive Study ◽  
The Impact ◽  
The City

In this research, we present an analysis carried out in the city of Poza Rica, state of Veracruz, Mexico on the meaning and significance of education that students attribute to the master programs related to education. We base this work from the Theory of Social Representations of Serge Moscovici (1961) and the Method of Symbolic Interactionism of Herbert Blumer (1969), this research is consistent with the educational policies in the training of professionals, due that from an inductive study with a cualitative perspective, we can do an analysis with more relevance on the impact that the offer of postgraduate has on the training of current professionals. Two study contexts were taken: masters in education offered in the public sector and masters in education offered in the private sector. As well, the agencies that shape the policies for the evaluation of postgraduate programs in Mexico, particularly with emphasis on the CONACYT framework.

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.

Police Service Crime Mapping as Civic Technology

2016 ◽  
Vol 5 (3) ◽  
pp. 13-26 ◽  
Author(s):  
Teresa Scassa
Keyword(s):  
Public Sector ◽  
North America ◽  
Private Sector ◽  
Crime Mapping ◽  
The Public ◽  
Police Services ◽  
Municipal Police ◽  
The City ◽  
Civic Technology

It is increasingly common for municipal police services in North America to make online crime maps available to the public. This form of civic technology is now so widely used that there is a competitive private sector market for crime mapping platforms. This paper considers the crime maps made available by three Canadian police forces using platforms developed by U.S.-based private sector corporations. The paper considers how these crime maps present particular narratives of crime in the city, evaluates the quality of the mapped data, and explores how laws shape and constrain the use and reuse of crime data. It considers as well the problems that may arise in using off-the-shelf solutions – particularly ones developed in another country. It asks whether this model of crime mapping advances or limits goals of transparency and accountability, and what lessons it offers about the use of private sector civic technologies to serve public sector purposes.

scholarly journals Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Caijun Yang ◽  
Shuchen Hu ◽  
Dan Ye ◽  
Minghuan Jiang ◽  
Zaheer-Ud-Din Babar ◽  
...  
Keyword(s):  
Private Sector ◽  
Access To Medicines ◽  
Public Hospitals ◽  
Essential Medicines ◽  
Shaanxi Province ◽  
Price Ratio ◽  
Medicine Price ◽  
Cross Sectional ◽  
The Public ◽  
Health Action

Objectives: To evaluate the price and availability of medicines in China.Methods: A standard methodology developed by WHO and Health Action International was used to collect medicine price and availability data. We obtained cross-sectional data for 48 medicines from 519 facilities (280 public hospitals and 239 private retail pharmacies) in five provinces in China in 2018. We also collected longitudinal data for 31 medicines in Shaanxi Province in 2010, 2012, 2014, and 2018. Medicine price was compared with the international reference price to obtain a median price ratio (MPR). The availability and price in five provinces were compared in matched sets. We used general estimating equations to calculate differences in availability and median prices from 2010 to 2018.Findings: Mean availability of surveyed medicines in five provinces was low in both public (4.29–32.87%) and private sectors (13.50–43.75%). The MPR for lowest priced generics (LPGs) was acceptable (1.80–3.02) and for originator brands (OBs) was much higher (9.14–12.65). The variation was significant for both availability and price of medicines across provinces. In Shaanxi Province, the availability of medicines decreased between 2010 and 2018, but this was not significant in the public or private sector. Compared with 2010, the median adjusted patient price was significantly lower in 2018 for nine OBs (difference −22.4%; p = 0.005) and 20 LPGs (−20.5%; p = 0.046) in the public sector and 10 OBs (−10.2%; p = 0.047) in the private sector.Conclusion: Access to medicines was found to be poor and unequal across China in 2018. Future interventions are needed, and possible strategies include effective and efficient procurement, promoting the development of retail pharmacies and increasing medicine price transparency.

scholarly journals Impact of National Drug Pricing Policy 2018 on access to medicines in Lahore division, Pakistan: a pre-post survey study using WHO/HAI methodology

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e034720
Author(s):  
Amna Saeed ◽  
Hamid Saeed ◽  
Zikria Saleem ◽  
Caijun Yang ◽  
Minghuan Jiang ◽  
...  
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Standard Treatment ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Drug Pricing ◽  
Pricing Policy ◽  
The Public ◽  
National Drug ◽  
The Mean

ObjectiveTo evaluate the impact of new National Drug Pricing Policy (NDPP) 2018 on access to medicines in terms of prices, availability and affordability.DesignTwo cross-sectional surveys were undertaken before and after the launch of NDPP 2018, using a modified WHO/Health Action International (WHO/HAI) methodology.SettingFour districts of Lahore division, Pakistan.Participants16 public sector hospitals and 16 private sector retail pharmacies.MeasuresThe pre and post survey data on prices and availability of lowest price generics (LPGs) and originator brands (OBs) of 50 medicines were obtained by visiting the same public and private sector health facilities (n=32). Out of 50, 46 surveyed medicines were from the National Essential Medicines List. Inflation-adjusted median unit prices (MUPs) and median price ratios (MPRs) from 2019 were used for price comparison. Affordability was calculated in terms of number of days’ wages required to get a standard treatment by the lowest paid unskilled government worker.ResultsThe overall mean percent availabilities remained poor in both years, that is, far less than 80%. In the public sector, the mean percent availability of OBs improved from 6.8% to 33.1%, whereas, in the case of LPGs, it was reduced from 35.1% to 9%. In the private sector, the mean percent availability of both OBs and LPGs demonstrated slight improvements in 2019, that is, 55.0%–58.3% and 20.3%–32.3%. The adjusted MUPs and MPRs of OBs significantly increased by a median of 4.29% (Wilcoxon test p=0.001, p=0.0001), whereas the adjusted MUPs and MPRs of LPGs increased by a median of 15.7% (p=0.002, p=0.0002). Overall, the affordability of many medicines for common ailments was reduced significantly in 2019.ConclusionsThe availability of medicines slightly improved, except in the case of LPGs, which was reduced in the public sector. The implementation of NDPP 2018 led to increase in drug prices, making the standard treatment for some of the most prevalent ailments unaffordable. So verily, the drug pricing policy must be reviewed to ensure access to essential medicines.

scholarly journals Monitoring Cardiovascular Medicine Prices as a Tool for Analyzing the Effectiveness of Government Intervetions to Ensure Access to Medicines at the Regional Level

2020 ◽  
Vol 16 (6) ◽  
pp. 916-924
Author(s):  
C. M. Razzakova ◽  
L. E. Ziganshina
Keyword(s):  
Comparative Analysis ◽  
Public Sector ◽  
Private Sector ◽  
Access To Medicines ◽  
Generic Medicines ◽  
Public And Private ◽  
The Public ◽  
Reference Prices ◽  
Medicine Prices ◽  
The City

Aim. The aim of our study was to continue a comparative analysis of availability and access to cardiovascular medicines in 2017 and 2018 in the city of Kazan according to the original WHO/HAI methodology to assess the effectiveness of government interventions to ensure access to medicines.Material and methods. We performed a comparative analysis of prices of cardiovascular medicines in 2017 and 2018 in Kazan using the World Health Organization and Health Action International (WHO/HAI) methodology, to assess medicines' availability and affordability to ensure their rational use. We studied availability and prices of 71 cardiovascular medicines in public and private pharmacies in the city of Kazan and analyzed procurement prices of these medicines in hospitals. Also we studied the affordability of medicines, as well as performed pharmacoeconomic cost-minimization analysis for arterial hypertension pharmacotherapy in 2018. For each name, we studied the prices for the original brand and its lowest-priced generic. We compared medicine prices with international reference, delivered by the Management Sciences for Health and by expressing them as median price ratio (MPR).Results. In the public sector, prices of generic medicines were at the level of reference prices with the indicators of MPR 1.14 [0.41-1.84] and 1.17 [0.49-2.21], in 2017 and 2018 respectively. In the private sector, prices of generics reduced 2 times in 2018 compared to 2017, with the decrease in MPR from 2.22 [1.12-3.91] to 1.25 [0.44-2.32], (p<0.05). In the public sector, the affordability indicators of generics were the same in the studied years (Me=0.24 in 2017 and Me=0.26 in 2018). However, in the private sector there was a 2.5 times reduction in the affordability of generics (reduction Me from 0.66 to 0.24, p<0.05) in 2018 compared to 2017. From 2017 to 2018 the affordability of original brands changed from 1.9 to 1.3 in the public sector and from 2.3 to 1.5 in the private sector, but this change was not statistically significant (p>0.05). In 2018, depending on the choice of the medicine the annual course of therapy of hypertension varied from 149 to 28835 rubles.Conclusions. In 2018, the prices of generic cardiovascular medicines, but not of originator brands, reached the level of reference prices in both the public and private sectors of Kazan. According to the WHO/HAI methodology, generic cardiovascular medicines became affordable. In the private sector, there was a reduction in the prices of generic medicines, but not of originator brands, with an improvement of affordability of generics in 2018 compared to 2017.

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.

scholarly journals Public-Private Partnerships: A Strategy for Effective Private Partnerships in Health Care Provision: A Policy Option

2021 ◽  
Author(s):  
Hojatolah Gharaee ◽  
Saber Azami-aghdash
Keyword(s):  
Health Care ◽  
Public Sector ◽  
Private Sector ◽  
Health System ◽  
Policy Option ◽  
Private Companies ◽  
Factors Affecting ◽  
The Public ◽  
Financial Gain ◽  
Cultural Conditions

Background and Aim: One of the most effective ways to cope with the financial constraints of health system, especially in developing countries, can be to engage the private sector in the form of a public-private partnership (PPP). Hence, the purpose of the present study is to introduce PPP as a general policy to increase the effective participation of the private sector in health system. Methods: Initially, existing literature was reviewed to identify methods, areas, and experiences in PPP. Then, an expert panel was organized with researchers, professors and experts in health services management and policy making. At the beginning of the panel, the content obtained in the previous step was presented, and then the requirements of PPP implementation in healthcare was discussed. Results: Considering the discussions, we can summarize the factors affecting PPP implementation in three topics: A) Private Sector Conditions: Sufficient number of eligible companies, significant financial gain for private companies; B) Public Sector Conditions: Principles, policies and indicators related to outsourcing of services, availability of transferable services, units or substations to private sector, lower cost of providing services in the private sector than the public sector; C) Background: Political, legal, economic and cultural conditions, successful experiences in other cities and provinces, support of the health system scientific body, common language and contract conditions. Conclusion: Given the private sector’s capabilities and potentials to improve the quality and quantity of services provided, transparent PPP policies should be developed as an appropriate strategy for effective private sector participation in the provision of health care, and required infrastructure must be provided

scholarly journals Access to essential medicines for children: a cross-sectional survey measuring medicine prices, availability and affordability in Hanam province, Vietnam

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e051465
Author(s):  
Dai Xuan Dinh ◽  
Huong Thi Thanh Nguyen ◽  
Van Minh Nguyen
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Urban Areas ◽  
Essential Medicines ◽  
Secondary Outcome ◽  
National Study ◽  
Cross Sectional ◽  
The Public ◽  
The Mean ◽  
Medicines For Children

ObjectiveTo identify the availability, prices and affordability of essential medicines for children (cEMs) in Hanam province, Vietnam.DesignCross-sectional study.SettingOne city and five districts of Hanam province.Participants66 public health facilities and 66 private drugstores.Primary and secondary outcome measuresThe standardised methodology of the WHO and Health Action International was used to investigate 30 paediatric essential medicines. For each medicine, data were collected for two products: the lowest-priced medicine (LPM) and the highest-priced medicine (HPM). The availability of medicine was computed as the percentage of facilities in which this medicine was found on the day of data collection. Median prices of individual medicines were reported in local currency. Affordability was calculated as the number of days’ wages required for the lowest-paid unskilled government worker to purchase standard treatments for common diseases. Data were analysed using R software V.4.1.0.ResultsThe mean availability of LPMs in the private sector (33.2%, SD=38.0%) was higher than that in the public sector (24.9%, SD=39.4%) (p<0.05). The mean availability of HPMs was extremely low in both sectors (11.3% and 5.8%, respectively). The mean availability of cEMs in urban areas was significantly higher than that in rural areas (36.5% and 31.6%, respectively, p<0.05). In the public sector, the prices of LPMs were nearly equal to the international reference prices (IRPs). In the private sector, LPMs were generally sold at 4.06 times their IRPs. However, in both sectors, the affordability of LPMs was reasonable for most conditions as standard treatments only cost a day’s wage or less.ConclusionThe low availability was the main reason hindering access to cEMs in Hanam, especially in the countryside. A national study on cEMs should be conducted, and some practical policies should be promulgated to enhance access to cEMs.

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.

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