Medicines shortages in Pakistan: a qualitative study to explore current situation, reasons and possible solutions to overcome the barriers
Medicines shortages in Pakistan: a qualitative study to explore current situation, reasons and possible solutions to overcome the barriers
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DOI：
10.1136/bmjopen-2018-027028
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发表时间：
2019-09-01
期刊：
影响因子：
2.9
通讯作者：
Asghar, Saima
中科院分区：
文献类型：
--
作者：
Atif, Muhammad;Malik, Iram;Asghar, Saima
目的本研究旨在评估巴基斯坦药品短缺的现状，并确定其影响，原因和克服障碍的可能解决方案。设计定性研究。设置本研究于2018年5月至2018年7月在巴基斯坦的三个城市进行，包括伊斯兰堡，卡拉奇和巴哈瓦尔布尔，取决于最相关的关键线人的可用性。参与者卫生监管机构，主要和次要结果指标研究主要探讨了巴基斯坦药品短缺的现状，原因和潜在的解决方案。第二个结果是特定品牌短缺的问题。采用饱和点标准确定样本量。方便的抽样技术被用来招募参与者。访谈进行了录音和逐字记录。结果共有41名利益相关者参与了本研究，包括12名卫生监管部门、6名药品生产企业、8名药品经营企业和15名药师。数据分析产生了4个主题，16个次主题，51个类别。基本的救命药品供应短缺。药品供应短缺的主要原因是有效药物成分和原材料的可得性问题、缺乏传统的分配系统和突然的需求波动。在建议的解决方案中，三个最常见的是制造商的便利和监管，合理的价格固定和库存控制system.Conclusion改善药品供应短缺，这可能会对巴基斯坦的患者的临床和财务影响。造成药品短缺的原因是多方面的、复杂的。政府必须发挥强制性领导作用，优先解决这一问题，以改善患者获得药品的机会。
Objective This study was conducted to assess current situation of medicines shortages in Pakistan and to identify its impact, reasons and possible solutions to overcome the barriers.Design A qualitative study.Setting The study was conducted between May 2018 and July 2018 in three cities of Pakistan including Islamabad, Karachi and Bahawalpur, depending on the availability of most relevant key informants.Participants Health regulators, pharmaceutical manufacturers, pharmaceutical distributors and pharmacists.Primary and secondary outcome measure Study primarily explored current situation, reasons and potential solutions of medicines shortages in Pakistan. Secondary outcome was the issue of particular brand shortage.Method Semistructured interviews were conducted. Sample size was determined by using saturation point criteria. Convenient sampling techniques were used to recruit the participants. The interviews were audiorecorded and transcribed verbatim. Data were analysed using inductive thematic analysis.Results A total of 41 stakeholders including 12 health regulators, 6 pharmaceutical manufacturers, 8 pharmaceutical distributors and 15 pharmacists participated in this study. Data analysis yielded 4 themes, 16 subthemes, 51 categories. Essential and life-saving medicines were in short supply. The major reasons of short supply of medicines were active pharmaceutical ingredient and raw material availability issues, lack of traditional distribution system and sudden demand fluctuation. Among proposed solutions, three most common were the facilitation and regulation of manufacturers, reasonable price fixation and improvements in the inventory control system.Conclusion Medicines were short in supply, and this may have clinical and financial impact on the patients in Pakistan. There were multiple and complex reasons of medicines shortages. Mandatory government leadership is required to resolve the issue on priority basis for improving the access of medicines to the patients.