Prices and availability of locally produced and imported medicines in Ethiopia and Tanzania.
Prices and availability of locally produced and imported medicines in Ethiopia and Tanzania.
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DOI：
10.1186/s40545-016-0095-1
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发表时间：
2017-01-01
影响因子：
4.2
通讯作者：
Laing, R
中科院分区：
文献类型：
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作者：
Ewen, M;Kaplan, W;Laing, R
背景技术背景：为了评估政策的影响，支持当地的药品生产，以提高获得medicines.METHODS：我们适应了世界卫生组织/HAI仪器测量药品的可用性和价格，以区分当地的进口产品，然后在埃塞俄比亚和坦桑尼亚进行试点测试。在每个销售点，记录了国家清单上所有库存药品的价格。还收集了政府采购价格。价格进行了比较，以国际参考，并表示为中位数价格比（MPR）。结果：埃塞俄比亚政府支付更多的本地产品（中位数MPR=1.20）比进口（中位数MPR=0.84）。在作为当地和进口产品采购的9种药品中，有8种进口时价格较低。与进口产品相比，在公共部门（分别为48%和19%）和私营部门（分别为54%和35%），当地产品的供应情况更好。公共部门进口的患者价格较低（中位数MPR=1.18[进口]对1.44[本地]），私营部门较高（中位数MPR=5.42[进口]对1.85[本地]）。在公共部门，患者支付的本地和进口产品的价格分别比政府采购价格高出17%和53%。坦桑尼亚政府为当地产品（中位数MPR=0.69）支付的费用低于进口产品（中位数MPR=1.34）。在公共部门，本地和进口产品的可获得性分别为21%和32%，患者为本地产品支付的费用略高（中位数MPR=1.35[进口] vs. 1.44[本地]）。在私营部门，当地产品的供应（21%）比进口产品（70%）少，但价格相似（中位数MPR=2.29[进口]对2.27[当地]）。在公共部门，患者支付135%和65%以上的政府采购价格为本地和进口products.CONCLUSIONS：我们的研究结果表明，本地生产如何影响可用性和价格，以及它如何可以影响在公共部门的优惠采购和加价。政府需要评估当地生产政策的影响，并调整政策，以保护患者不为当地产品支付更多费用。
BACKGROUND: To assess the effect of policies supporting local medicine production to improve access to medicines.METHODS: We adapted the WHO/HAI instruments measuring medicines availability and prices to differentiate local from imported products, then pilot tested in Ethiopia and Tanzania. In each outlet, prices were recorded for all products in stock for medicines on a country-specific list. Government procurement prices were also collected. Prices were compared to an international reference and expressed as median price ratios (MPR).RESULTS: The Ethiopian government paid more for local products (median MPR=1.20) than for imports (median MPR=0.84). Eight of nine medicines procured as both local and imported products were cheaper when imported. Availability was better for local products compared to imports, in the public (48% vs. 19%, respectively) and private (54% vs. 35%, respectively) sectors. Patient prices were lower for imports in the public sector (median MPR=1.18[imported] vs. 1.44[local]) and higher in the private sector (median MPR=5.42[imported] vs. 1.85[local]). In the public sector, patients paid 17% and 53% more than the government procurement price for local and imported products, respectively. The Tanzanian government paid less for local products (median MPR=0.69) than imports (median MPR=1.34). In the public sector, availability of local and imported products was 21% and 32% respectively, with patients paying slightly more for local products (median MPR=1.35[imported] vs. 1.44[local]). In the private sector, local products were less available (21%) than imports (70%) but prices were similar (median MPR=2.29[imported] vs. 2.27[local]). In the public sector, patients paid 135% and 65% more than the government procurement price for local and imported products, respectively.CONCLUSIONS: Our results show how local production can affect availability and prices, and how it can be influenced by preferential purchasing and mark-ups in the public sector. Governments need to evaluate the impact of local production policies, and adjust policies to protect patients from paying more for local products.