Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data
Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data
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DOI：
10.1186/1471-2261-10-25
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发表时间：
2010-06-09
影响因子：
2.1
通讯作者：
Laing, Richard O.
中科院分区：
文献类型：
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作者：
van Mourik, Maaike S. M.;Cameron, Alexandra;Laing, Richard O.
背景：全球心血管疾病（CVD）负担持续上升。CVD的成功治疗需要充分的药物管理。目的是利用根据世界卫生组织/国际卫生行动方法收集的标准化数据，审查发展中国家心血管药物的可得性、定价和可负担性。方法：阿替洛尔、卡托普利、氢氯噻嗪、氯沙坦、硝苯地平。分析了来自36个国家的数据。结果测量是可获得性百分比、价格与国际参考价格的比率以及最低工资的非熟练政府工作人员购买一个月慢性治疗所需的工资天数。患者价格根据通货膨胀和购买力进行调整，采购价格仅根据通货膨胀进行调整。对非专利产品和原创品牌产品以及公共和私营部门的数据进行了分析，并由世界银行收入组进行了汇总。结果：对于所有的测量，在调查中有很大的差异。心血管药物的总体可得性较差（公共部门平均26.3%，私营部门平均57.3%）。有些国家的采购价格极具竞争力，而另一些国家则一贯支付高价。患者价格通常大大高于国际参考价格；然而，一些国家表现良好。在许多情况下，慢性降压药治疗的费用超过了一天的工资。特别是当单一疗法不足时，治疗变得负担不起。结论：这项研究的结果强调需要将注意力和资金集中在使慢性病药物可及性上，特别是在公共部门。为实现这一目标，提出了若干政策选择。
Background: The global burden of cardiovascular disease (CVD) continues to rise. Successful treatment of CVD requires adequate pharmaceutical management. The aim was to examine the availability, pricing and affordability of cardiovascular medicines in developing countries using the standardized data collected according to the World Health Organization/Health Action International methodology.Methods: The following medicines were included: atenolol, captopril, hydrochlorothiazide, losartan and nifedipine. Data from 36 countries were analyzed. Outcome measures were percentage availability, price ratios to international reference prices and number of day's wages needed by the lowest-paid unskilled government worker to purchase one month of chronic treatment. Patient prices were adjusted for inflation and purchasing power, procurement prices only for inflation. Data were analyzed for both generic and originator brand products and the public and private sector and summarized by World Bank Income Groups.Results: For all measures, there was great variability across surveys. The overall availability of cardiovascular medicines was poor (mean 26.3% in public sector, 57.3% private sector). Procurement prices were very competitive in some countries, whereas others consistently paid high prices. Patient prices were generally substantially higher than international references prices; some countries, however, performed well. Chronic treatment with anti-hypertensive medication cost more than one day's wages in many cases. In particular when monotherapy is insufficient, treatment became unaffordable.Conclusions: The results of this study emphasize the need of focusing attention and financing on making chronic disease medicines accessible, in particular in the public sector. Several policy options are suggested to reach this goal.