Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability
Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability
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DOI：
10.1161/jaha.119.015302
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发表时间：
2020-05-05
影响因子：
5.4
通讯作者：
Kishore, Sandeep P.
中科院分区：
文献类型：
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作者：
Husain, Muhammad Jami;Datta, Biplab Kumar;Kishore, Sandeep P.
背景药物的可及性对于心血管疾病和高血压的长期护理非常重要。这项研究提供了一个跨国评估的可用性，价格，方法和结果我们使用世界卫生组织53个国家的国家基本药物清单（EML）在线存储库，转录了12种心血管疾病/高血压药物的纳入信息。各国基本药物清单中的高血压药物。关于可用性、价格和负担能力的数据来自59个国家的84项调查，这些调查使用了世界卫生组织的国际卫生行动调查方法。我们总结并比较了公共和私营部门以及国家收入群体中价格最低的仿制药和原研药的指标。在低收入和中低收入国家，选定药物的平均可用性为54%，在高收入和中高收入国家为60%，仿制药（61%）高于品牌药（41%）。在所有药品类别中，品牌药和仿制药的平均患者中位价格比分别为80.3和16.7，低收入和中低收入国家的患者中位价格比高于高收入和中高收入国家。一个月的抗高血压药物费用，品牌药平均为6.0日工资，仿制药平均为1.8日工资。低收入和中低收入国家的负担能力低于高收入和中高收入国家的品牌和仿制药。ConclusionsThe可用性和可及性的药品是一个持续的挑战卫生系统。低可用性和高成本是全世界使用和坚持使用基本心血管疾病和抗高血压药物的主要障碍，特别是在低收入和中低收入国家。
BackgroundAccess to medicines is important for long-term care of cardiovascular diseases and hypertension. This study provides a cross-country assessment of availability, prices, and affordability of cardiovascular disease and hypertension medicines to identify areas for improvement in access to medication treatment.Methods and ResultsWe used the World Health Organization online repository of national essential medicines lists (EMLs) for 53 countries to transcribe the information on the inclusion of 12 cardiovascular disease/hypertension medications within each country's essential medicines list. Data on availability, price, and affordability were obtained from 84 surveys in 59 countries that used the World Health Organization's Health Action International survey methodology. We summarized and compared the indicators across lowest-price generic and originator brand medicines in the public and private sectors and by country income groups. The average availability of the select medications was 54% in low- and lower-middle-income countries and 60% in high- and upper-middle-income countries, and was higher for generic (61%) than brand medicines (41%). The average patient median price ratio was 80.3 for brand and 16.7 for generic medicines and was higher for patients in low- and lower-middle-income countries compared with high- and upper-middle-income countries across all medicine categories. The costs of 1 month's antihypertensive medications were, on average, 6.0 days' wage for brand medicine and 1.8 days' wage for generics. Affordability was lower in low- and lower-middle-income countries than high- and upper-middle-income countries for both brand and generic medications.ConclusionsThe availability and accessibility of pharmaceuticals is an ongoing challenge for health systems. Low availability and high costs are major barriers to the use of and adherence to essential cardiovascular disease and antihypertensive medications worldwide, particularly in low- and lower-middle-income countries.