期刊论文详细信息
BMC Public Health
A national survey on availability, price and affordability of selected essential medicines for non communicable diseases in Sri Lanka
BVS Hemantha Beneragama1  Chandanie A Wanigatunge2  Panthihage Ruvini L Dabare3 
[1]Directorate of Medical Technology and Supplies, Ministry of Healthcare and Nutrition, Colombo, Sri Lanka
[2]Department of Pharmacology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
[3]Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
关键词: Non communicable diseases;    Essential medicines;    Price;    Affordability;    Availability;   
Others  :  1128733
DOI  :  10.1186/1471-2458-14-817
 received in 2014-05-04, accepted in 2014-08-04,  发布年份 2014
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【 摘 要 】

Background

Access to medicines is a universal right. Low availability and low affordability of medicines are issues that deny this right to a significant proportion of the world population. The objective of this study was to determine the availability, price and affordability of essential medicines prescribed to treat non communicable diseases in Sri Lanka.

Methods

Methodology was based on the 2nd edition of the World Health Organization Health Action International Manual. A country survey was conducted and facilities representing both public and private pharmacies were selected. A total of 109 facilities was surveyed. At each facility data on the availability and prices of 50 essential medicines for non communicable diseases were collected. Percentage availability, median price of originator brand and lowest priced generic, median price ratio to the International Reference Price were calculated for surveyed medicines. Affordability was determined using the daily incomes of the lowest - paid unskilled government worker.

Results

Semi government community pharmacies had the highest (>80%) availability while outdoor pharmacies of public health care facilities, private pharmacies and outdoor pharmacies of private hospital showed a fairly high availability (50 - 80%) of surveyed medicines.

Unit price of 76% of selected individual medicines was less than ten Sri Lankan rupees. Out of these 28% of medicines cost less than one Sri Lanka rupee. For 21 of the surveyed medicines the median price ratio to the international reference price was less than one. The prices of originator brands for 14 surveyed medicines were more than five times that of the lowest price generics.

Less than a single day’s wages was adequate to purchase a month's supply of the lowest priced generic of more than 67% of surveyed medicines.

Conclusions

The availability of selected essential medicines was fairly high in both public and private sectors in Sri Lanka. Most medicines are affordable to the lowest income earners in the community. There were many generic brands and generics available for most of the medicines in private and semi government community pharmacies increasing both availability and affordability.

【 授权许可】

   
2014 Dabare et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]United Nations Publication: Indicators for Monitoring the Millennium Development Goals. United Nations Development Group; 2003.
  • [2]World Health Organization: WHO medicines strategy. Geneva, Switzerland: Countries at the core 2004-2007; 2004.
  • [3]Ministry of Health: National list of Essential medicines Sri Lanka: 5th Revision, 2013–2014. Sri Lanka; 2013.
  • [4]WHO/HAI: Measuring medicine prices, availability, affordability and price components. 2nd edition. Geneva, Switzerland; 2008.
  • [5]World Health Organization: Preventing chronic disease: a vital investment. Geneva, Switzerland; 2005.
  • [6]World Health Organization: Prevention of recurrent heart attacks and strokes in low and middle income populations: evidence-based recommendations for policy-makers and health professionals. Geneva, Switzerland; 2003.
  • [7]Hogerzeil HV, Jonathan L, Wirtz VJ, P Kishore SP, Selvaraj S, Kiddell-Monroe R, Mwangi-Powell FN FN, von Schoen-Angerer T: Promotion of access to essential medicines for non-communicable diseases: practical implications of the UN political declaration. Lancet 2013, 381:680-689.
  • [8]Mendis S, Fukino K, Cameron A, Laing R, Filipe A Jr, Khatib O, Leowski J, Ewene M: The availability and affordability of selected essential medicines for chronic diseases in six low- and middle-income countries. Bull World Health Org 2007, 85(4):279-287.
  • [9]Yusuf S, Islam S, Chow CK, Rangarajan S, Dagenais G, Diaz R, Gupta R, Kelishadi R, Iqbal R, Avezum A, Kruger A, Kutty R, Lanas F, Lisheng L, Wei L, Lopez-Jaramillo P, Oguz A, Rahman O, Swidan H, Yusoff K, Zatonski W, Rosengren A, Teo KK: Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey. Lancet 2011, 378:1231-1243.
  • [10]Ministry of Finance & Planning: Annual bulletin of medical statistics. Sri Lanka; 2009. http://203.94.76.60/health/eng/publications/AHB/News%20Letter%20Format%20%28English%29.pdf webcite
  • [11]Ministry of Healthcare and Nutrition: Sri Lanka – health at a glance. Vol 1. Sri Lanka; 2008.
  • [12]Non communicable diseases in the South-East Asia Region: Situation and response 2011 Regional Office for South-East Asia: World Health Organization; http://203.94.76.60/health/eng/publications/AHB/News%20Letter%20Format%20%28English%29.pdf webcite
  • [13]Indralal De Silva W: The Age Structure Transition and the Demographic Dividend: An Opportunity for Rapid Economic Take-off in Sri Lanka. Sri Lanka J Adv Soc Stud 2012, 2(1):3-46.
  • [14]Fernando WHKN, Wijesinghe DGNG: Assessment of Nutritional Status and Disease Prevalence among Elderly Population in Elderly Homes in Kandy. Tropical Agric Res 2010, 21(3):229-237.
  • [15]Sri Lanka Census of Population and Housing 2012. http://www.statistics.gov.lk/PopHouSat/CPH2011/Pages/Activities/Reports/CPH_2012_5Per_Rpt.pdf webcite
  • [16]Ganga Senarathna SMDK: Uthpali Mannapperuma, B 381.M. Rohini Fernandopulle.: Medicine prices, availability and affordability in Sri Lanka. Indian J Pharmacol 2011, 43(1):60-63.
  • [17]Balasubramaniam R, Beneragama BVSH, Sri Ranganathan S: A national survey of availability of key essential medicines for children in Sri Lanka. Ceylon Med J 2011, 56(3):101-107. 386
  • [18]Ministry of Healthcare and Nutrition: National list of Essential medicines Sri Lanka, 4th Revision. Sri Lanka; 2009.
  • [19]Gelders S, Ewen M, Noguchi N, Laing R: Price, availability and affordability: An International comparison of chronic diseases medicines. World Health Organization and Health Action International: Cairo; 2006.
  • [20]Frye JE (Ed): International drug price indicator guide. USA: Management Sciences for Health; 2012.
  • [21]The Gazette of the Democratic Socialist Republic of Sri Lanka, extraordinary 2012. [http://www.pubad.gov.lk/web/images/stories/dos/sm/sm%28e%29.pdf webcite]
  • [22]van Mourik M, Alexandra C, Marg E, Laing RO: Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data. BMC Cardiovasc Disord 2010, 10:25.
  • [23]WHO: The Selection of essential drugs. Report of the WHO Expert Committee. 2011 (including the 17th model list of Essential Medicines and 3rd WHO model list of Essential Medicines for Children) Technical Report Series No. 965. Geneva: WHO; 2011.
  • [24]Perera BJC, Cooray JHL (Eds), Sri Lanka Medical Association: Guidelines on the Management of Asthma. 3rd edition. Sri Lanka; 2005.
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