Health policy and systems research in access to medicines: a prioritized agenda for low- and middle-income countries

Health Research Policy and Systems

Kent Ranson²  Richard Laing¹  Joelle Hoebert³  Dena Javadi²  Maryam Bigdeli² 

[1] Department of Essential Medicines and Health Products, World Health Organization, 20, avenue Appia, 1211 Geneva, Switzerland;Alliance for Health Policy and Systems Research, World Health Organization, 20, avenue Appia, 1211 Geneva, Switzerland;Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, P.O. Box 80 082, 3508 TB Utrecht, The Netherlands

关键词: Priority setting;    Health systems research;    Health systems;    Access to medicines;   

Others  :  805142
DOI  :  10.1186/1478-4505-11-37

 received in 2013-03-20, accepted in 2013-09-26,  发布年份 2013

【 摘 要 】

Objectives

To identify priority policy issues in access to medicines (ATM) relevant for low- and middle-income countries, to identify research questions that would help address these policy issues, and to prioritize these research questions in a health policy and systems research (HPSR) agenda.

Methods

The study involved i) country- and regional-level priority-setting exercises performed in 17 countries across five regions, with a desk review of relevant grey and published literature combined with mapping and interviews of national and regional stakeholders; ii) interviews with global-level stakeholders; iii) a scoping of published literature; and iv) a consensus building exercise with global stakeholders which resulted in the formulation and ranking of HPSR questions in the field of ATM.

Results

A list of 18 priority policy issues was established following analysis of country-, regional-, and global-level exercises. Eighteen research questions were formulated during the global stakeholders’ meeting and ranked according to four ranking criteria (innovation, impact on health and health systems, equity, and lack of research). The top three research questions were: i) In risk protection schemes, which innovations and policies improve equitable access to and appropriate use of medicines, sustainability of the insurance system, and financial impact on the insured? ii) How can stakeholders use the information available in the system, e.g., price, availability, quality, utilization, registration, procurement, in a transparent way towards improving access and use of medicines? and iii) How do policies and other interventions into private markets, such as information, subsidies, price controls, donation, regulatory mechanisms, promotion practices, etc., impact on access to and appropriate use of medicines?

Conclusions

Our HPSR agenda adopts a health systems perspective and will guide relevant, innovative research, likely to bear an impact on health, health systems and equity.

【 授权许可】

   
2013 Bigdeli et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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