Differential pricing of medicines to improve access to medicines for hypertension and diabetes control in Ghana: The Ghana Access and Affordability Program, a multi-center prospective trial

Gates Open Research

article

Fred Stephen Sarfo¹  Linda M. Mobula³  Lynda Arthur⁵  Jacob Plange-Rhule⁶  Gilbert Burnham⁴  Jasper Sablah⁵  Edith Gavor⁷  Daniel Ansong¹  Osei Sarfo-Kantanka²  Rexford Adu Gyamfi⁸  James Duah⁹  Bertha Abraham^1,10  David Ofori-Adjei^1,11 

[1] Department of Medicine, Kwame Nkrumah University of Science and Technology;Department of Medicine, Komfo Anokye Teaching Hospital;School of Medicine, Johns Hopkins University;Johns Hopkins Bloomberg School of Public Health;Ghana Access and Affordability Program;Ghana College of Physicians and Surgeons;Ghana Health Services;Agogo Presbyterian Hospital;King's Medical Center;Atua Government Hospital;Department of Medicine & Therapeutics, University of Ghana

关键词: Differential Pricing;    Access;    Affordability;    Hypertension;    Diabetes;    Control;   

DOI  :  10.12688/gatesopenres.13044.1

学科分类：电子与电气工程

来源: American Journal Of Pharmtech Research

【 摘 要 】

Background: Access to medicines for hypertension and diabetes mellitus (DM) management is challenging in resource-limited countries. We sought to assess whether differential pricing of medicines based on socio-economic status would improve affordability of antihypertensive and anti-diabetic medications. A quasi-experimental, prospective cohort study was implemented at five Ghanaian health facilities, using medicines differentially priced by three pharmaceutical companies. Methods:6/18 on a multi-dimensional poverty index scale. Study medicines were purchased at either the DP or MP when prescribed. Participants were followed for 18 months to assess blood pressure (BP) and glycemic control. Predictors of ability to purchase study medicines were assessed using parsimonious logistic regression models. Results: 3,296 participants were enrolled with mean age of 57±12.7 years, 76.6% females. 1,869 (56.7%) had hypertension, 422 (12.8%) had DM, and 1,005 (30.5%) with both hypertension and DM. Average follow-up was 14 months. There were prescriptions of study medications for 526 participants of which 238 (45.2%) were able to make purchases at DP 60.9% versus MP 39.1%. Independent predictors of purchasing ability were higher income, MP arm, willingness to purchase additional medicines, and being at tertiary level institution. Conclusions: Approximately 45% of Ghanaians could afford prescribed study medicines provided at a differential pricing mechanism albeit at an unsustainable basis. Further price reductions are expected to enhance access to medicines for hypertension and DM control.

【 授权许可】

CC BY