Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data

BMC Cardiovascular Disorders

Research Article

Richard O Laing¹  Alexandra Cameron²  Marg Ewen³  Maaike SM van Mourik⁴ 

[1] Department of Essential Medicines and Pharmaceutical Policies, World Health Organization, Geneva, Switzerland;Department of Essential Medicines and Pharmaceutical Policies, World Health Organization, Geneva, Switzerland;Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands;Health Action International Global, Amsterdam, The Netherlands;Student at the Faculty of Medicine, University Medical Centre, Utrecht, The Netherlands;Department of Essential Medicines and Pharmaceutical Policies, World Health Organization, Geneva, Switzerland;

关键词: Private Sector;    Public Sector;    Captopril;    Losartan;    Purchase Power Parity;   

DOI  :  10.1186/1471-2261-10-25

 received in 2010-01-26, accepted in 2010-06-09,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsThe 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.ResultsFor 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.ConclusionsThe 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.

【 授权许可】

CC BY   
© van Mourik et al; licensee BioMed Central Ltd. 2010