The Availability, Pricing and Affordability of Three Essential Asthma Medicines in 52 Low- and Middle-Income Countries

Babar, Zaheer Ud Din; Lessing, Charon; Macé, Cécile; Bissell, Karen

doi:10.1007/s40273-013-0095-9

Cited by 87 publications

(85 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding is in consonance with that of Shabangu and Suleman [35] who found most of the respondents in their study were unable to receive all their prescribed medicines in the government hospital in each of their visits in the past six months prior to the study (also see [36, 37, 38]). The finding also resonates with that of Muhammed et al [39] who found that more than half of the participants (53.6%) in their study preferred PMVs to public health facilities mainly because of the lack of essential medicines and the high cost of care.…”

Section: Discussionsupporting

confidence: 88%

Overdependence on For-Profit Pharmacies: A Descriptive Survey of User Evaluation of Medicines Availability in Public Hospitals in Selected Nigerian States

2016

View full text Add to dashboard Cite

ObjectiveLower availability of medicines in Nigerian public health facilities—the most affordable option for the masses—undermines global health reforms to improve access to health for all, especially the chronically ill and poor. Thus, a sizeable proportion of healthcare users, irrespective of purchasing power, buy medicines at higher costs from for-profit pharmacies. We examined user evaluation of medicine availability in public facilities and how this influences their choice of where to buy medicines in selected states—Cross River, Enugu and Oyo—in Nigeria.MethodsWe approached and interviewed 1711 healthcare users using a semi-structured, interviewer-administered questionnaire as they exited for-profit pharmacies after purchasing medicines. This ensured that both clients who had presented at health facilities (private/public) and those who did not were included. Information was collected on why respondents could not buy medicines at the hospitals they attended, their views of medicine availability and whether their choice of where to buy medicines is influenced by non-availability.Principal FindingsRespondents’ mean age was 37.7±14.4 years; 52% were males, 59% were married, 82% earned ≥NGN18, 000 (US$57.19) per month, and 72% were not insured. Majority (66%) had prescriptions; of this, 70% were from public facilities. Eighteen percent of all respondents indicated that all their medicines were usually available at the public facilities, most (29%), some (44%) and not always available (10%). Reasons for using for-profit pharmacies included: health workers attitudes (43%), referral by providers (43%); inadequate money to purchase all prescribed drugs (42%) and cumbersome processes for obtaining medicines.ConclusionsLower availability of medicines has serious implications for healthcare behavior, especially because of poverty. It is crucial for government to fulfill its mandate of equitable access to care for all by making medicines available and cheap through reviving and sustaining the drug revolving fund scheme and encouraging the prescription of generic drugs in all public health facilities.

show abstract

Section: Discussionsupporting

confidence: 88%

Overdependence on For-Profit Pharmacies: A Descriptive Survey of User Evaluation of Medicines Availability in Public Hospitals in Selected Nigerian States

2016

View full text Add to dashboard Cite

show abstract

“…In 2007, a summary report from six countries on the availability and affordability of medicines for chronic diseases, using the WHO/HAI methodology, included data from the public and the private for-profit sectors in Malawi [13]. A study on prices and affordability of medicines of three asthma medicines, carried out by questionnaire in 52 countries [19], also included Malawi. Lufesi et al .…”

Section: Introductionmentioning

confidence: 99%

Availability and affordability of antimalarial and antibiotic medicines in Malawi

Khuluza

Heide

2017

PLoS ONE

View full text Add to dashboard Cite

BackgroundAvailability and affordability of medicines are key determinants of universal health coverage, yet achieving them presents a major challenge especially in low-income countries. We here present an analysis of availability and prices of antimalarial and antibiotic medicines in public, faith-based and private health facilities in Malawi. Medicines are provided free of charge in the public health care system of Malawi. In contrast, facilities of the Christian Health Association of Malawi (CHAM) usually charge their patients for medicines, as do private for-profit facilities.MethodsAs part of a study on medicine quality, samples of six antimalarial and six antibiotic medicines were collected in 31 health facilities in four districts of southern Malawi. These included 15 public facilities (i.e. health centres, district hospitals and central hospitals), eight CHAM and eight private facilities. Random selection was used in choosing the included health facilities. The availability of medicines was recorded, including the number of units which could be collected of each medicine, as well as the prices of medicines which were charged in CHAM and private facilities. These data were analyzed using the standard methodology developed by the World Health Organization (WHO) and Health Action International (HAI).ResultsAvailability of the antimalarials artemether/lumefantrine and sulfadoxine/pyrimethamine, which are provided with financial support from international donors, was high in public and CHAM facilities (93% and 100%, respectively). However, availability of antibiotics was much lower (e.g. 40% availability of amoxicillin tablets/capsules in public health centres). Medicine prices were lower than reported from many other countries. The median price ratio (MPR) to a wholesale international procurement price was 2.8 in CHAM facilities and even lower in the private sector (MPR 2.3). Nevertheless, for 10 of the 12 investigated medicines the cost for one course of treatment exceeded the daily wage of a low-paid government worker in Malawi and therefore had to be considered as unaffordable for a major part of the population.ConclusionsContinued efforts are required to improve the availability of essential medicines in Malawi. The free provision of medicines in the public health care system remains important in order to achieve universal health coverage, due to the low income in this country.

show abstract

“…1 Exacerbations, poor symptom control and decreased quality of life remain significant problems in spite of the progress made in asthma pharmacotherapy.…”

Section: Introductionmentioning

confidence: 99%

Increases in peripheral SIRT1: A new biological characteristic of asthma

Wang

et al. 2015

Respirology

View full text Add to dashboard Cite

Background and objective: Silent information regulator 1 (SIRT1) is a class III histone deacetylase that exerts both anti-inflammatory and anti-aging effects. However, no data are available regarding SIRT1 expression in patients with asthma. Here, we studied SIRT1 levels in the serum of patients with asthma and analysed the distribution of SIRT1 in both the serum and the lungs in an asthmatic mouse model to determine its clinical significance. Methods: Serum SIRT1 levels, total immunoglobulin E (IgE) levels and peripheral blood eosinophil percentages as well as pulmonary function were quantified in 97 patients with asthma and 118 healthy volunteers. BALB/c mice were sensitized and challenged using ovalbumin (OVA) to produce the asthmatic model, and SIRT1 levels in both the serum and the lung tissues were subsequently measured. Results: The serum SIRT1 levels were significantly elevated in the patients with asthma compared with the controls. Serum SIRT1 levels positively correlated with total IgE levels and negatively correlated with pulmonary function. In the OVA-sensitized and challenged mice, an increased serum SIRT1 level was confirmed, whereas decreased SIRT1 expression was observed in the lung tissues. Conclusions: These data indicate that lung SIRT1 expression decreased while serum SIRT1 increased in the setting of asthma. Serum SIRT1 levels correlate positively with both IgE levels and negatively with pulmonary function, suggesting that increased peripheral SIRT1 levels represent a new biological characteristic of asthma. Increased serum SIRT1 may be an auxiliary index for the diagnosis of asthma and elevating lung SIRT1 levels may be a new strategy for asthma therapy.

show abstract

The Availability, Pricing and Affordability of Three Essential Asthma Medicines in 52 Low- and Middle-Income Countries

Cited by 87 publications

References 11 publications

Overdependence on For-Profit Pharmacies: A Descriptive Survey of User Evaluation of Medicines Availability in Public Hospitals in Selected Nigerian States

Overdependence on For-Profit Pharmacies: A Descriptive Survey of User Evaluation of Medicines Availability in Public Hospitals in Selected Nigerian States

Availability and affordability of antimalarial and antibiotic medicines in Malawi

Increases in peripheral SIRT1: A new biological characteristic of asthma

Contact Info

Product

Resources

About