Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability
Background Access to medicines is important for long‐term care of cardiovascular diseases and hypertension. This study provides a cross‐country assessment of availability, prices, and affordability of cardiovascular disease and hypertension medicines to identify areas for improvement in access to me...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.015302 |
| _version_ | 1818775075918184448 |
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| author | Muhammad Jami Husain Biplab Kumar Datta Deliana Kostova Kristy T. Joseph Samira Asma Patricia Richter Marc G. Jaffe Sandeep P. Kishore |
| author_facet | Muhammad Jami Husain Biplab Kumar Datta Deliana Kostova Kristy T. Joseph Samira Asma Patricia Richter Marc G. Jaffe Sandeep P. Kishore |
| author_sort | Muhammad Jami Husain |
| collection | DOAJ |
| description | Background Access to medicines is important for long‐term care of cardiovascular diseases and hypertension. This study provides a cross‐country assessment of availability, prices, and affordability of cardiovascular disease and hypertension medicines to identify areas for improvement in access to medication treatment. Methods and Results We used the World Health Organization online repository of national essential medicines lists (EMLs) for 53 countries to transcribe the information on the inclusion of 12 cardiovascular disease/hypertension medications within each country's essential medicines list. Data on availability, price, and affordability were obtained from 84 surveys in 59 countries that used the World Health Organization's Health Action International survey methodology. We summarized and compared the indicators across lowest‐price generic and originator brand medicines in the public and private sectors and by country income groups. The average availability of the select medications was 54% in low‐ and lower‐middle‐income countries and 60% in high‐ and upper‐middle‐income countries, and was higher for generic (61%) than brand medicines (41%). The average patient median price ratio was 80.3 for brand and 16.7 for generic medicines and was higher for patients in low‐ and lower‐middle‐income countries compared with high‐ and upper‐middle‐income countries across all medicine categories. The costs of 1 month's antihypertensive medications were, on average, 6.0 days’ wage for brand medicine and 1.8 days’ wage for generics. Affordability was lower in low‐ and lower‐middle‐income countries than high‐ and upper‐middle‐income countries for both brand and generic medications. Conclusions The availability and accessibility of pharmaceuticals is an ongoing challenge for health systems. Low availability and high costs are major barriers to the use of and adherence to essential cardiovascular disease and antihypertensive medications worldwide, particularly in low‐ and lower‐middle‐income countries. |
| first_indexed | 2024-12-18T10:51:17Z |
| format | Article |
| id | doaj.art-d5f5c16e60aa4f408995f73a5de0f61b |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-18T10:51:17Z |
| publishDate | 2020-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-d5f5c16e60aa4f408995f73a5de0f61b2022-12-21T21:10:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-05-019910.1161/JAHA.119.015302Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and AffordabilityMuhammad Jami Husain0Biplab Kumar Datta1Deliana Kostova2Kristy T. Joseph3Samira Asma4Patricia Richter5Marc G. Jaffe6Sandeep P. Kishore7Global Noncommunicable Diseases Branch Division of Global Health Protection Center for Global Health Centers for Disease Control and Prevention Atlanta GAGlobal Noncommunicable Diseases Branch Division of Global Health Protection Center for Global Health Centers for Disease Control and Prevention Atlanta GAGlobal Noncommunicable Diseases Branch Division of Global Health Protection Center for Global Health Centers for Disease Control and Prevention Atlanta GAGlobal Noncommunicable Diseases Branch Division of Global Health Protection Center for Global Health Centers for Disease Control and Prevention Atlanta GAGlobal Noncommunicable Diseases Branch Division of Global Health Protection Center for Global Health Centers for Disease Control and Prevention Atlanta GAGlobal Noncommunicable Diseases Branch Division of Global Health Protection Center for Global Health Centers for Disease Control and Prevention Atlanta GAResolve to Save Lives, an Initiative of Vital Strategies New York NYDepartment of Health System Design & Global Health and Department of Medicine Icahn School of Medicine at Mount Sinai Health System New York USABackground Access to medicines is important for long‐term care of cardiovascular diseases and hypertension. This study provides a cross‐country assessment of availability, prices, and affordability of cardiovascular disease and hypertension medicines to identify areas for improvement in access to medication treatment. Methods and Results We used the World Health Organization online repository of national essential medicines lists (EMLs) for 53 countries to transcribe the information on the inclusion of 12 cardiovascular disease/hypertension medications within each country's essential medicines list. Data on availability, price, and affordability were obtained from 84 surveys in 59 countries that used the World Health Organization's Health Action International survey methodology. We summarized and compared the indicators across lowest‐price generic and originator brand medicines in the public and private sectors and by country income groups. The average availability of the select medications was 54% in low‐ and lower‐middle‐income countries and 60% in high‐ and upper‐middle‐income countries, and was higher for generic (61%) than brand medicines (41%). The average patient median price ratio was 80.3 for brand and 16.7 for generic medicines and was higher for patients in low‐ and lower‐middle‐income countries compared with high‐ and upper‐middle‐income countries across all medicine categories. The costs of 1 month's antihypertensive medications were, on average, 6.0 days’ wage for brand medicine and 1.8 days’ wage for generics. Affordability was lower in low‐ and lower‐middle‐income countries than high‐ and upper‐middle‐income countries for both brand and generic medications. Conclusions The availability and accessibility of pharmaceuticals is an ongoing challenge for health systems. Low availability and high costs are major barriers to the use of and adherence to essential cardiovascular disease and antihypertensive medications worldwide, particularly in low‐ and lower‐middle‐income countries.https://www.ahajournals.org/doi/10.1161/JAHA.119.015302cardiovascular diseaseessential medicine listshealthcare accesshealthcare costshypertensionmedication |
| spellingShingle | Muhammad Jami Husain Biplab Kumar Datta Deliana Kostova Kristy T. Joseph Samira Asma Patricia Richter Marc G. Jaffe Sandeep P. Kishore Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular disease essential medicine lists healthcare access healthcare costs hypertension medication |
| title | Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability |
| title_full | Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability |
| title_fullStr | Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability |
| title_full_unstemmed | Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability |
| title_short | Access to Cardiovascular Disease and Hypertension Medicines in Developing Countries: An Analysis of Essential Medicine Lists, Price, Availability, and Affordability |
| title_sort | access to cardiovascular disease and hypertension medicines in developing countries an analysis of essential medicine lists price availability and affordability |
| topic | cardiovascular disease essential medicine lists healthcare access healthcare costs hypertension medication |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.015302 |
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