埃塞俄比亚南部用于治疗非传染性疾病的基本药物的获取情况:使用世界卫生组织/HAI 方法进行分析。

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL
SAGE Open Medicine Pub Date : 2024-07-30 eCollection Date: 2024-01-01 DOI:10.1177/20503121241266318
Getahun Asmamaw, Tekalign Shimelis, Dinksew Tewuhibo, Teshome Bitew, Wondim Ayenew
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引用次数: 0

摘要

研究目的本研究旨在通过分析埃塞俄比亚南部加莫区阿尔巴明奇镇用于治疗非传染性疾病的基本药物的可用性、价格和可负担性,评估这些药物的可及性:方法:采用世界卫生组织/国际健康行动组织的方法,于 2023 年 3 月 2 日至 5 月 2 日在埃塞俄比亚南部阿尔巴明奇镇的公立和私立医疗机构进行了横断面设计。中位数价格比作为衡量标准。采用 Shapiro-Wilk 和 Kolmogorov-Smirnov 等统计检验来评估价格数据的正态分布。此外,还采用了 Wilcoxon-Mann-Whitney U 检验来比较公立和私立医疗机构之间的买方价格(患者价格)中位数。通过估算埃塞俄比亚收入最低的政府雇员为负担处方药物治疗所需的工资天数来确定治疗的可负担性:在接受调查的 23 家医疗机构中,用于治疗非传染性疾病的基本药物的总体供应率为 18.7%(范围:0%-30.1%),其中公立和私立医疗机构分别占 16.3% 和 38.3%。总体卫生部门的原研品牌药物供应率为 1.1%,公共部门为 0.6%,私营部门为 1.2%。最低价非专利药的总体供应率为 36.2%(范围:0%-26.2%;公共部门:32.0%;私营部 门:37.1%)。只有 7 种最低价非专利药达到了世界卫生组织 80%及以上的目标。私立医院最低价仿制药的总体中位价是公立医院的两倍。价格中位数排名前五位的药品是氨氯地平、呋塞米、胰岛素、倍氯米松和沙丁胺醇。Mann-Whitney U 检验表明,11.6%的最低价非专利药品在公私部门的中位数价格差距具有显著的统计学意义(p 结论:公私部门的中位数价格差距在统计学上是显著的:这项研究揭示了非传染性疾病基本药物的有限供应和对患者造成的潜在经济负担。供应有限表明,需要改善供应链管理和稳定的库存供应。所发现的价格差异和可负担性挑战突出表明,有必要采取价格监管和补贴计划等政策干预措施,以确保埃塞俄比亚南部阿尔巴明奇镇公平获得基本非传染性疾病药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Access to essential medicines used in the management of noncommunicable diseases in Southern Ethiopia: Analysis using WHO/HAI methodology.

Objectives: This study aims to assess access to essential medicines used in the management of noncommunicable diseases through analysis of the availability, prices, and affordability of these essential medicines in Arba Minch town, Gamo Zone, Southern Ethiopia.

Methods: A cross-sectional design was carried out using the World Health Organization/health action international methodology between 2 March and 2 May 2023, within public and private healthcare facilities located in Arba Minch town, Southern Ethiopia. The median price ratio served as a metric. Statistical tests like the Shapiro-Wilk and Kolmogorov-Smirnov were utilized to assess the normal distribution of price data. The Wilcoxon-Mann-Whitney U test was also employed to compare median buyer's prices (patient prices) between public and private healthcare institutions. Treatment affordability was determined by estimating the number of days' wages required by the lowest-paid government employee in Ethiopia to afford the prescribed medication regimen.

Results: Among 23 health facilities surveyed, the pooled availability of essential medicine used in the management of noncommunicable diseases was 18.7% (range: 0%-30.1%), with the public and private facilities contributing 16.3% and 38.3%, respectively. The overall percentage of availability originator brand versions was 1.1% for overall health sectors, 0.6% for public sectors, and 1.2% for private sectors. The overall percent availability of lowest price generics was 36.2% (range: 0%-26.2%; public: 32.0%; private: 37.1%). Only seven lowest price generics satisfied the World Health Organization target of 80% and above. The overall median price of lowest price generic medicines in private was two times higher than in public sectors. The top five median price scorers were amlodipine, furosemide, insulin, beclomethasone, and salbutamol. The Mann-Whitney U test showed that 11.6% of lowest price generics medicines had a statistically significant median price disparity between the public and private sectors (p < 0.05). The overall percent of unaffordability was found to be 100.0%, (public: 70.4; private: 100.0%).

Conclusions: This study revealed the limited availability and potential financial burdens on patients seeking essential noncommunicable disease medications. Limited availability suggests the need for better supply chain management and consistent stock availability. The price disparities and affordability challenges identified underscore the necessity for policy interventions such as price regulation and subsidized programs to ensure equitable access to essential noncommunicable disease medications in Arba Minch town, Southern Ethiopia.

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SAGE Open Medicine
SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.30%
发文量
289
审稿时长
12 weeks
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