对改善药品获取的政策方法进行系统审查的证据

IF 0.2 Q4 HEALTH CARE SCIENCES & SERVICES
Celestino Kuchena, A. Qutieshat
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引用次数: 0

摘要

关于药品获取的现行框架建议将全球采购作为一种解决方案,假设药品在全球市场上存在。然而,获得药品仍然具有挑战性,尤其是在发展中国家。这是一个全球性的担忧,因为联合国认为获得基本药物的机会有限是确保健康权的五个指标之一。为了填补卫生系统研究的研究空白并为决策提供信息,我们综合了政府政策如何影响中低收入国家(LMIC)药品获取的系统审查证据。我们选择了快速审查方法来缩短时间,避免错过政策“机会之窗”。为了只包括新冠肺炎开始后发表的研究,我们选择了2019年至2022年11月2日发表的系统审查。这也符合文献中关于查看最近系统综述的建议。这些主题采用主题和文本叙述方法进行分组。这篇综述包括32项研究,这些研究从不同的角度考察了获得药物的途径。需要同时采取供给和需求两方面的政策来改善医疗服务。LMIC负担不起药品,而且供应永远无法满足需求。LMIC由于议价能力有限,将继续与药品定价作斗争。卫生设施中的城市偏见和政策变化减少了药品的供应和使用。各国领导人必须做出维持国内资金的政策决定。政策制定者应该考虑到组织可能会违背政策目标。LMIC政府必须制定多管齐下的战略来应对其独特的挑战,而不是照搬发达国家的做法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evidence from systematic reviews on policy approaches to improving access to medicines
The prevailing frameworks on access to medicines advise global procurement as a solution by assuming the presence of medicines on the global market. Yet access to medicines remains challenging, especially in developing countries. This is a global worry because the UN considers limited access to essential medicines as one of the five indicators of securing the right to health. To fill a research gap in health system studies and inform policymaking, we synthesized evidence from systematic reviews of how government policies affect low- and middle-income country (LMIC) medicine access. We chose a rapid review approach to reduce timelines and avoid missing policy “windows of opportunity.” To include only studies published after the start of COVID-19, we chose systematic reviews published between 2019 and November 2nd, 2022. This was also in line with recommendations in the literature to look at recent systematic reviews. The themes were grouped using a thematic and textual narrative approach. This review included 32 studies that examined access to medicine from various perspectives. Both supply- and demand-side policies are needed to improve medical access. LMICs cannot afford medicines, and supply never meets demand. LMICs will continue to struggle with pharmaceutical pricing due to their limited bargaining power. The urban bias in health facilities and policy changes reduce medicine availability and use. Leaders must make policy decisions to sustain domestic funds. Policymakers should consider that organizations may act against policy goals. Instead of copying developed nations, LMIC governments must develop multipronged strategies to address their unique challenges.
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CiteScore
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