Essential Medicines Are More Available than Other Medicines around the Globe

Bazargani, Y. T.; Ewen, Margaret; Boer, Anthonius de; Leufkens, Hubert G. M.; Mantel‐Teeuwisse, Aukje K.

doi:10.1371/journal.pone.0087576

Cited by 95 publications

(98 citation statements)

References 24 publications

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“…Essential medicines in general are more available than non-essential ones, reflecting as it does the significance of the concept [30] . Countries with a solid public health sector, such as Sri Lanka, have strong procurement system, better availability and lower and affordable price of essential medicines; in fact, medicines are available free of charge from retail pharmacies of State Pharmaceuticals Corporation and at affordably low price from private outlets [31] .…”

Section: Resultsmentioning

confidence: 99%

Adapting Pharmaceutical Pricing and Reimbursement Strategies for Achieving Universal Health Coverage in Nepal: Lessons from Selected Low- And Lower-Middle-Income Countries

Acharya¹

2016

IJPS

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Universal health coverage is increasingly being embraced by low-and high-income countries alike, and pharmaceuticals are an integral part of it. With Nepal adopting national health insurance policy and willing to implement the same, guidance regarding pharmaceutical pricing, coverage and reimbursement becomes the order of the day. This study reviews pricing and reimbursement policies and techniques in low-and lower-middle-income countries which are implementing or intend to implement universal health coverage schemes, and provides recommendations on policies and techniques applicable and most pertinent to Nepal. For this, relevant literature on 11 countries was searched. The countries studied here are at different stages of universal health coverage, and they are aligning their pharmaceutical pricing and reimbursement policies and techniques with their universal health coverage policy. Considerable variation exists among these countries in regard to pricing, ranging from ceiling pricing (based on cost-plus, external referencing or market-based technique) to free pricing. All these countries have framed their essential medicines list; few or all of the medicines in the list are provided free of charge to targeted groups. Different universal health coverage schemes are at work in these countries, financing strategy for which span tax-based, premiumbased and payroll deductions. Reimbursement decisions are intricately linked with pricing, with majority of the countries putting into effect a fixed reimbursable amount strategy for reimbursed products. In regard to Nepal, as it is beginning its universal health coverage journey, the ideal approach would be a ceiling price for essential medicines (applicable to both in-insurance and out-insurance) and reference or index pricing for reimbursed products. Key words: Universal health coverage, pharmaceutical pricing, reimbursement, low-and lower-middleincome countriesTouted as a global health transition, third of its kind, Universal Health Coverage (UHC) has entered the health lexicon of low, middle and high-income countries alike [1] . Countries are formulating and implementing their health policies with an eye to UHC. UHC was founded with two core objectives, to provide accessibility to health care services, and to provide financial risk protection for utilization of those services [2] . It encompasses three elements namely health services, population, and proportion of cost [3] . It necessitates a health services package, which is made available to the populace with no or minimal charge (in the form of co-payment, co-insurance or deductibles) at the time of service use [3] . Among different health services covered, or considered to be covered, by the health benefits package, pharmaceuticals pose a peculiar challenge.Coverage of pharmaceuticals entails decisions regarding their pricing and reimbursement. Total pharmaceutical expenditure (TPE) is on the rise globally, accounting for an average 1.5% of global gross domestic product (GDP) in 2006 [4] . TPE has a share of 24....

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Section: Resultsmentioning

confidence: 99%

Adapting Pharmaceutical Pricing and Reimbursement Strategies for Achieving Universal Health Coverage in Nepal: Lessons from Selected Low- And Lower-Middle-Income Countries

Acharya¹

2016

IJPS

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“…Pharmacoepidemiologic studies analyzing public records for policy implementation, drug availability and drug uses have shown that essential medicines lists are associated with improved availability and quality use of medicines, particularly in lowand middle-income countries. 4,[10][11][12] For example, South Africa drafted an essential medicines list in 1995, guaranteeing availability and thereby ensuring the improved distribution of 85% of its key medicines to primary care centres. 13 Similarly, the Palestinian Ministry of Health created an essential medicines list in 2000 and observed significant improvement in several health indicators, such as quality use of medicines for antibiotics, injectables and numbers of medicines per encounter, and rational choice selection from the essential medicines list.…”

Section: Are Essential Medicines Lists and Like Policies Effective?mentioning

confidence: 99%

The case for an essential medicines list for Canada

Eom

Grootendorst

Duffin

2016

CMAJ

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“…4 Medicines selected for the Model List are associated with increased global availability in both the public and private sectors when compared to nonessential medicines. 5 The Model List has grown from 208 medicines in 1977 to over 400 medicines in the 2015 edition. It includes a core list of efficacious, safe, and cost-effective medicines relevant to a basic health care system, and a complementary list of medicines for which specialized diagnostic or monitoring facilities, specialist medical care, or specialist training are needed.…”

Section: Introductionmentioning

confidence: 99%

Expanding medicines for neurologic disorders on the WHO Model List

2017

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The WHO Model List of Essential Medicines is a recommended formulary for high-priority diseases based on public health trends and epidemiology patterns. The biennial publication serves as a guide for countries, particularly low-and lower-middle-income countries, to develop their own national essential medicines list (EML), and many nongovernmental organizations base their medication supplies on the WHO EML. Over the last 40 years, WHO has expanded the EML in response to treatment gaps for infectious diseases, pediatrics, palliative care, and cancer. In contrast, neurotherapeutics are poorly represented on the Model List despite the global burden of neurologic disorders, which have continued to increase in the last decade. It is imperative that the neurology community advocate for more evidence-based neurologic medicines on the WHO EML. Equitable access to essential neurologic medicines is a crucial step toward reducing the treatment gap for high-burden neurologic disorders worldwide. Neurology ® 2017;88:e87-e91 GLOSSARY EML 5 essential medicines list; LMIC 5 low-and lower-middle-income countries; NGO 5 nongovernmental organization.The burden of neurologic disorders on the global population continues to increase, particularly in low-and lower-middle-income countries (LMICs).1 The most recent estimates from the Global Burden of Disease Study show that stroke is the second highest cause of mortality and morbidity worldwide.1,2 Migraine, meningitis, and dementia rank in the top 30 causes of disability-adjusted life-years, and epilepsy in the top 50, of 315 diseases and injuries studied. Numerous treatment gaps exist for high-burden neurologic disorders in LMICs, 3 and improved access to essential neurologic medicines deserves prioritization.The WHO publishes its Model List of Essential Medicines in order to guide developing countries in their national drug policies, ensure equitable access to essential medicines, and promote rational use of medicines. The essential medicines concept has inspired over 110 countries to generate a national essential medicines list (EML). In addition, many nongovernmental organizations (NGOs) that facilitate health care in resource-poor settings (e.g., United Nations High Commissioner for Refugees, Médecins Sans Frontières, and International Federation of Red Cross and Red Crescent Societies) accept donations and distribute medicines in accordance with the WHO EML. 4 Medicines selected for the Model List are associated with increased global availability in both the public and private sectors when compared to nonessential medicines. 5 The Model List has grown from 208 medicines in 1977 to over 400 medicines in the 2015 edition. It includes a core list of efficacious, safe, and cost-effective medicines relevant to a basic health care system, and a complementary list of medicines for which specialized diagnostic or monitoring facilities, specialist medical care, or specialist training are needed.6 While the WHO EML has expanded in response to treatment gaps for infectious diseases,...

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Essential Medicines Are More Available than Other Medicines around the Globe

Cited by 95 publications

References 24 publications

Adapting Pharmaceutical Pricing and Reimbursement Strategies for Achieving Universal Health Coverage in Nepal: Lessons from Selected Low- And Lower-Middle-Income Countries

Adapting Pharmaceutical Pricing and Reimbursement Strategies for Achieving Universal Health Coverage in Nepal: Lessons from Selected Low- And Lower-Middle-Income Countries

The case for an essential medicines list for Canada

Expanding medicines for neurologic disorders on the WHO Model List

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