Importance of medicine quality in achieving universal health coverage

Abstract

Objective To assess the importance of ensuring medicine quality in order to achieve universal health coverage (UHC). Methods We developed a systems map connecting medicines quality assurance systems with UHC goals to illustrate the ensuing impact of quality-assured medicines in the implementation of UHC. The association between UHC and medicine quality was further examined in the context of essential medicines in low-and middle-income countries (LMICs) by analyzing data on reported prevalence of substandard and falsified essential medicines and established indicators for UHC. Finally, we examined the health and economic savings of improving antimalarial quality in four countries in sub-Saharan Africa: the Democratic Republic of the Congo (DRC), Nigeria, Uganda, and Zambia. Findings A systems perspective demonstrates how quality assurance of medicines supports dimensions of UHC. Across 63 LMICs, the reported prevalence of substandard and falsified essential medicines was found to be negatively associated with both an indicator for coverage of essential services (p = 0.05) and with an indicator for government effectiveness (p = 0.04). We estimated that investing in improving the quality of antimalarials by 10% would

The Indonesian Strategy to Achieve Universal Health Coverage through National Health Insurance System: Its Challenges in Human Resources

“…Low-middle-income countries that procure substandard essential medicines show a negative relationship indicator between service coverage and government effectiveness. While in drug services, the friendly attitude of officers, completeness of prescriptions, and drug safety information have a significant positive effect on hospital pharmacy use, 35,36 factors of doctors, pharmacists, and patients have a joint impact on the availability of drugs in the NHI. 37 Service quality assurance and cost control cannot stand alone.…”

Accessing quality‐assured medicines for pregnancy complications in lower‐ and middle‐income countries

“…Nevertheless, assisting manufacturers to produce quality-assured medicines is essential. The impact of substandard or falsified anti-malarial drugs has a huge negative cost implication in LMICs, 6 while the cost of hospital care of women with PPH is considerably more than those without bleeding, something that can be reduced by using quality-assured medicines. 7 It is not inevitable that substandard products reach women who need them for their own survival and/or the survival of their newborn, but countries must ensure that the only medicines available are quality-assured (SRA-approved or WHO-prequalified).…”

The importance of visual inspection in national quality assurance systems for medicines

“…In summary, these real-life cases indicate that a careful visual inspection, i.e., a simple and inexpensive technology, is of paramount importance in monitoring the quality of medicines not only in the field, but also at central level. In a pharmaceutical scenario characterized by a situation of multiple quality standards [ 7 – 10 ], complex distribution networks [ 11 , 12 ], and weaknesses of the pharmaceutical systems [ 13 , 14 ], it can provide additional important guidance to timely recall suspicious batches, to revoke marketing authorizations of unreliable suppliers, and to protect public health [ 15 ]. Central medical stores and regulatory agencies need to consider the visual inspection as part of their prequalification and ongoing requalification system.…”