Prices, Availability and Affordability of Medicines with Value-Added Tax Exemption: A Cross-Sectional Survey in the Philippines

Lambojon, Krizzia; Chang, Jie; Saeed, Amna; Hayat, Khezar; Li, Pengchao; Jiang, Minghuan; Atif, Naveel; Desalegn, Gebrehaweria Kassa; Khan, Faiz Ullah; Fang, Yu

doi:10.3390/ijerph17145242

Cited by 18 publications

(12 citation statements)

References 16 publications

(20 reference statements)

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“…Most previous studies of this type have been in developing countries. Comparatively, the availability of LPGs in our study was similar to the results in Pakistan (Saeed et al, 2019) and Philippines (Lambojon et al, 2020) but lower than those in Bangladesh (Kasonde et al, 2019), Malawi (Khuluza and Haefele-Abah, 2019), Jordan (Alefan et al, 2018), and Rwanda (Bizimana et al, 2020), where the availability of LPGs was fairly high; however, the availability of OBs in those countries was similar. Comparing with the price in other developing countries, LPGs in our study had November 2020 | Volume 11 | Article 602421 similar or a little higher price, while OBs had a much higher price.…”

Section: Discussionsupporting

confidence: 78%

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Yang

et al. 2020

Front. Pharmacol.

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Objectives: To evaluate the price and availability of medicines in China.Methods: A standard methodology developed by WHO and Health Action International was used to collect medicine price and availability data. We obtained cross-sectional data for 48 medicines from 519 facilities (280 public hospitals and 239 private retail pharmacies) in five provinces in China in 2018. We also collected longitudinal data for 31 medicines in Shaanxi Province in 2010, 2012, 2014, and 2018. Medicine price was compared with the international reference price to obtain a median price ratio (MPR). The availability and price in five provinces were compared in matched sets. We used general estimating equations to calculate differences in availability and median prices from 2010 to 2018.Findings: Mean availability of surveyed medicines in five provinces was low in both public (4.29–32.87%) and private sectors (13.50–43.75%). The MPR for lowest priced generics (LPGs) was acceptable (1.80–3.02) and for originator brands (OBs) was much higher (9.14–12.65). The variation was significant for both availability and price of medicines across provinces. In Shaanxi Province, the availability of medicines decreased between 2010 and 2018, but this was not significant in the public or private sector. Compared with 2010, the median adjusted patient price was significantly lower in 2018 for nine OBs (difference −22.4%; p = 0.005) and 20 LPGs (−20.5%; p = 0.046) in the public sector and 10 OBs (−10.2%; p = 0.047) in the private sector.Conclusion: Access to medicines was found to be poor and unequal across China in 2018. Future interventions are needed, and possible strategies include effective and efficient procurement, promoting the development of retail pharmacies and increasing medicine price transparency.

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Section: Discussionsupporting

confidence: 78%

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Yang

et al. 2020

Front. Pharmacol.

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“…Overall, the average availability of OB medicines was lower than that of LPG medicines (Figure1-2). The ndings are consistent with prior surveys in developing countries [14,20,21] . They found that most of the OB medicines were produced by large international manufacturers.…”

Section: Discussionsupporting

confidence: 90%

What Factors Hindered the Access to Essential Anti-Cancer Medicine in Public Hospitals amongst the Local Population in Hubei Province, China?

Chen

Feng

Yan

et al. 2021

Preprint

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BackgroundCancer poses a serious threat to one’s health, which caused significant economic burden on the family and society. Poor availability and affordability resulted in some essential medicines failing to meet the basic health needs of this group of patients. The objective of this study was to evaluate the availability, prices and affordability of 32 anticancer essential medicines in Hubei Province, China.MethodsData on the availability and price related information of 32 essential anticancer medicines in the capital and five other cities of Hubei Province were collected. A total of 28 hospitals were sampled, which included 13 tertiary hospitals and 15 secondary hospitals. We used the standard methods developed by the World Health Organization (WHO) and Health Action International (HAI) to compare the differences in drug price, availability and affordability between secondary hospitals and tertiary hospitals. ResultsOverall, the availability of medicine was higher in tertiary hospitals. The average availability of originator brand (OBs) was 13.70% (tertiary hospitals) VS 6.67% (secondary hospitals), and lowest-priced generic (LPGs) was 62.83% (tertiary hospitals) VS 42.92% (secondary hospitals). The MPR value of most sampled medicines in secondary hospitals were less than 1. In contrast, the MPR of Cytarabine (17.15), Oxaliplatin (12.73) were significantly higher than the international reference price. The top three OBs’ total expenses for 30-day treatment were Irinotecan, Oxaliplatin, Bicalutamide. Further, their affordability was relative low, as the costs for one course using these medicines were much higher than 20% of the minimum family monthly income.ConclusionThough the “Zero Mark-Up” and “Two Vote” Policies have been implemented in China, the availability issue yet to be addressed. High price and low affordability were the major barriers to the access of essential anticancer medicines. Measures should be taken to provide sufficient, available and affordable medicines to patients in need.

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“…After investigating 13 tertiary hospitals and 15 secondary hospitals' essential drugs, overall, we found that 7.57% of OB and 40.88% of LPGs were available in Hubei Province, China. The findings are similar with prior surveys in developing countries (Khuluza and Haefele-Abah, 2019;Saeed et al, 2019;Lambojon et al, 2020). Amna Saeed found that the overall availability of surveyed medicines in public sector was 6.8% only for OBs and 35.3% for the LPGs in Pakistan.…”

Section: Availability Of Surveyed Medicinessupporting

confidence: 88%

What Factors Hindered the Access to Essential Anticancer Medicine in Public Hospitals for the Local Population in Hubei Province, China

et al. 2021

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Background:Cancer poses a serious threat to one’s health, which caused significant economic burden on the family and society. Poor availability and affordability resulted in some essential medicines failing to meet the basic health needs of this group of patients. The objective of this study was to evaluate the availability, prices and affordability of 32 anticancer essential medicines in Hubei Province, China.Methods: Data on the availability and price related information of 32 essential anticancer medicines in the capital and five other cities of Hubei Province were collected. A total of 28 hospitals were sampled, which included 13 tertiary hospitals and 15 secondary hospitals. We used the standard methods developed by the World Health Organization and Health Action International to compare the differences in drug price, availability and affordability between secondary hospitals and tertiary hospitals.Results: Overall, the availability of medicine was higher in tertiary hospitals. The average availability of originator brand (OBs) was 13.70% (tertiary hospitals) VS 6.67% (secondary hospitals), and lowest-priced generic (LPGs) was 62.83% (tertiary hospitals) VS 42.92% (secondary hospitals). The MPR value of most sampled medicines in secondary hospitals were less than 1. In contrast, the MPR of Cytarabine (17.15), Oxaliplatin (12.73) were significantly higher than the international reference price. The top three OBs’ total expenses for 30-days treatment were Irinotecan, Oxaliplatin, Bicalutamide. Further, their affordability was relative low, as the costs for one course using these medicines were much higher than 20% of the minimum family monthly income.Conclusion: Though the “Zero Mark-Up” and “Centralized procurement policy of anti-tumor drugs” policies have been implemented in China, the availability issue yet to be addressed. High price and low affordability were the major barriers to the access of essential anticancer medicines. Measures should be taken to provide sufficient, available and affordable medicines to patients in need.

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Prices, Availability and Affordability of Medicines with Value-Added Tax Exemption: A Cross-Sectional Survey in the Philippines

Cited by 18 publications

References 16 publications

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

What Factors Hindered the Access to Essential Anti-Cancer Medicine in Public Hospitals amongst the Local Population in Hubei Province, China?

What Factors Hindered the Access to Essential Anticancer Medicine in Public Hospitals for the Local Population in Hubei Province, China

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