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Tytuł:
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Impact of National Drug Pricing Policy 2018 on access to medicines in Lahore division, Pakistan: a pre-post survey study using WHO/HAI methodology.
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Autorzy:
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Saeed A; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China.; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Saeed H; Department of Pharmaceutics, University of the Punjab, Lahore, Pakistan.
Saleem Z; Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan.
Yang C; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China.; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Jiang M; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China.; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Zhao M; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China.; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Ji W; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China.; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Aziz MM; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China.; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Khan FU; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China.; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Gillani AH; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China.; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Atif N; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China.; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Fang Y; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Shaanxi, China .; Center for Drug Safety and Policy Research, Xian Jiaotong University, Shaanxi, China.; Shaanxi Centre for Health Reform and Development Research, Shaanxi, China.
Babar ZUD; Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, West Yorkshire, UK.
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Źródło:
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BMJ open [BMJ Open] 2020 Oct 08; Vol. 10 (10), pp. e034720. Date of Electronic Publication: 2020 Oct 08.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
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MeSH Terms:
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Drug Costs*
Drugs, Essential*
Costs and Cost Analysis ; Cross-Sectional Studies ; Health Services Accessibility ; Humans ; Pakistan ; World Health Organization
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References:
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Health Policy Plan. 2010 May;25(3):219-29. (PMID: 19955093)
Lancet. 2009 Jan 17;373(9659):240-9. (PMID: 19042012)
Br Med Bull. 2014 Sep;111(1):31-44. (PMID: 25190759)
PLoS One. 2013 May 22;8(5):e63515. (PMID: 23717442)
Lancet. 2013 Jun 29;381(9885):2281-90. (PMID: 23684257)
PLoS One. 2019 Apr 25;14(4):e0216122. (PMID: 31022276)
BMJ. 2004 Apr 3;328(7443):807-10. (PMID: 15070638)
Lancet. 2011 Feb 19;377(9766):680-9. (PMID: 21269677)
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Front Pharmacol. 2017 Aug 02;8:504. (PMID: 28824429)
BMC Health Serv Res. 2019 Jun 13;19(1):383. (PMID: 31196078)
J Pak Med Assoc. 2014 Nov;64(11):1218-9. (PMID: 25831633)
PLoS One. 2019 Feb 12;14(2):e0212125. (PMID: 30753219)
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Contributed Indexing:
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Keywords: health economics; health policy; health services administration & management; pharmacology
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Molecular Sequence:
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Dryad 10.5061/dryad.tqjq2bvwq
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Substance Nomenclature:
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0 (Drugs, Essential)
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Entry Date(s):
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Date Created: 20201009 Date Completed: 20210514 Latest Revision: 20210514
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Update Code:
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20240105
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PubMed Central ID:
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PMC7545625
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DOI:
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10.1136/bmjopen-2019-034720
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PMID:
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33033079
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Objective: To evaluate the impact of new National Drug Pricing Policy (NDPP) 2018 on access to medicines in terms of prices, availability and affordability.
Design: Two cross-sectional surveys were undertaken before and after the launch of NDPP 2018, using a modified WHO/Health Action International (WHO/HAI) methodology.
Setting: Four districts of Lahore division, Pakistan.
Participants: 16 public sector hospitals and 16 private sector retail pharmacies.
Measures: The pre and post survey data on prices and availability of lowest price generics (LPGs) and originator brands (OBs) of 50 medicines were obtained by visiting the same public and private sector health facilities (n=32). Out of 50, 46 surveyed medicines were from the National Essential Medicines List. Inflation-adjusted median unit prices (MUPs) and median price ratios (MPRs) from 2019 were used for price comparison. Affordability was calculated in terms of number of days' wages required to get a standard treatment by the lowest paid unskilled government worker.
Results: The overall mean percent availabilities remained poor in both years, that is, far less than 80%. In the public sector, the mean percent availability of OBs improved from 6.8% to 33.1%, whereas, in the case of LPGs, it was reduced from 35.1% to 9%. In the private sector, the mean percent availability of both OBs and LPGs demonstrated slight improvements in 2019, that is, 55.0%-58.3% and 20.3%-32.3%. The adjusted MUPs and MPRs of OBs significantly increased by a median of 4.29% (Wilcoxon test p=0.001, p=0.0001), whereas the adjusted MUPs and MPRs of LPGs increased by a median of 15.7% (p=0.002, p=0.0002). Overall, the affordability of many medicines for common ailments was reduced significantly in 2019.
Conclusions: The availability of medicines slightly improved, except in the case of LPGs, which was reduced in the public sector. The implementation of NDPP 2018 led to increase in drug prices, making the standard treatment for some of the most prevalent ailments unaffordable. So verily, the drug pricing policy must be reviewed to ensure access to essential medicines.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
