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1.
Rev. panam. salud pública ; 45: e57, 2021. tab, graf
Article in English | LILACS | ID: biblio-1251987

ABSTRACT

ABSTRACT Objective. To examine multiple aspects of the medicines in CARICOM procurement markets, including manufacturer headquarters location, regulatory history, and type (innovator versus generic); the proportion of World Health Organization (WHO) essential medicines; and the most expensive medicines procured. Methods. An analysis of procurement information from selected CARICOM procurers. Four public sector procurement lists were obtained based on public availability or sharing of data from public sector procurers. Analyses were based on parameters available or deduced from these data. Results. The majority of products come from manufacturers headquartered in North America and Europe (63%-67%). The percentage of medicines procured from generic companies is 60%-87%; and 25%-50% of medicines procured are on the WHO Essential Medicines List. Wide price variations exist in the most expensive medicines purchased. Conclusions. The analysis identifies vulnerabilities and opportunities in the procurement situation of CARICOM states, particularly related to quality and rational use of medicines. This analysis represents a baseline that governments and other stakeholders can use in the future.


RESUMEN Objetivo. Revisar los múltiples aspectos de los medicamentos en los mercados de compras y los proveedores de CARICOM, como la ubicación de la sede del fabricante, el historial de regulación, el tipo (patentado versus genérico); la proporción de medicamentos esenciales de la Organización Mundial de la Salud (OMS); y los medicamentos comprados más caros. Métodos. Se analizó información sobre la compra por parte de determinados organismos de CARICOM. La información procedía de cuatro listas de organismos del sector público que realizan las compras, que se consiguieron en función de su disponibilidad pública o de los datos distribuidos por los organismos del sector público que realizan las compras. Los análisis estaban basados en los parámetros disponibles o derivados de estos datos. Resultados. La mayoría de los productos proviene de fabricantes radicados en América del Norte y Europa (entre 63% y 67%). El porcentaje de medicamentos que se compra de empresas genéricas oscila entre 60% y 87%; y de 25% a 50% de los medicamentos que se compran están en la Lista de Medicamentos Esenciales de la OMS. Hay una gran divergencia de precios entre los medicamentos comprados más caros. Conclusiones. En el análisis se han encontrado vulnerabilidades y oportunidades con respecto a la situación de las compras de medicamentos de los Estados de CARICOM, especialmente en cuanto a la calidad y al uso racional de los medicamentos. Este análisis representa una línea de base que los gobiernos u otros interesados directos pueden utilizar en el futuro.


RESUMO Objetivo. Examinar vários aspectos relacionados aos mercados e fornecedores de produtos farmacêuticos da CARICOM, incluindo a localização da sede do laboratório fabricante, histórico regulatório e tipo de produtos (inovadores versus genéricos); proporção de medicamentos adquiridos que constam da relação de medicamentos essenciais da Organização Mundial da Saúde (OMS); e medicamentos mais caros comprados. Métodos. Foi realizada uma análise de informação sobre compras feitas por compradores selecionados da CARICOM. Quatro listas de compras do setor público foram obtidas com informação de acesso público ou compartilhada pelos compradores. As análises foram feitas com base em parâmetros disponíveis ou inferidos a partir dos dados. Resultados. A maioria dos produtos farmacêuticos é proveniente de laboratórios com sedes na América do Norte e Europa (63%-67%). Do total, 60%-87% dos medicamentos adquiridos são de laboratórios de produtos genéricos e 25%-50% constam da relação de medicamentos essenciais da OMS. Existe uma ampla variação nos preços dos medicamentos mais caros comprados. Conclusões. Foram identificadas fragilidades e oportunidades na situação de compras dos países da CARICOM, em particular relacionadas à qualidade dos produtos e ao uso racional dos medicamentos. Esta análise serve de referência a ser usada futuramente pelos governos e outras partes interessadas.


Subject(s)
Humans , Drugs, Generic/economics , Drugs, Essential/economics , Pharmaceutical Trade , World Health Organization , Public Sector , Economics, Pharmaceutical , Drugs, Essential/supply & distribution
2.
Einstein (Säo Paulo) ; 18: eGS4442, 2020. tab, graf
Article in English | LILACS | ID: biblio-1039730

ABSTRACT

ABSTRACT Objective To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease. Methods We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center. Results Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage. Conclusion Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.


RESUMO Objetivo Analisar as demandas judiciais do brometo de tiotrópio para tratar a doença pulmonar obstrutiva crônica. Métodos Foram considerados dados secundários dos sistemas gerenciais de assistência farmacêutica, disponibilizados pelo Centro de Medicamentos do Paraná. Resultados Ações civis públicas e ações ordinárias, de procedimento comum, entre outras, foram as mais praticadas pelos pacientes para obter o medicamento. Duas Regionais de Saúde do Paraná (Londrina e Umuarama) concentraram mais de 50% das ações. Quanto à especialidade dos médicos prescritores, 33,8% eram pneumologistas. Verificou-se discreto impacto financeiro do brometo de tiotrópio nos gastos gerais com medicamentos pelo Centro de Medicamentos do Paraná. Entretanto, também houve relevante impacto financeiro individual, pois uma unidade do medicamento consome 38% do salário mínimo. Conclusão O estudo aponta para a necessidade de incorporação deste medicamento da classe broncodilatadores anticolinérgicos de longa duração, no Sistema Único de Saúde.


Subject(s)
Humans , Bronchodilator Agents/economics , Drugs, Essential/supply & distribution , Pulmonary Disease, Chronic Obstructive/economics , Judicial Role , Tiotropium Bromide/economics , Health Services Needs and Demand/legislation & jurisprudence , Time Factors , Brazil , Retrospective Studies , Statistics, Nonparametric , Drugs, Essential/economics , Pulmonary Disease, Chronic Obstructive/drug therapy , Health Services Accessibility/economics , Health Services Accessibility/legislation & jurisprudence , Health Services Accessibility/trends , Health Services Needs and Demand/economics , Health Services Needs and Demand/trends , National Health Programs
3.
Rev. saúde pública (Online) ; 53: 50, jan. 2019. tab, graf
Article in English | LILACS | ID: biblio-1004504

ABSTRACT

ABSTRACT OBJECTIVE To analyze the regional allocation of the resources from the Brazilian Popular Pharmacy Program, taking into account the relative availability of the program and the potential needs of the region. METHODS Data from the National Health Survey of the Annual Report of Social Information and the administrative database of the program were used to create a non-parametric indicator of coverage using multiple data envelopment analysis technique. This indicator considers the relative availability of the program, taking into account equal access to equal needs (equity based on regional needs). The analysis of this indicator shows if the regions that most need pharmaceutical assistance are those that receive more resources from the Brazilian Popular Pharmacy Program. RESULTS The states belonging to the richest regions of the country, Southeast and South, present wider relative coverage of the Brazilian Popular Pharmacy Program compared to poorer localities. In addition, the inequalities observed between locations are better explained by inefficiency in the transfer of resources to the basic component of pharmaceutical care than by the Brazilian Popular Pharmacy Program itself. According to the model, a 43.76% increase in the transfer to the basic component of pharmaceutical care would be required in order to improve equity, whereas the increase required by the Brazilian Popular Pharmacy Program is equivalent to 22.71%. CONCLUSIONS Although the Brazilian Popular Pharmacy Program seeks to reduce the socioeconomic inequalities observed in access to pharmaceutical care, which integrates health care services, regional disparities in access to medicine persist. These regional differences are attributed mostly to allocation failures and problems in managing the conventional pharmaceutical care cycle provided through SUS pharmacies.


RESUMO OBJETIVO Analisar a alocação regional dos recursos do Programa Farmácia Popular do Brasil, levando em conta a disponibilidade relativa do programa e as necessidades potenciais da região. MÉTODOS Os dados da Pesquisa Nacional de Saúde, da Relação Anual de Informações Sociais e da base administrativa do programa foram usados para criar um indicador não paramétrico de cobertura a partir da técnica de análise envoltória de dados múltipla. Esse indicador considera a disponibilidade relativa do programa, considerando a equidade de acesso para necessidades idênticas (equidade baseada nas necessidades regionais). A análise desse indicador mostra se as regiões que mais necessitam de assistência farmacêutica são aquelas que recebem mais recursos do Programa Farmácia Popular do Brasil. RESULTADOS Os estados pertencentes às regiões mais ricas do país, Sudeste e Sul, apresentam maior cobertura relativa do Programa Farmácia Popular do Brasil em relação às localidades mais pobres. Ademais, as desigualdades observadas entre os locais são melhor explicadas por ineficiência no repasse dos recursos para o componente básico da assistência farmacêutica do que pelo Programa Farmácia Popular do Brasil em si. Segundo o modelo, para melhorar a equidade, seria necessário um aumento de 43,76% nos repasses ao componente básico da assistência farmacêutica, enquanto o aumento requerido pelo Programa Farmácia Popular do Brasil equivale a 22,71%. CONCLUSÕES Apesar de o Programa Farmácia Popular do Brasil buscar atenuar as desigualdades socioeconômicas observadas no acesso à assistência farmacêutica, que integra os serviços de atenção à saúde, persistem as disparidades regionais no acesso a medicamentos. Essas diferenças regionais são atribuídas em maior parte a falhas na alocação e problemas na gestão do ciclo de assistência farmacêutica convencional prestada por meio das farmácias do SUS.


Subject(s)
Humans , Health Care Rationing/statistics & numerical data , Drugs, Essential/supply & distribution , Health Equity/statistics & numerical data , Resource Allocation/statistics & numerical data , National Health Programs/statistics & numerical data , Reference Values , Socioeconomic Factors , Brazil , Budgets/statistics & numerical data , Health Care Rationing/economics , Cross-Sectional Studies , Drugs, Essential/economics , Health Equity/economics , Resource Allocation/economics , Spatial Analysis , Health Services Needs and Demand , National Health Programs/economics
4.
Ciênc. Saúde Colet. (Impr.) ; 22(8): 2453-2462, Ago. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-890411

ABSTRACT

Resumo Este estudo tem por objetivo analisar o valor financeiro aplicado por habitante/ano em municípios brasileiros para aquisição de medicamentos do Componente Básico da Assistência Farmacêutica, segundo porte populacional e região geográfica do país. Foi realizada análise descritiva dos dados de aquisição de medicamentos, registrados na Base Nacional de Dados das Ações e Serviços de Assistência Farmacêutica, no período de julho de 2013 a junho de 2014 (n = 960). A grande maioria dos municípios (73%) aplicou um valor por habitante/ano menor do que o mínimo recomendado pela legislação vigente e, desses, 47% possuem até 20 mil habitantes. Verificou-se também que a região Norte é a que possui maior número de municípios com menor aplicação de recursos e que os da região Sudeste, em média, aplicaram um valor por habitante/ano maior e adquiriram mais itens do que aqueles das demais regiões. As disparidades regionais e demográficas na aplicação de recursos financeiros trazem como reflexão a importância da rediscussão do modelo de financiamento da assistência farmacêutica básica e da responsabilidade das esferas do SUS na gestão eficiente desse recurso para prover o acesso a medicamentos à população.


Abstract This study shows a descriptive data analysis related to the procurement of medicines for primary care in Brazilian municipalities, as recorded in the National database of Pharmaceutical Service Actions and Services for the period July 2013 - June 2014, by geographic region and population size. Nine hundred and sixty municipalities were analyzed, of which 27% invested monetary value equal to or greater than the minimum statutory recommendations and 43% of these are located in the Southeast. The North region has the highest number of municipalities with less investment. Municipalities with a population over 500,000 inhabitants used, on average, lower resources to provide more items to users. The average number of items purchased was 86 and represents 25% of the National List of Essential Medicines (Rename); 64% had a decentralized resource management and the most commonly used procurement method was "tender". The most purchased drugs are in line with the most prevalent primary care diseases. Findings showed that most municipalities invests below statutory recommendations and are located mainly in the North, Northeast and Midwest. It was not possible to establish a trend between population and amount invested per capita/year.


Subject(s)
Humans , Primary Health Care/economics , Pharmaceutical Preparations/economics , Health Expenditures/statistics & numerical data , Drugs, Essential/economics , Brazil , Cross-Sectional Studies , Retrospective Studies , Cities
5.
Ciênc. Saúde Colet. (Impr.) ; 22(5): 1417-1428, maio 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-839969

ABSTRACT

Resumo O presente trabalho buscou verificar os aspectos relacionados ao registro sanitário e à incorporação de tecnologias no SUS para as doenças da pobreza. Trata-se de estudo exploratório, descritivo, desenvolvido entre janeiro e maio de 2016, em que foram realizados levantamentos e análises de documentos nos sítios eletrônicos da Anvisa, FDA, EMA, Conitec e Sistema Saúde Legis. Verificou-se um total de 132 medicamentos elencados na Rename 2014 para atendimento específico das doenças da pobreza, sendo que mais de um terço (49) possuem apenas um produtor nacional e outros 24 não possuem registro no país. No período de 2006 a 2014 houve crescimento de 46% do número de medicamentos na Rename para tais doenças. Apesar dos avanços do SUS nos campos da regulação e incorporação de tecnologias, dado o desinteresse de mercado e a condição de negligência para as doenças da pobreza, a atuação do Estado é imprescindível para garantir o acesso às melhores terapias disponíveis, visando à redução das iniquidades em saúde. Infere-se que o Brasil precisa avançar na regulação e incorporação de medicamentos sem interesse mercadológico, agenda inconclusa que pode gerar barreiras de acesso às tecnologias para as populações vulneráveis.


Abstract The study aimed to examine the regulation and adoption of health technologies for the diseases of poverty in the Brazil’s Unified Health System (SUS). An exploratory, descriptive study was conducted between January and May 2016 consisting of the search and analysis of relevant documents on the websites of Brazil’s National Health Surveillance Agency, the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), the National Commission for the Adoption of Technologies by the SUS, and Saúde Legis (the Ministry of Health’s Legislation System). The 2014 version of the Brazilian National List of Essential Medicines (RENAME, acronym in Portuguese) contained 132 medicines for diseases of poverty. Over one-third of these (49) had only one national producer, while 24 were not registered in the country. The number of medicines contained in the RENAME dedicated to this group of diseases increased by 46% between 2006 and 2014. Despite advances in the regulation and incorporation of technologies by the SUS, given the lack of market interest and neglect of diseases of poverty, the government has a vital role to play in ensuring access to the best available therapies in order to reduce health inequalities. It therefore follows that Brazil needs to improve the regulation of medicines that do not attract market interest.


Subject(s)
Humans , Biomedical Technology/statistics & numerical data , Delivery of Health Care/organization & administration , Health Services Accessibility , National Health Programs/organization & administration , Poverty , Socioeconomic Factors , Brazil , Pharmaceutical Preparations/economics , Pharmaceutical Preparations/supply & distribution , Drugs, Essential/economics , Drugs, Essential/supply & distribution , Biomedical Technology/economics , Biomedical Technology/legislation & jurisprudence , Delivery of Health Care/economics , Diffusion of Innovation , Health Status Disparities
6.
Einstein (Säo Paulo) ; 15(1): 85-91, Jan.-Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-840297

ABSTRACT

ABSTRACT Objective To describe the profile of lawsuits related to drug requests filled at the Federal Justice of the State of Paraná. Methods A cross-sectional study, and the data were obtained through consulting the lawsuits at the online system of the Federal Justice of Paraná. Results Out of 347 lawsuits included in the study, 55% of plaintiffs were women, with a median age of 56 years. Oncology was the field with more requests (23.6%), and the highest mean costs. A wide variety of diseases and broad variety of requested drugs were found in the lawsuits. Approximately two-thirds of them were requested by the brand name, and the most often requested drugs were palivizumab and tiotropium bromide. Only 14.5% of the requested medicines were registered in the National Medication Register. The Public Defender’s Office filled actions in 89.6% of cases and all lawsuits had an interim relief. The mean time for approval was 35 days and 70% of requests were granted. Conclusion Oncology was the field with the highest demand for medicines at the Federal Justice of Paraná in 2014. A great variety of medications was requested. The Public Defender´s Office represented most lawsuits. All demands had an interim relief, and the majority of requests were granted, within an average of 35 days.


RESUMO Objetivo Descrever o perfil das ações que solicitam medicamentos ajuizadas na Justiça Federal do Paraná. Métodos Estudo transversal descritivo, cujos dados foram obtidos por meio de consulta aos processos no sistema on-line da Justiça Federal do Paraná. Resultados Dentre os 347 processos incluídos no estudo, 55% dos autores eram mulheres, com mediana da idade de 56 anos, sendo a área mais procurada a oncologia (23,6%). A área oncológica também foi a que apresentou maiores custos médios. Foi ampla a variedade de doenças geradoras das ações e também foi consequentemente grande a variedade de medicamentos solicitados. Cerca de dois terços dos fármacos foram solicitados pelo nome comercial, e os mais requeridos foram o palivizumabe e brometo de tiotrópio. Apenas 14,5% dos medicamentos solicitados estavam cadastrados no Registro Nacional de Medicamentos. A Defensoria Pública impetrou as ações em 89,6% dos casos. Todos os processos pediam antecipação de tutela do medicamento. O tempo médio para deferimento foi de 35 dias, sendo que 70% dos pedidos foram deferidos. Conclusão A área com maior número de casos de demanda de medicamentos na Justiça Federal do Paraná no ano de 2014 foi de Oncologia. Observou-se grande variedade de medicamentos solicitados. A maioria das ações foi impetrada pela Defensoria Pública. Todas as demandas exigiram antecipação de tutela, sendo que a maioria dos pedidos foram deferidos, num prazo médio de 35 dias.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Pharmaceutical Preparations/supply & distribution , Drugs, Essential/supply & distribution , Patient Rights/legislation & jurisprudence , Legislation, Drug/statistics & numerical data , Social Justice , Brazil , Pharmaceutical Preparations/economics , Cross-Sectional Studies , Retrospective Studies , Drug Costs , Sex Distribution , Statistics, Nonparametric , Drugs, Essential/economics
7.
Indian J Med Ethics ; 2013 Apr-Jun ; 10 (2): 86-95
Article in English | IMSEAR | ID: sea-153606

ABSTRACT

The government is planning to introduce free generic and essential medicines in public health facilities. Most people in India buy healthcare from the private sector, a compulsion that accounts for a high proportion of healthcare-related expenditure. To reduce the burden of healthcare costs, the government must improve availability and affordability of generic and essential medicines in the market. It can do so because India's large pharmaceutical industry is a major source of generic medicines.


Subject(s)
Attitude to Health , Drug Costs/legislation & jurisprudence , Drugs, Essential/economics , Drugs, Generic/economics , Health Services Accessibility/economics , Humans , India
8.
Cad. saúde pública ; 28(3): 479-489, mar. 2012. tab
Article in Portuguese | LILACS | ID: lil-616961

ABSTRACT

O estudo analisa os gastos da judicialização de medicamentos para a mucopolissacaridose (MPS), uma doença rara, de alto custo, fora da política de assistência farmacêutica e com benefício clínico. O levantamento de dados foi realizado nos arquivos de 196 dossiês que determinou que o Ministério da Saúde fornecesse medicamentos no período entre 2006 e 2010, e nos registros administrativos e contábeis do Ministério da Saúde. A análise identifica sujeição do governo brasileiro a monopólios de distribuição de medicamentos e, consequentemente, perda de sua capacidade de administrar compras. Também identifica que a imposição da aquisição imediata e individualizada impede a obtenção de economias de escala com a compra planejada de maiores quantidades de medicamento, e impõe dificuldades logísticas para o controle das quantidades consumidas e estocadas. Conclui-se que a judicialização decorre da ausência de uma política clara do sistema de saúde para doenças raras em geral, e tem como consequência gastos acima do necessário para o tratamento.


This study analyzes expenditures backed by court rulings to ensure the public provision of medicines for treatment of mucopolysaccharidosis (MPS), a rare disease that requires high-cost drugs not covered by the Brazilian government's policy for pharmaceutical care and which have disputed clinical efficacy. The methodology included a review of files from 196 court rulings ordering the Brazilian Ministry of Health to provide the medicines, in addition to Ministry of Health administrative records. According to the analysis, the "judicialization" of the health system subjected the Brazilian government to a monopoly in the distribution of medicines and consequently the loss of its capacity to manage drug purchases. The study also indicates that the imposition of immediate, individualized purchases prevents obtaining economies of scale with planned procurement of larger amounts of the medication, besides causing logistic difficulties in controlling the amounts consumed and stored. In conclusion, litigation results from the lack of a clear policy in the health system for rare diseases in general, thereby leading to excessive expenditures for MPS treatment.


Subject(s)
Humans , Drug Costs/legislation & jurisprudence , Drugs, Essential/economics , Health Policy/legislation & jurisprudence , Mucopolysaccharidoses/drug therapy , Rare Diseases/drug therapy , Brazil , Drugs, Essential/supply & distribution , Health Expenditures/legislation & jurisprudence , Health Services Accessibility/legislation & jurisprudence , Iduronate Sulfatase/economics , Iduronate Sulfatase/supply & distribution , /economics , /supply & distribution , Public Sector , Recombinant Proteins/economics , Recombinant Proteins/supply & distribution
9.
Physis (Rio J.) ; 21(2): 359-376, 2011. ilus, graf, tab
Article in Portuguese | LILACS | ID: lil-596057

ABSTRACT

Este estudo objetivou realizar uma avaliação econômica das anticitocinas adalimumabe (ADA), etanercepte (ETA) e infliximabe (IFX) para o tratamento da artrite reumatoide no Estado do Paraná, sob a perspectiva do SUS. Os dados de eficácia e segurança dos tratamentos foram buscados na literatura, e os custos foram calculados com valores gastos pelo SUS para cada um dos tratamentos. Foi elaborado o modelo de Markov para obter a relação custo-efetividade de cada tratamento. A relação custo-efetividade incremental (ICER) comparado ao tratamento padrão também foi calculada para cada anticitocina. Análises de sensibilidade e taxas de desconto foram aplicadas. Na avaliação custo-efetividade, encontraram-se custos por QALY de R$ 511.633,00, R$ 437.486,00 e R$ 657.593,00 para ADA, ETA e IFX, respectivamente. O ICER por QALY foi R$ 628.124,00, R$ 509.974,00 e R$ 965.927,00 para ADA, ETA e IFX, respectivamente. Nas análises de sensibilidade, o ETA e o ADA apresentaram valores próximos. Cabe aos gestores públicos e aos médicos prescritores a escolha adequada para cada paciente, entre os tratamentos disponibilizados.


This study aimed to perform an economic evaluation of anticytokines adalimumab (ADA), etanercept (ETA) and infliximab (IFX) for the treatment of rheumatoid arthritis in the State of Parana, in Brazil, in the perspective of the Brazilian Unified Health System. Data on efficacy and safety of treatment were collected in literature, and costs were calculated on the amounts spent by the Government for each treatment. A Markov model was performed to get the cost-effectiveness of each treatment. The incremental cost-effectiveness relationship (ICER) compared to a standard treatment was also calculated for each anticytokine. Sensitivity analysis and discount rates were applied. In assessing cost-effectiveness we found the following values (cost at R$ per QALY): 511,633.00, 437,486.00 and 657,593.00 (respectively for ADA, ETA and IFX). The ICER (R$ per QALY) was 628,124.00, 509,974.00 and 965,927.00 (for ADA, ETA and IFX). In the sensitivity analysis, ETA and ADA showed similar values. It is for public managers and physicians the choice for each patient, among the treatments available.


Subject(s)
Humans , Male , Female , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/prevention & control , Arthritis, Rheumatoid/therapy , Cost-Effectiveness Evaluation , Health Care Costs/ethics , Chronic Disease/economics , Chronic Disease/prevention & control , Chronic Disease/therapy , Unified Health System/economics , Unified Health System/ethics , Drugs, Essential/economics , Drugs, Essential/therapeutic use , Pharmaceutical Services
10.
SJPH-Sudanese Journal of Public Health. 2010; 5 (1): 32-37
in English | IMEMR | ID: emr-99200

ABSTRACT

Although availability of essential medicines is one of the most important objectives of national medicines' policies, the unavailability of essential medicines remains a major problem for poor countries. The study was carried out to measure availability and duration of out of stock of essential medicines in Sudan. The study was carried out using the World Health Organization [WHO] Operational Package for Assessing and Monitoring Pharmaceutical Situation in Countries format for data collection. On the average, availability of selected essential medicines at the public pharmacy, medicine stores and the private pharmacies was found to be 80.6%, 90.0% and 93.0%, respectively. The survey found the mean duration of stock out at medicines store was 26.5 days and no records available about inventory control at the pharmacy level. Among the states, the study found low availability of medicines at North Kordufan public pharmacies. The study found no statistical significant difference as far as a Developing country concerning availability of medicines at rural or urban areas [p > 0.05]. Generally availability and stock out duration of essential medicines in the Sudan were acceptable


Subject(s)
Humans , Drugs, Essential/economics , Developing Countries , World Health Organization , Health Services Accessibility
12.
Indian J Med Ethics ; 2008 Jan-Mar; 5(1): 24-5
Article in English | IMSEAR | ID: sea-53422

ABSTRACT

The National Drug Policy (NDP), 1982, of Bangladesh was expected to make available essential, good quality drugs at affordable prices. This article gives an overview of the situation today, more than two decades after the Drugs (Control) Ordinance, 1982, was promulgated to implement the NDP. While there have been some successes, many of the goals of this initiative are yet to be achieved. Inadequate supply of essential drugs, substandard quality, uncontrolled drug prices and inappropriate uses of drugs are major problems in Bangladesh.


Subject(s)
Bangladesh , Developing Countries , Drug Utilization/economics , Drug and Narcotic Control/organization & administration , Drugs, Essential/economics , Health Policy/economics , Humans , Quality Control
13.
Rev. panam. salud pública ; 22(2): 118-123, ago. 2007. tab
Article in English | LILACS | ID: lil-467151

ABSTRACT

OBJECTIVES: Price is a key obstacle for consumer access to essential drugs, especially in developing countries. This study sought to compare the retail prices of essential drugs on the private market in Brazil with that of two international pricing standards. METHODS: The retail price of all drugs on Brazil's Essential Drugs List, July 2000 edition, were compared to the retail price of the same drugs on the Swedish market and on a referential bulk-price indicator from low-cost suppliers on the international market. Ratios of Brazil's prices to Sweden's prices and Brazil's prices to the international bulk mean price-per-unit for each drug were calculated. Using linear regression analysis, the ratios were also studied in relation to the number of manufacturers. RESULTS: For the 132 drugs that were listed on both Brazil's and Sweden's lists, unitary retail prices in Brazil were 1.9 times higher. Of the 94 drugs found on both Brazil's list and the international unit-price indicator, Brazil's national mean unit prices were 13.1 more expensive. No relationship was found between the number of manufacturers for each product and the ratios of prices. CONCLUSIONS: Average retail prices of essential drugs in Brazil are significantly higher than in Sweden. Furthermore, international bulk prices indicate that drugs are brought to market by Brazil's private pharmacies at prices that may be excessively high in relation to production costs, creating high profit margins. The expected price-lowering effects of competition were not identified.


OBJETIVO: Los precios constituyen un obstáculo clave para el acceso del consumidor a los medicamentos esenciales, especialmente en los países en desarrollo. El objetivo de este estudio fue comparar los precios minoristas de los medicamentos esenciales en el mercado privado de Brasil con los de dos estándares internacionales de precios. MÉTHODS: Se compararon los precios minoristas de todos los medicamentos de la Lista de Medicamentos Esenciales de Brasil, edición de julio de 2000, con los precios minoristas de los mismos medicamentos en el mercado de Suecia y los indicadores de precios mayoristas de referencia de suministradores de bajo costo en el mercado internacional. Se calculó la razón entre los precios de cada medicamento en Brasil y en Suecia y entre los de Brasil y los precios mayoristas internacionales promedio por unidad. Se empleó el análisis de regresión lineal para estudiar también las razones según el número de productores. RESULTADOS: Los precios unitarios minoristas de los 132 medicamentos contenidos tanto en la lista de Brasil como en la de Suecia fueron 1,9 veces mayores en Brasil. De los 94 medicamentos que están tanto en la lista de Brasil como en el indicador internacional de precios unitarios, los precios unitarios nacionales promedio en Brasil fueron 13,1 mayores. No se encontró relación entre el número de productores de cada medicamento y la razón de precios. CONCLUSIONES: Los precios minoristas promedio de los medicamentos esenciales en Brasil son significativamente mayores que en Suecia. Además, según los precios mayoristas internacionales, las compañías farmacéuticas privadas de Brasil pudieran estar sacando al mercado medicamentos con precios excesivamente altos en relación con los costos de producción, lo que origina elevados márgenes de ganancia. No se encontró el efecto esperado de reducción de precios debido a la competencia.


Subject(s)
Humans , Drug Costs , Drugs, Essential/economics , Economics, Pharmaceutical , Australia , Brazil , Health Policy , Linear Models , Sweden , United States
14.
Article in English | IMSEAR | ID: sea-20886

ABSTRACT

BACKGROUND & OBJECTIVE: The price and availability of medicines are key components in determining access to effective treatment. Data on prices and availability of common medicines in public and private sector in different States of India are scarce. Hence, surveys were undertaken in different States of India to evaluate these metrics. METHODS: During October 2004 to January 2005, six surveys were undertaken simultaneously in five States of India to assess medicine prices and availability of essential medicines (n = 21-28) using the World Health Organization and Health Action International methodology. Surveys were conducted at Chennai, Haryana, Karnataka, West Bengal, and at two sites in Maharashtra. For each medicine, data were collected for the Innovator Brand (IB), Most Sold Generic (MSG), and Lowest Priced Generic (LPG) at randomly selected public and private facilities in each site surveyed. Prices were compared to an international reference benchmark (expressed as median price ratio - MPR). RESULTS: The procurement price of medicines in the public sector was 0.27 to 0.48 times the international reference price. However, these medicines were inadequately available and the median availability in the public sector ranged from 0 to 30 per cent. The median prices of medicines in the private sector were less than twice the IRP, although a few innovator brands were more expensive. No difference was observed between the prices of the most sold generic (MSG) and the lowest priced generic (LPG) available at the facilities. Interestingly, price variation was observed among different generic equivalents of ciprofloxacin in each region. The price of LPG diazepam in the private sector was thirty three times its procurement price in the public sector. INTERPRETATION & CONCLUSION: The survey revealed low procurement prices and poor availability in the public sector. Thus, the majority of the population purchased medicines from private pharmacies, where generics were usually available although prices of certain medicines were high. Various policy measures could increase the availability and accessibility of medicines for the population.


Subject(s)
Drug Costs , Drugs, Essential/economics , Health Services Accessibility/economics , India , Private Sector/economics , Public Sector/economics
19.
Washington, D.C; Pan Américan Health Organization. División of Health Systems and Services Development; 1998. 93 p. ilus.
Monography in English | LILACS | ID: lil-379112
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