ABSTRACT
Objective: In this study, we assess population-level data of COVID-19 treatments in Iran compared to Ministry of Health (MOH)-published guidelines to gain a better insight into the quality of care for this disease. Methods: National sales data of each recommended and nonrecommended COVID-19 medicine were used to proxy utilization between March 21, 2020, and March 21, 2021, or Iranian year 1399. COVID-19-attributed sales volume and number of patients were estimated by adjusting sales data with pre-COVID-19 average growth rate, recommended dose, and duration of treatment. Next, they were compared with the MOH guidelines in outpatient and inpatient settings. Furthermore, the list of top 10 molecules of the market and top 10 COVID-19-indicated molecules in terms of values were extracted to assess the economic burden of COVID-19 prescription drugs and their share. Findings: The estimated number of patients receiving COVID-19 treatments in some outpatient medicines such as recommended hydroxychloroquine was over 2.2 million. Favipiravir and remdesivir were collectively about two inpatient medicines 260,000; however, neither of these two medicines was recommended in the MOH guidelines. In some fewer specific medicines such as dexamethasone, prednisolone, azithromycin, and naproxen, the estimated number of COVID-19-attributed patients were incomparable with the officially announced number of confirmed cases in the year of study, which could be related to nonconfirmed diagnosed cases, irrational use, or prescribing, or limitations of our data and study. The total COVID-19-attributed market of candidate medicines was over 15 trillion IR Rials (almost 4.3% of the total market). Remdesivir, with over 60% of the total COVID-19 attributed market, followed by favipiravir, was among the highest value medicines. Conclusion: Despite the release of the COVID-19 guideline by Iran MOH, misalignment in the enforcement of decisions was a serious weakness (cases of favipiravir and remdesivir). This weakness led to some economic burden on the health-care system and raised ethical concerns.
ABSTRACT
In the 21st century, while some people seek to use artificial intelligence for health services delivery, others have to surrender their health rights to meet basic needs. The gradient in health has become more pronounced in the COVID-19 crisis considering discrepancies in disease prevalence, geographical accessibility, availability, affordability, quality/safety of health services, and human resources. Through PubMed, GoogleScholar, Scopus, WHO, OECD, and UN databases, the English documents and global statistics were collected. Determining the role of health equity-related factors and introducing mechanisms to maintain regional and international justice in health, specifically during the COVID-19 pandemic, were among the core concepts of this paper. Social determinants of health (SDH), interregional and intraregional bodies are the main drivers of discrimination in health services. Governments should relish chief health strategists' role in possessing legitimacy, accountability, direction, transparent performance, fairness, and good governance in one word. Improving health literacy and telemedicine, providing income support, and reforming insurance where needed, are other national mechanisms to amend inequity. Among interregional issues, what is concerning is the matter of sanctions on access to health services, which is against the Universal Declaration of Human Rights. Shortage of vital medications, ventilators, test kits, COVID-19 vaccines, pharmaceutical raw materials, foreign currency, decreased national currency value, purchasing power parity, and quality/safety of health services resulted from such oppression. The article also provides practical suggestions, paving the way for re-establishing global solidarity and developing health justice in deprived regions.
ABSTRACT
BACKGROUND: The novel coronavirus disease 2019 (COVID-19) was characterized as a global pandemic by the WHO on March 11th, 2020. This pandemic had major effects on the health market, the pharmaceutical sector, and was associated with considerable impacts; which may appear in short and long-term time-horizon and need identification and appropriate planning to reduce their socio-economic burden. OBJECTIVES: Current short communication study assessed pharmaceutical market crisis during the COVID-19 era; discussing short- and long-term impacts of the pandemic on the pharmaceutical sector. RESULTS: Short-term impacts of COVID-19 pandemic includes demand changes, regulation revisions, research and development process changes and the shift towards tele-communication and tele-medicine. In addition, industry growth slow-down, approval delays, moving towards self-sufficiency in pharm-production supply chain and trend changes in consumption of health-market products along with ethical dilemma could be anticipated as long-term impacts of COVID-19 pandemic on pharmaceutical sector in both global and local levels. CONCLUSION: The pandemic of COVID-19 poses considerable crisis on the health markets, including the pharmaceutical sector; and identification of these effects, may guide policy-makers towards more evidence-informed planning to overcome accompanying challenges. Graphical abstract .