Health system interventions for the cost containment of drugs used for cardiovascular diseases: a systematic review and exploration of how the results could be adapted to the Sri Lankan context  

作　　者：Jayasekara Liyana Patabendige Chaminda Sanjeewa Kularatna Dilantha Dharmagunawardene Reece Hinchclffe Alexia Rohde David Brain Ruvini Manjula Hettiarachchi Sucharitha Rangi Weerasuriya Sunil Senarath Yapa Sameera Senanayake 

机构地区：[1]Australian Centre for Health Services Innovation and Centre for Healthcare Transformation,School of Public Health and Social Work,Queensland University of Technology,Queensland,Australia [2]Ministry of Health,Colombo,Sri Lanka [3]Health Services and Systems Research,Duke-NUS Medical School,Singapore [4]National Heart Research Institute Singapore,National Heart Centre Singapore,Singapore [5]School of Applied Psychology,Grifith Health Group,Grifith University,Queensland,Australia [6]School of Public Health and Social Work,Faculty of Health,Queensland University of Technology,Queensland,Australia [7]Centre for the Business and Economics of Health,The University of Queensland,Queensland,Australia

出　　处：《Global Health Journal》2024年第4期181-189,共9页全球健康杂志（英文）

摘　　要：Objectives:Cardiovascular disease(CVD)in low and middle-income countries(LMICs),accounts for over 80%of global CVD-related deaths.The high cost of drugs is a major concern in not of managing CVD.This study aimed to conduct a comprehensive review to identify interventions for cost containment of cvD drugs and use the inter-vention scalability assessment tool(ISAT)to examine the acceptability and application of relevant interventions in the Sri Lankan context,that can also be adaptable to other LMICs.Methods:A systematic search across three databases(Medline,Web of Science and Embase)was completed to identify relevant health system interventions.The ISAT assessed the feasibility of adapting the identified interven-tions to Sri Lanka,using structured interviews with 25 Sri Lankan stakeholders representing five groups:health managers,cardiologists,pharmacists,nursing officers,and patients.Results:The search yielded nine publications.Five were conducted on a national scale,while others were con-ducted at the regional levels.Seven were published in developed countries.The identified interventions were categorised into six intervention themes:Imposing a ceiling price or reference price;introduction of the polypill;introduction of volume price contract initiatives;prescribing generic and essential drugs;one intervention pack-age including generics,essential medicine,90-day drugs,and free delivery;and a second intervention package including discounts,rebates,cost-free medicine,and bundling.Assessment of six intervention themes revealed that methods of setting ceiling prices and controlling generic drug prescribing were the most popular,while other interventions were least popular..Conclusions:The study provides a roadmap for future interventions based on successful scaling,emphasizing the importance of understanding contextual variables and encourages stakeholder participation in policy assessments and advocacy.The findings highlighted the potential for enhancing the access to affordable CVD drugs not only in Sri Lanka,bu

关 键 词：Cardiovascular disease DRUG COST Interventions 

分 类 号：R97[医药卫生—药品] R197.1[医药卫生—药学]