Access to essential medicines for diabetes care:availability,price,and affordability in central Ethiopia  

作　　者：Hachalu Dugasa Deressa Habtamu Abuye Alemayehu Adinew Mohammed KAli Tedla Kebede Bruck Messele Habte 

机构地区：[1]School of Pharmacy,College of Health Sciences,Addis Ababa University,P.O.Box 9086,Addis Ababa,Ethiopia [2]Addis Ababa City Administration Regional Health Bureau,Addis Ababa,Ethiopia [3]Department of Pharmacy,College of Medicine and Health Sciences,Wachemo University,Hossaena,Ethiopia [4]Department of Family and Preventive Medicine,School of Medicine,Emory University,Atlanta,GA,US [5]Emory Global Diabetes Research Center of the Woodruff Health Sciences Center and Emory University,Atlanta,GA,US [6]School of Medicine,College of Health Sciences,Addis Ababa University,Addis Ababa,Ethiopia

出　　处：《Global Health Research and Policy》2024年第1期480-491,共12页全球健康研究与政策(英文)

基　　金：The first author received financial support from the Graduate Programs of Addis Ababa University to conduct the research;The last author was a research fellow at the Rollins School of Public Health as part of the COALESCE program,which is a project funded by the Fogarty International Center of the National Institutes of Health under Award Number D43 TW011404 during the authorship of this article.

摘　　要：Background Diabetes is a major global public health burden.Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines(EMs)which is a challenge especially in low-and-middle-income countries such as Ethiopia.This study aimed to assess the accessibility of EMs used for diabetes care in central Ethiopia’s public and private medicine outlets with respect to availability and affordability parameters.Methods A cross-sectional study was conducted in 60 selected public and private medicine outlets in central Ethiopia from January to February 2022 using the World Health Organization/Health Action International(WHO/HAI)standard tool to assess access to EMs.We included EMs that lower glucose,blood pressure,and cholesterol as these are all critical for diabetes care.Availability was determined as the percentage of surveyed outlets per sector in which the selected lowest-priced generic(LPG)and originator brand(OB)products were found.The number of days’wages required by the lowest paid government worker(LPGW)to purchase a one month’s supply of medicines was used to measure affordability while median price was determined to assess patient price and price markup difference between public procurement and retail prices.Results Across all facilities,availability of LPG and OB medicines were 34.6%and 2.5%respectively.Only two glucose-lowering(glibenclamide 5 mg and metformin 500 mg)and two blood pressure-lowering medications(nifedipine 20 mg and hydrochlorothiazide 25 mg)surpassed the WHO’s target of 80%availability.The median price based on the least measurable unit of LPG diabetes EMs was 1.6 ETB(0.033 USD)in public and 4.65 ETB(0.095 USD)in pri-vate outlets.The cost of one month’s supply of diabetes EMs was equivalent to 0.3 to 3.1 days wages in public and 1.0 to 11.0 days wages in private outlets,respectively,for a typical LPGW.Thus,58.8%and 84.6%of LPG diabetes EMs included in the price analysis were unaffordable in private and public outlets,respectively

关 键 词：ACCESS AVAILABILITY AFFORDABILITY DIABETES Essential medicines Non-communicable diseases Central Ethiopia 

分 类 号：R58[医药卫生—内分泌]