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Essential Medicines Are More Available than Other Medicines around the Globe

BACKGROUND: The World Health Organization (WHO) promotes the development of national Essential Medicines Lists (EMLs) in order to improve the availability and use of medicines considered essential within health care systems. However, despite over 3 decades of international efforts, studies show an i...

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Autores principales: Bazargani, Yaser T., Ewen, Margaret, de Boer, Anthonius, Leufkens, Hubert G. M., Mantel-Teeuwisse, Aukje K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922716/
https://www.ncbi.nlm.nih.gov/pubmed/24533058
http://dx.doi.org/10.1371/journal.pone.0087576
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author Bazargani, Yaser T.
Ewen, Margaret
de Boer, Anthonius
Leufkens, Hubert G. M.
Mantel-Teeuwisse, Aukje K.
author_facet Bazargani, Yaser T.
Ewen, Margaret
de Boer, Anthonius
Leufkens, Hubert G. M.
Mantel-Teeuwisse, Aukje K.
author_sort Bazargani, Yaser T.
collection PubMed
description BACKGROUND: The World Health Organization (WHO) promotes the development of national Essential Medicines Lists (EMLs) in order to improve the availability and use of medicines considered essential within health care systems. However, despite over 3 decades of international efforts, studies show an inconsistent pattern in the availability of essential medicines. We evaluated and compared the availability of essential medicines, and medicines not included in national EMLs, at global and regional levels. METHODS: Medicine availability in the public and private sector were calculated based on data obtained from national and provincial facility-based surveys undertaken in 23 countries using the WHO/HAI methodology. The medicines were grouped according to their inclusion (‘essential’) or exclusion (termed ‘non-essential’) in each country’s EML current at the time of the survey. Availability was calculated for originator brands, generics and any product type (originator brands or generics) and compared between the two groups. Results were aggregated by WHO regions, World Bank country income groups, a wealth inequality measure, and therapeutic groups. FINDINGS: Across all sectors and any product type, the median availability of essential medicines was suboptimal at 61·5% (IQR 20·6%–86·7%) but significantly higher than non-essential medicines at 27·3% (IQR 3·6%–70·0%). The median availability of essential medicines was 40·0% in the public sector and 78·1% in the private sector; compared to 6·6% and 57·1% for non-essential medicines respectively. A reverse trend between national income level categories and the availability of essential medicines was identified in the public sector. INTERPRETATION: EMLs have influenced the provision of medicines and have resulted in higher availability of essential medicines compared to non-essential medicines particularly in the public sector and in low and lower middle income countries. However, the availability of essential medicines, especially in the public sector does not ensure equitable access.
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spelling pubmed-39227162014-02-14 Essential Medicines Are More Available than Other Medicines around the Globe Bazargani, Yaser T. Ewen, Margaret de Boer, Anthonius Leufkens, Hubert G. M. Mantel-Teeuwisse, Aukje K. PLoS One Research Article BACKGROUND: The World Health Organization (WHO) promotes the development of national Essential Medicines Lists (EMLs) in order to improve the availability and use of medicines considered essential within health care systems. However, despite over 3 decades of international efforts, studies show an inconsistent pattern in the availability of essential medicines. We evaluated and compared the availability of essential medicines, and medicines not included in national EMLs, at global and regional levels. METHODS: Medicine availability in the public and private sector were calculated based on data obtained from national and provincial facility-based surveys undertaken in 23 countries using the WHO/HAI methodology. The medicines were grouped according to their inclusion (‘essential’) or exclusion (termed ‘non-essential’) in each country’s EML current at the time of the survey. Availability was calculated for originator brands, generics and any product type (originator brands or generics) and compared between the two groups. Results were aggregated by WHO regions, World Bank country income groups, a wealth inequality measure, and therapeutic groups. FINDINGS: Across all sectors and any product type, the median availability of essential medicines was suboptimal at 61·5% (IQR 20·6%–86·7%) but significantly higher than non-essential medicines at 27·3% (IQR 3·6%–70·0%). The median availability of essential medicines was 40·0% in the public sector and 78·1% in the private sector; compared to 6·6% and 57·1% for non-essential medicines respectively. A reverse trend between national income level categories and the availability of essential medicines was identified in the public sector. INTERPRETATION: EMLs have influenced the provision of medicines and have resulted in higher availability of essential medicines compared to non-essential medicines particularly in the public sector and in low and lower middle income countries. However, the availability of essential medicines, especially in the public sector does not ensure equitable access. Public Library of Science 2014-02-12 /pmc/articles/PMC3922716/ /pubmed/24533058 http://dx.doi.org/10.1371/journal.pone.0087576 Text en © 2014 Bazargani et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Bazargani, Yaser T.
Ewen, Margaret
de Boer, Anthonius
Leufkens, Hubert G. M.
Mantel-Teeuwisse, Aukje K.
Essential Medicines Are More Available than Other Medicines around the Globe
title Essential Medicines Are More Available than Other Medicines around the Globe
title_full Essential Medicines Are More Available than Other Medicines around the Globe
title_fullStr Essential Medicines Are More Available than Other Medicines around the Globe
title_full_unstemmed Essential Medicines Are More Available than Other Medicines around the Globe
title_short Essential Medicines Are More Available than Other Medicines around the Globe
title_sort essential medicines are more available than other medicines around the globe
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922716/
https://www.ncbi.nlm.nih.gov/pubmed/24533058
http://dx.doi.org/10.1371/journal.pone.0087576
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