Have we improved use of medicines in developing and transitional countries and do we know how to? Two decades of evidence (original) (raw)
Related papers
Ten recommendations to improve use of medicines in developing countries
Health Policy and Planning, 2001
Inappropriate prescribing reduces the quality of medical care and leads to a waste of resources. To address these problems, a variety of educational and administrative approaches to improve prescribing have been tried. This article reviews the experiences of the last decade in order to identify which interventions have proven effective in developing countries, and suggests a range of policy options for health planners and managers.
Access to Medicine in Developing Countries
American Journal of Medicine and Medical Sciences, 2017
In developing countries, access to medicine confronts several barriers that induces an increase in the rates of mortality and morbidity. The objective of the following paper is to present evidence on the status of accessing medicine in developing and to outline its barriers. The article collects its data from ten resources that address the topic of identifying barriers that reduce access to medicine in developing countries. Collected data confirmed the increased rate of morbidity and mortality in developing countries due to reduced access to medicine especially medicine for treating chronic diseases. As for the barriers confronted in accessing medicine, the health system was involved and held responsible for the unstable availability and unaffordability of medicines. Results collected from articles also confirmed that pharmaceutical companies and medication research centres of universities are also responsible and considered as a barrier for accessing medicine since their patents fo...
Ten Recommendations to Improve Pharmacy Practice in Low and Middle-Income Countries (LMICs)
SSRN Electronic Journal, 2020
Medicines are important health interventions and their appropriate use could improve health outcomes. Throughout the globe, pharmacists play a very important role to improve the use of medicines. Though high-income countries are debating on futuristic approaches, independent prescribing of pharmacists, clinical skills, and to expand pharmacy services; a large majority of low and middle-income countries still lag behind to strengthen pharmacy practice. This paper presents a key set of recommendations that can improve pharmacy practice in low and middle-income countries (LMICs). The ten recommendations include (1) Mandatory presence of graduate-level pharmacists at community pharmacies (2) Clear demarcation of the roles and responsibilities of different categories of pharmacists (3) Effective categorization and implementation of medicines into (a) prescription medicines (b) pharmacists only medicines (c) over the counter medicines (4) Enforcement of laws and regulations for the sale of medicines (5) Prohibiting doctors from dispensing medicines (the dispensing separation between pharmacists and doctors). (6) Involving pharmacies and pharmacists in Universal Health Coverage Schemes to improve the affordability of medicines (7) Strengthening national medicines regulatory authorities to improve the quality, safety, and effectiveness of medicines (8) Training of pharmacists in clinical skills, vaccination, and minor ailment schemes (9) Promoting independent medicines information for consumers and healthcare professionals by developing national medicines information strategy (10) Mandatory Continuing Professional Development (CPD) programs for the Pharmacists.
Promoting quality use of medicines in South-East Asia: reports from country situational analyses
BMC health services research, 2018
Irrational use of medicines is widespread in the South-East Asia Region (SEAR), where policy implementation to encourage quality use of medicines (QUM) is often low. The aim was to determine whether public-sector QUM is better in SEAR countries implementing essential medicines (EM) policies than in those not implementing them. Data on six QUM indicators and 25 EM policies were extracted from situational analysis reports of 20 country (2-week) visits made during 2010-2015. The average difference (as percent) for the QUM indicators between countries implementing versus not implementing specific policies was calculated. Policies associated with better (> 1%) QUM were included in regression of a composite QUM score versus total number of policies implemented. Twenty-two policies were associated with better (> 1%) QUM. Twelve policies were associated with 3.6-9.5% significantly better use (p < 0.05), namely: standard treatment guidelines; formulary; a government unit to promote ...
Health Policy, 2011
Objectives: Health insurance systems have great potential to improve the cost-effective use of medicines by leveraging better provider prescribing, more cost-effective use by consumers, and lower prices from industry. Despite ample evidence from high-income countries, little is known about insurance system strategies targeting medicines in lowand middle-income countries (LMIC). This paper provides a critical review of the literature on these strategies and their impacts in LMIC. Methods: We conducted a systematic review of published peer-reviewed and grey literature and organized the insurance system strategies into four categories: medicines selection, purchasing, contracting and utilization management. Results: In n = 63 reviewed publications we found reasonable evidence supporting the use of insurance as an overall strategy to improve access to pharmaceuticals and outcomes in LMIC. Beyond this, most of the literature focused on provider contracting strategies to influence prescribing. There was very little evidence on medicines selection, purchasing, or utilization management strategies. Conclusions: There is a paucity of published evidence on the impact of insurance system strategies on improving the use of medicines in LMIC. The existing evidence is questionable since the majority of the published studies utilize weak study designs. This review highlights the need for well-designed studies to build an evidence base on the impact of medicines management strategies deployed by LMIC insurance programs.
Systematic Reviews in Pharmacy, 2018
Drugs are vital to saving and improving public health. However, medicines are often not available at the facility because stocks run out or in particular, pharmaceuticals are not available due to a shortage of supplies. Implementation of pharmacy services should ensure safe, quality, usable and affordable availability drug. A systematic review was conducted to identify related studies. Electronic databases used to identify relevant studies are, ScienceDirect, Plos, PubMed and Google Scholar. This study is limited to English and publications from 2007 to 2017. The electronic database search earned 33 articles while only six studies met the criteria for review. There is the relatively low availability of drugs in some developing countries and the average availability of generic drugs is better than Innovator Brand drugs, especially in the public sector. Most of the factors that may affect drug availability are related to government policies to improve drug access and lower prices so that national drug policy review in each country is required. Overall, the method used to measure the availability of drugs using a reference method used by WHO Health Action International. The availability of drugs in low, lower and upper middle countries still need to be improved by increasing drug access and enhancing prices by using appropriate government policies. The WHO HAI method is effectively used to measure the availability of drugs by using the core drug and supplementary drug references by the established reference.
Medicine improves the quality of life and increases mean age of human beings as it fights against diseases. Accessibility to medicines is the fundamental right of every person. The principle of the essential medicines (EMs) is that a limited number of availability of medicine will promote to a better supply chain and rational prescribing to the rural and remote health centers for any developing countries. Furthermore, it was also expected that this concept will also ensure better procurement policy at lower costs, more in amount, with easier storage. Thereby, EMs will safeguard and improve distribution and dispensing of medicine. Correspondingly, motivational and dedicated training program regarding drug information and adverse drug reactions will boost up access to medicine and health-care. In addition, the selection of medicine from EM is the first step in the direction of the rational use of medicine and progress and ensuring the quality of health care. Thereafter, selection needs to be followed by appropriate use. Everyone should receive the right medicine, in an adequate dose for an adequate duration, with appropriate information and follow-up treatment, and at an affordable cost. The acceptance and implementation of World Health Organization-promoted EM policies in deferent countries have improved quality use of medicine in terms of accessibility and affordability, predominantly in developing countries. The corporations and teamwork among various participants of health care are instantly obligatory to progress equitable access to medicines in low-and middle-income countries.
Advances in Pharmacological and Pharmaceutical Sciences
Irrational prescribing is common, especially in developing countries. It is important to identify the magnitude of irrational use, to take necessary steps to promote rational prescribing. We identified core prescribing indicators and commonly prescribed medicines at ward settings (IW) and outpatients’ clinics (OPC) in a tertiary care hospital in Sri Lanka. A descriptive cross-sectional study was carried out at IW and OPC settings. Prescriptions were obtained from 5 major specialties (Clinical Medicine (CM), Gynaecology and Obstetrics (GO), Paediatrics, Psychiatry, and Surgery). The WHO core prescribing indicators were used to describe the pattern of prescribing, and the most commonly prescribed medicines were identified. A total of 1,318 prescriptions were analyzed. The five most commonly prescribed medicines were paracetamol (31.0%), omeprazole (20.6%), folic acid (18.3%), atorvastatin (16.2%), and salbutamol (15.3%). The average number of medicines per encounter was 4.8 ± 3.6 (IW:...