Hilbrich Lutz, Truelsen Thomas, Yusuf Salim
Boehringer Ingelheim Pharmaceuticals Inc., Department of General Medicine, Ridgefield, CT, USA.
Int J Stroke. 2007 May;2(2):104-8. doi: 10.1111/j.1747-4949.2007.00118.x.
Research into the prevention and treatment of stroke and cardiovascular disease has focused primarily on the needs of high-income countries (HIC). However, the majority of all stroke and cardiovascular deaths occurs in low- and middle-income countries (LMIC), with further rises in these countries predicted.
In HIC, proven strategies for the treatment of stroke and cardiovascular disease are well established and cost-effective. Developing strategies to include LMIC is therefore crucial to curb the global epidemic of stroke and cardiovascular disease. For example, pharmaceutical companies are being encouraged to make certain drugs more affordable in low- and middle-income companies, and the same principle could be applied to drugs for the prevention of stroke. Furthermore, centers from LMIC are now often included in clinical trials, resulting in trials that are more globally relevant and affordable and that enhance the participation of healthcare professionals from a broad range of countries.
More cost-effective drug development processes and affordable prices, while protecting intellectual property rights, will prevent the ever-increasing burden of stroke becoming unmanageable in LMIC.
中风和心血管疾病的预防与治疗研究主要集中在高收入国家（HIC）的需求上。然而，所有中风和心血管疾病死亡病例的大多数发生在低收入和中等收入国家（LMIC），预计这些国家的此类死亡人数还会进一步上升。
在高收入国家，已证实的中风和心血管疾病治疗策略已确立且具有成本效益。因此，制定纳入低收入和中等收入国家的策略对于遏制全球中风和心血管疾病流行至关重要。例如，正在鼓励制药公司使某些药物在低收入和中等收入国家更具可承受性，同样的原则也可应用于预防中风的药物。此外，低收入和中等收入国家的研究中心现在经常被纳入临床试验，从而产生更具全球相关性且成本更低的试验，并提高了来自广泛国家的医疗专业人员的参与度。
在保护知识产权的同时，更具成本效益的药物研发流程和可承受的价格将防止低收入和中等收入国家中风负担不断增加而变得难以控制。
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