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坦桑尼亚莫罗戈罗市区政府和私立卫生部门间青蒿素联合疗法的价格差异及其对疟疾药物消费模式的影响

Artemisinin combination therapies price disparity between government and private health sectors and its implication on antimalarial drug consumption pattern in Morogoro Urban District, Tanzania.

作者信息

Malisa Allen Lewis, Kiriba Deodatus

机构信息

Department of Biological Sciences, Faculty of Science, Sokoine University of Agriculture, Box 3038, Morogoro, Tanzaia.

出版信息

BMC Res Notes. 2012 Mar 28;5:165. doi: 10.1186/1756-0500-5-165.

Abstract

BACKGROUND

Universal access to effective treatments is a goal of the Roll Back Malaria Partnership. However, despite official commitments and substantial increases in financing, this objective remains elusive, as development assistance continue to be routed largely through government channels, leaving the much needed highly effective treatments inaccessible or unaffordable to those seeking services in the private sector.

METHODS

To quantify the effect of price disparity between the government and private health systems, this study have audited 92 government and private Drug Selling Units (DSUs) in Morogoro urban district in Tanzania to determine the levels, trend and consumption pattern of antimalarial drugs in the two health systems. A combination of observation, interviews and questionnaire administered to the service providers of the randomly selected DSUs were used to collect data.

RESULTS

ALU was the most selling antimalarial drug in the government health system at a subsidized price of 300 TShs (0.18 US$). By contrast, ALU that was available in the private sector (coartem) was being sold at a price of about 10,000 TShs (5.9 US$), the price that was by far unaffordable, prompting people to resort to cheap but failed drugs. As a result, metakelfin (the phased out drug) was the most selling drug in the private health system at a price ranging from 500 to 2,000 TShs (0.29-1.18 US$).

CONCLUSIONS

In order for the prompt diagnosis and treatment with effective drugs intervention to have big impact on malaria in mostly low socioeconomic malaria-endemic areas of Africa, inequities in affordability and access to effective treatment must be eliminated. For this to be ensued, subsidized drugs should be made available in both government and private health sectors to promote a universal access to effective safe and affordable life saving antimalarial drugs.

摘要

背景

普及有效治疗方法是抗击疟疾伙伴关系的目标。然而,尽管有官方承诺且资金大幅增加,但这一目标仍难以实现,因为发展援助仍主要通过政府渠道提供,使得急需的高效治疗方法对于在私营部门寻求服务的人来说难以获得或负担不起。

方法

为了量化政府和私营卫生系统之间价格差异的影响,本研究对坦桑尼亚莫罗戈罗市区的92个政府和私营药品销售单位(DSU)进行了审计,以确定这两个卫生系统中抗疟药物的水平、趋势和消费模式。通过对随机选择的DSU的服务提供者进行观察、访谈和问卷调查相结合的方式来收集数据。

结果

在政府卫生系统中,青蒿琥酯-呋喃坦啶(ALU)是最畅销的抗疟药物,补贴价格为300坦桑尼亚先令(0.18美元)。相比之下,私营部门提供的青蒿琥酯-呋喃坦啶(科泰复)售价约为10,000坦桑尼亚先令(5.9美元),这一价格远远超出人们的承受能力,促使人们转而使用便宜但效果不佳的药物。结果,甲氟喹(已淘汰的药物)成为私营卫生系统中最畅销的药物,价格在500至2,000坦桑尼亚先令(0.29 - 1.18美元)之间。

结论

为了使在非洲大多数社会经济地位较低的疟疾流行地区,通过有效药物干预进行及时诊断和治疗对疟疾产生重大影响,必须消除在可负担性和获得有效治疗方面的不平等现象。要实现这一点,政府和私营卫生部门都应提供补贴药物,以促进普遍获得有效、安全且可负担得起的救命抗疟药物。

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