Alefan Qais, Amairi Rawan, Tawalbeh Shoroq
Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan.
BMC Health Serv Res. 2018 Oct 19;18(1):787. doi: 10.1186/s12913-018-3593-9.
Free access to essential medicines is a fundamental right. Governments should provide accessible and affordable medicines to people. The purpose of this study was to evaluate medicines' prices, availability and affordability in Jordan.
Data was collected from 30 public sectors and 30 private sectors in 6 regions in Jordan. At each institution, the availability and prices data of 50 originator brand (OB) medicines and lowest-price generic (LPG) equivalent medicines were collected. Medicines' prices were compared with international reference prices (IRPs) to obtain a median price ratio (MPR). Availability of medicines was determined on the day of data collection. Affordability was calculated with regards to the daily income of the lowest-paid unskilled government employee.
Availability of medicines in public and private sectors was 72% and 76% for LPGs, respectively. Median MPRs of procurement prices for OBs and LPGs in the public sector were 1.1 and 5.5 times the IRPs, respectively. Private sector OB medicines were priced 4.8 times higher than IRPs, whereas LPGs were 3.8 times higher. OBs cost 14% more than LPGs in private sector. The median MPRs of patient prices for LPGs in the public sector were lower than in the private sector (1.1 versus 7.6). Generally, medicines' prices are affordable in public sector that the lowest paid unskilled government employee need less than a 1 day income to purchase the LPGs. While in private sector, the medicine prices are not affordable. For example, the treatment of hypertension either by LPGs or OBs needs more than 1 day income by lowest paid unskilled government employee.
This study showed good availability of LPGs in the public sector. In private sector, it showed good availability of LPGs and OBs with higher patient prices. The procurement prices in the public sector were reasonable in comparison to IRPs. Policy evaluation efforts must be directed to cut medicines prices and to improve affordability in private sector.
免费获取基本药物是一项基本权利。政府应为民众提供可获取且价格合理的药物。本研究的目的是评估约旦药品的价格、可及性和可负担性。
从约旦6个地区的30个公共部门和30个私营部门收集数据。在每个机构,收集50种原研品牌(OB)药品和最低价仿制药(LPG)等效药品的可及性和价格数据。将药品价格与国际参考价格(IRP)进行比较以获得中位数价格比(MPR)。在数据收集当天确定药品的可及性。根据收入最低的非技术政府雇员的日收入计算可负担性。
公共部门和私营部门中LPG的药品可及性分别为72%和76%。公共部门中OB和LPG采购价格的中位数MPR分别是IRP的1.1倍和5.5倍。私营部门的OB药品价格比IRP高4.8倍,而LPG则高3.8倍。私营部门中OB的成本比LPG高14%。公共部门中LPG患者价格的中位数MPR低于私营部门(1.1对7.6)。总体而言,公共部门的药品价格是可负担的,收入最低的非技术政府雇员购买LPG所需费用不到1天的收入。而在私营部门,药品价格不可负担。例如,无论是使用LPG还是OB治疗高血压,收入最低的非技术政府雇员都需要超过1天的收入。
本研究表明公共部门LPG的可及性良好。在私营部门,LPG和OB的可及性良好,但患者价格较高。与IRP相比,公共部门的采购价格合理。必须进行政策评估,以降低药品价格并提高私营部门的可负担性。