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非传染性疾病、基本药物获取和全民健康覆盖。

Noncommunicable diseases, access to essential medicines and universal health coverage.

机构信息

Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals , Geneva , Switzerland.

Health Technologies and Pharmaceuticals Programme, WHO Regional Office for Europe , Copenhagen , Denmark.

出版信息

Glob Health Action. 2019;12(1):1670014. doi: 10.1080/16549716.2019.1670014.

Abstract

Universal Health Coverage is key to reach the overall health-related Sustainable Development Goal, and within this, access to safe, effective, quality, and affordable essential medicines is critical. Currently, medicines for noncommunicable diseases in many countries are not available when needed and if they are present, are unaffordable. Countries face the challenges of rising prevalence of noncommunicable diseases due to increasing risk factors and ageing populations, along with under-diagnosis and under-treatment. Providing noncommunicable disease medicines is only one piece of a complex picture of providing care within Universal Health Coverage that requires strengthening health-care systems, as well as financial resources, priority setting, and monitoring and evaluation systems. Financing for Universal Health Coverage needs to enable adequate resources to be allocated for medicines with a focus on equity as well as priority setting for noncommunicable diseases medicines for reimbursement in benefits packages, efficient procurement and distribution of these medicines, supported by price regulation. These processes need to be evidence-based, transparent and grounded on national values and priorities. Monitoring and evaluation of availability and affordability are key components of sustainable reimbursement systems. With the current Universal Health Coverage agenda, the World Health Organization and countries can no longer ignore the issue of access to medicines for noncommunicable disease and need to develop the appropriate responses in order to guarantee equitable access.

摘要

全民健康覆盖是实现与健康相关的可持续发展目标的关键,而在这之中,获得安全、有效、优质和负担得起的基本药物至关重要。目前,许多国家的非传染性疾病药物在需要时无法获得,即使有供应,也负担不起。由于风险因素增加和人口老龄化,以及诊断不足和治疗不足,各国面临着非传染性疾病患病率上升的挑战。提供非传染性疾病药物只是全民健康覆盖提供护理这一复杂情况的一部分,需要加强卫生保健系统以及财政资源、优先事项设定、监测和评估系统。全民健康覆盖的融资需要确保有足够的资源用于药物,重点是公平性以及在福利套餐中为非传染性疾病药物报销确定优先事项,支持这些药物的高效采购和分配,并进行价格监管。这些过程需要以证据为基础,透明,并基于国家价值观和优先事项。可用性和可负担性的监测和评估是非传染性疾病可持续报销系统的关键组成部分。有了当前的全民健康覆盖议程,世界卫生组织和各国再也不能忽视非传染性疾病药物可及性问题,需要制定适当的应对措施,以保证公平获得药物。

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