College of Pharmacy, Qatar University, PO BOX 2713, Doha, Qatar.
Department of Pharmacy, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
BMC Health Serv Res. 2019 Dec 18;19(1):973. doi: 10.1186/s12913-019-4828-0.
Cardiovascular diseases are the leading cause of death in Lebanon and Qatar. When lifestyle modifications prove insufficient, medication becomes a cornerstone in controlling such diseases and saving lives. Price, availability, and affordability hinder the equitable access to medicines. The study aimed to assess prices, availability, and affordability of essential cardiovascular disease medicines in relation to pricing strategies in Qatar and Lebanon.
A cross-sectional survey using a variant of the World Health Organization and Health Action International (WHO/HAI) methodology as outlined in "Measuring medicine prices, availability, affordability and price components" (2008), second edition, was adopted. Prices and availability of 27 cardiovascular medicines were collected from public and private dispensing outlets. For international comparison, prices were adjusted to purchasing power parity. Data was analyzed across multiple sectors, within and across countries.
A total of 15 public and private outlets were surveyed in each country. Prices were more uniform in Qatar than in Lebanon. In the public sector, medicines were free-of-charge in Lebanon and priced lower than the international reference prices in Qatar. The ratio of medicine unit price to international reference price in the private sectors surveyed are significantly higher than the acceptable threshold of 4. This ratio of originator brands and lowest priced generics in Qatar were up to two and five times those in Lebanon, respectively, even after adjusting for purchasing power parity. However, prices of lowest priced generics in the private sector were at least 35% cheaper in Qatar and 65% cheaper in Lebanon than their comparative originator brands. Medicines were more available in the private sector in Lebanon than in Qatar, but only the originator brand availability in the public sector in Qatar exceeded the WHO target of more than 80%. While affordable in the public sector in Qatar, four out of thirteen medicines exceeded the threshold in all private sectors covered. Hence, only the public sector in Qatar had a satisfying level of availability and affordability.
Except for the Qatari public sector, medicine prices, availability, and affordability are falling short from targets. Key policy decisions should be implemented to improve access to medicines.
心血管疾病是黎巴嫩和卡塔尔的主要死因。当生活方式的改变被证明不足以控制疾病时，药物治疗就成为控制此类疾病和挽救生命的基石。价格、可及性和可负担性阻碍了药物的公平获取。本研究旨在评估与卡塔尔和黎巴嫩的定价策略相关的基本心血管疾病药物的价格、可及性和可负担性。
采用世界卫生组织和国际健康行动（WHO/HAI）方法的变体，该方法在《衡量药品价格、可及性、可负担性和价格构成》（2008 年，第二版）中有概述。从公共和私人配药点收集了 27 种心血管药物的价格和可及性。为了进行国际比较，价格已根据购买力平价进行了调整。数据在多个部门内和跨国家进行了分析。
每个国家共调查了 15 家公共和私人配药点。卡塔尔的价格比黎巴嫩更为统一。在公共部门，黎巴嫩的药品是免费的，价格低于卡塔尔的国际参考价格。调查的私营部门中，药品单位价格与国际参考价格的比率明显高于可接受的 4 倍阈值。即使在调整了购买力平价后，卡塔尔的原研药品牌和最低价格仿制药的这一比率也分别比黎巴嫩高 2 倍和 5 倍。然而，在卡塔尔，最低价格仿制药的价格比其原研药品牌至少便宜 35%，在黎巴嫩则便宜 65%。在黎巴嫩，私营部门的药品供应比卡塔尔更充足，但只有卡塔尔公共部门的原研药供应超过了世卫组织 80%以上的目标。虽然在卡塔尔的公共部门可以负担得起，但在所有覆盖的私营部门中，有四种药物超过了所有药物的阈值。因此，只有卡塔尔的公共部门在可及性和可负担性方面达到了令人满意的水平。
除了卡塔尔的公共部门外，药物的价格、可及性和可负担性都没有达到目标。应实施关键的政策决策，以改善药物的可及性。
