School of Global Public Health, New York University, New York, NY, United States of America.
Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
PLoS One. 2020 Dec 23;15(12):e0241555. doi: 10.1371/journal.pone.0241555. eCollection 2020.
Availability of essential medicines for non-communicable diseases (NCDs) is poor in low- and middle-income countries. Availability and cost are conventionally assessed using cross-sectional data. However, these characteristics may vary over time.
We carried out a prospective, descriptive analysis of the availability and cost of essential medicines in 23 Ugandan health facilities over a five-week period. We surveyed facility pharmacies in-person up to five times, recording availability and cost of 19 essential medicines for NCDs and four essential medicines for communicable diseases.
Availability of medicines varied substantially over time, especially among public facilities. Among private-for-profit facilities, the cost of the same medicine varied from week to week. Private-not-for-profit facilities experienced less dramatic fluctuations in price.
We conclude that there is a need for standardized, continuous monitoring to better characterize the availability and cost of essential medicines, understand demand for these medicines, and reduce uncertainty for patients.
在中低收入国家,非传染性疾病(NCDs)的基本药物供应情况较差。传统上,供应情况和成本是使用横断面数据评估的。然而,这些特征可能会随时间而变化。
我们在五个星期的时间内,对 23 家乌干达医疗机构的基本药物供应情况和成本进行了前瞻性、描述性分析。我们亲自对医疗机构的药房进行了多达五次的调查,记录了用于治疗 NCD 的 19 种基本药物和用于治疗传染病的 4 种基本药物的供应情况和成本。
药品的供应情况随时间有很大的变化,尤其是在公立医疗机构中。在私立营利性医疗机构中,同一药品的价格每周都在变化。私立非营利性医疗机构的价格波动则不那么剧烈。
我们的结论是,需要进行标准化、持续的监测,以更好地描述基本药物的供应情况和成本,了解对这些药物的需求,并减少患者的不确定性。