World Heart Federation, Geneva, Switzerland.
Research Unit of the Department of Medicine, Maputo Central Hospital, Maputo, Mozambique.
Glob Heart. 2023 Feb 28;18(1):8. doi: 10.5334/gh.1186. eCollection 2023.
To tackle the increasing burden of non-communicable diseases (NCDs) and reduce premature cardiovascular (CV) mortality by a third by the year 2030, countries must achieve 80% availability of affordable essential medicines (EMs) and technologies in all health facilities.
To evaluate access to EMs and diagnostics for CV diseases in Maputo City, Mozambique.
Using a modified version of World Health Organization (WHO)/Health Action International (HAI) methodology, we collected data on availability and price of 14 WHO Core EMs and 35 CV EMs in all 6 public-sector hospitals, 6 private-sector hospitals, and 30 private-retail pharmacies. Data on 19 tests and 17 devices were collected from hospitals. Medicine prices were compared with international reference prices (IRPs). Medicines were considered unaffordable if the lowest paid worker had to spend more than one day's wage to purchase a monthly supply.
Mean availability of CV EMs was lower than that of WHO Core EMs in both public (hospitals: 20.7% vs. 52.6%) and private sectors (retail pharmacies: 21.5% vs. 59.8%; hospitals: 22.2% vs. 50.0%). Mean availability of CV diagnostic tests and devices was lower in public (55.6% and 58.3%, respectively) compared to private sector (89.5% and 91.7%, respectively). Across WHO Core and CV EMs, the median price of lowest priced generic (LPG) and most sold generic (MSG) versions were 4.43 and 3.20 times the IRP, respectively. Relative to the IRP, median price of CV medicines was higher than that of Core EMs (LPG: 4.51 vs. 2.93). The lowest paid worker would spend 14.0 to 17.8 days' wage monthly to undergo secondary prevention.
Access to CV EMs is limited in Maputo City owing to low availability and poor affordability. Public-sector hospitals are not well equipped with essential CV diagnostics. This data could inform evidence-based policies for improving access to CV care in Mozambique.
为了应对非传染性疾病（NCD）负担不断增加的问题，并在 2030 年之前将心血管（CV）过早死亡率降低三分之一，各国必须确保所有卫生设施都能提供 80%可负担得起的基本药物（EMs）和技术。
评估莫桑比克马普托市 CV 疾病基本药物和诊断试剂的可及性。
采用世界卫生组织（WHO）/国际健康行动组织（HAI）修改版方法，我们收集了在 6 所公立医院、6 所私立医院和 30 家私人零售药店中 14 种 WHO 核心 EM 和 35 种 CV EM 的供应情况和价格数据。从医院收集了 19 项检测和 17 种设备的数据。如果最低薪工人购买一个月的供应品所需花费超过一天的工资，则认为药品价格不可负担。
在公立医院（零售药店：20.7%对 52.6%；医院：22.2%对 50.0%）和私立医院（零售药店：21.5%对 59.8%；医院：22.2%对 50.0%），CV EM 的总体供应情况均低于 WHO 核心 EM。在公立医院（分别为 55.6%和 58.3%），CV 诊断检测和设备的供应情况明显低于私立医院（分别为 89.5%和 91.7%）。在 WHO 核心 EM 和 CV EM 中，最便宜的通用药物（LPG）和最畅销的通用药物（MSG）的中位数价格分别为国际参考价格（IRP）的 4.43 倍和 3.20 倍。与 IRP 相比，CV 药物的中位数价格高于核心 EM（LPG：4.51 对 2.93）。最低工资工人每月需要花费 14.0 到 17.8 天的工资进行二级预防。
由于供应不足和价格负担能力差，莫桑比克马普托市 CV EM 的可及性有限。公立医院基本 CV 诊断设备配备不足。这些数据可以为改善莫桑比克 CV 护理提供循证政策依据。
