Oldfield Lachlan, Penm Jonathan, Moles Rebekah
School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Department of Pharmacy, Prince of Wales Hospital, Randwick, Australia.
Lancet Reg Health West Pac. 2024 Dec 14;54:101262. doi: 10.1016/j.lanwpc.2024.101262. eCollection 2025 Jan.
Access to essential medicines is imperative for delivering effective healthcare, yet a significant proportion of the global population continues to face barriers in obtaining them. The South Pacific Region (SPR) faces unique medicine access challenges due to geographic remoteness, economic limitations, and, strained healthcare infrastructure. To gain further insight, this study aimed to assess the availability, pricing, and, affordability of essential medicines stratified by World Bank income group.
The WHO and Health Action International standardised methodology was employed in the public and private sectors of New Caledonia, French Polynesia, Wallis and Futuna, Fiji, Vanuatu, and, the Solomon Islands between February 1st 2023 and October 1st 2023. We measured availability, median price ratio (MPR), and affordability. Data were analysed by World Bank income group.
Data were collected from 19 public-sector hospitals and 24 private-sector pharmacies. Lower-middle income countries (LMICs) had the lowest mean availability for both public and private sectors, while upper-middle and high-income countries (HICs) demonstrated moderate to high availability. The mean availability of lowest-priced generics (LPG) in LMICs was 59.1% in the public sector and 57.4% in the private sector, compared to 87.2% and 72.5% respectively in HICs. MPRs indicated high medicine prices across all categories. Affordability analysis revealed that medicines were unaffordable in LMICs yet affordable in UMICs and HICs.
LMICs within the South Pacific display low availability and poor affordability of essential medicines. Urgent targeted policy reform and strategic initiatives are required to ensure effective and equitable healthcare within this region.
This research was supported by l'Agence Française de Développement, Le Fonds Pacifique [CZZ3165ORC].
获取基本药物对于提供有效的医疗保健至关重要，但全球仍有很大一部分人口在获取药物方面面临障碍。南太平洋地区（SPR）由于地理位置偏远、经济限制以及紧张的医疗基础设施，面临着独特的药物获取挑战。为了获得更深入的了解，本研究旨在评估按世界银行收入组分层的基本药物的可及性、定价和可负担性。
2023年2月1日至2023年10月1日期间，在新喀里多尼亚、法属波利尼西亚、瓦利斯和富图纳、斐济、瓦努阿图以及所罗门群岛的公共和私营部门采用了世界卫生组织和国际卫生行动组织的标准化方法。我们测量了可及性、中位数价格比（MPR）和可负担性。数据按世界银行收入组进行分析。
从19家公立医院和24家私立药店收集了数据。中低收入国家（LMICs）在公共和私营部门的平均可及性最低，而上中等收入和高收入国家（HICs）的可及性为中等至高。中低收入国家公共部门最低价格仿制药（LPG）的平均可及性为59.1%，私营部门为57.4%，相比之下，高收入国家分别为87.2%和72.5%。MPR表明所有类别药物价格都很高。可负担性分析显示，基本药物在中低收入国家难以负担，而在中高收入国家和高收入国家则可以负担。
南太平洋地区的中低收入国家基本药物的可及性低且可负担性差。需要紧急进行有针对性的政策改革和战略举措，以确保该地区医疗保健的有效性和公平性。
本研究由法国开发署、太平洋基金[CZZ3165ORC]资助。
