ПИТАННЯ ЕКОНОМІЧНОЇ ДОСТУПНОСТІ ЛІКАРСЬКИХ ЗАСОБІВ НА АФРИКАНСЬКОМУ КОНТИНЕНТІ

Анотація

ISSUES OF ECONOMIC AVAILABILITY OF MEDICAL DRUGS IN AFRICA

O. Ievtushenko, Osama Abuzayid Mohamed Nur Ahmed

National University of Pharmacy, Kharkiv city

INTRODUCTION

Currently Africa with its highest index of diseases in the world maintains a serious dependence of imported medical drugs. Imported production comprises from 80 to 100% in some African countries, despite the fact that the incomes of population and medical support system doesn’t correspond completely with the consumption of expensive medical drugs (further MD). There is an extremely severe problem of physical and economical availability of MD  in theEastern Mediterraneancountries.

OBJECTIVE STATEMENT OF THE ARTICLE

In connection with the above mentioned, the purpose of the work is the analysis of economic availability of MD in theEastern Mediterraneancountries, and also  the comparison of the received indexes with the indexes of  European countries. In the researches it has been participated such countries as Sudan, Egypt, Lebanon, Uganda and Ethiopia. To compare the received indexes of availability and their level determination it has been made the comparison of indexes among themselves and also with the indexes of the developed country of the European continent. As a standard it has been taken Germany as a country with one of the most developed pharmaceutical markets in the world and the strongest health care system, which finances medical and pharmaceutical assurance among all the EU countries.

RESEARCH METHODS

In this work it has been taken into account the pharma-economic  methods of analysis and methodology of the World Health Organization  (WHO) and Health Action International (HAI) «Prices determination of MD, their availability and price of components ", data obtained during this methodology examination [1, 4, 6-11]; information from regional and national sources [12]; and also the scientific publications on this topic [2,3,5]. Data concerning prices for medicines and the cost of treatment course were obtained in studying of retail prices in pharmacies of the above mentioned countries. In the total examination it has been studied the MD  which are used for the treatment of chronic diseases and which are included in the international list recommended for the continuous monitoring (study) by the World Health Organization .

RESULTS AND IT DELIBERATION

According to WHO recommendations, it has been selected the basic MD for the treatment of 14 the most common diseases, which will allow to make the international research. Also it is allowable to include in this list of MD the most important for the treatment of specific diseases in certain countries. Yes, for the African countries  such drugs are the remedies for the  malaria treatment.

In the study it has been participated the generic MD sold at the lowest price. Further it has been determined the economic availability of studied MD, taking into account the ratio of the treatment cost by this drug (according to the  international treatment protocols) and the daily wage of unskilled low paid public officer in these countries.

During the determination of economic accessibility of medicines it has been used the paying capacity adequacy ratio, which includes the lowest retail price of the drug (or the treatment course price), and the average salary for a certain period of time.

The analysis shows that the availability of MD in some African countries is situated at the unsatisfactory level. Regarding the indicators of availability general perception, the lowest indicators hasSudan, the highest accessible indexes has Egypt. By comparison of the availability of MD in African countries and in Germany, for the diclofenac treatment course in Germany it is necessary to spend 0.24 of one day wages, and in Sudan - 5.3, which is higher in 22 times; for the paracetamol treatment the Sudan patients spend more in 10 times.

Thus, the availability economic analysis of basic MD confirms  thatEgyptandLebanonassist a relatively low cost of basic MD, which is close to the level of the European countries. Especially in Egypt, the major part of economic availability indicators of medical drugs corresponds to parameters of the country with the developed pharmaceutical market and a strong health care system and this is Germany. Thus, the indicators ofEgyptare almost identical with those ofGermanyat the prices of Diclofenac, Atenolol, Captopril, Glibenclamide, Ceftriaxone, Diazepam, and even lower - with  Salbutamol, Amitriptyline, the antimalarial medical drugs.

Thus, in Sudan is marked with the rather high prices and, consequently, low availability on a number of medical drugs such as Diclofenac, Paracetamol, Captopril, Simvastatin, Amitriptyline. Thus, patient inSudanneed  spend in 22 times more of money to the diclofenac treatment than patients inGermany. A treatment will paracetamol will be in10 times more expensive, treatment with captopril will be in 7 times more expensive. Comparison of availability indexes in theSudanwith the African region countries is also accompanied by a situation where the indicators availability of MD are in 3 - 10 times worse than in other countries with similar health care system. The necessity of  generic MD availability analyses, especially for the countries with the health care systems which are forming will help to make the fast and low priced  determination of the availability level of medicines for the population, the  timely reaction in case of indexes deterioration, the regulation of public policy of countries in the pricing field on MD as well as coordination of original and generic drugs use, which allow to reduce the budgetary costs of medical assistance without the quality loss.

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