Quantifying the Impoverishing Effects of Purchasing Medicines A Cross-Country Comparison of the Affordability of Medicines in the Developing World 英文参考文献.docVIP

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Quantifying the Impoverishing Effects of Purchasing Medicines A Cross-Country Comparison of the Affordability of Medicines in the Developing World 英文参考文献.doc

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Quantifying the Impoverishing Effects of Purchasing Medicines A Cross-Country Comparison of the Affordability of Medicines in the Developing World 英文参考文献

QuantifyingtheImpoverishingEffectsofPurchasing Medicines:ACross-CountryComparisonofthe AffordabilityofMedicinesintheDevelopingWorld LaurensM.Nie¨ns1*,AlexandraCameron2,EllenVandePoel1,MargaretEwen3,WernerB.F.Brouwer1, RichardLaing2 1InstituteforMedicalTechnologyAssessmentandInstituteforHealthPolicyManagement,ErasmusUniversityRotterdam,TheNetherlands,2EssentialMedicinesand PharmaceuticalPolicies,WorldHealthOrganization,Geneva,Switzerland,3HealthActionInternationalGlobal,Amsterdam,TheNetherlands Abstract Background:Increasingattentionisbeingpaidtotheaffordabilityofmedicinesinlow-andmiddle-incomecountries(LICs and MICs) where medicines are often highly priced in relation to income levels. The impoverishing effect of medicine purchasescanbeestimatedbydeterminingpre-andpostpaymentincomes,whicharethencomparedtoapovertyline. Hereweestimatetheimpoverishingeffectsoffourmedicinesin16LICsandMICsusingtheimpoverishmentmethodasa metricofaffordability. Methods and Findings: Affordability was assessed in terms of the proportion of the population being pushed below US$1.25 or US$2 per day poverty levels because of the purchase of medicines. The prices of salbutamol 100mcg/dose inhaler,glibenclamide5mgcap/tab,atenolol50mgcap/tab,andamoxicillin250mgcap/tabwereobtainedfromfacility- basedsurveysundertakenusingastandardmeasurementmethodology.TheWorldBank’sWorldDevelopmentIndicators providedhouseholdexpendituredataandinformationonincomedistributions.Inthecountriesstudied,purchasingthese medicineswouldimpoverishlargeportionsofthepopulation(upto86%).Originatorbrandproductswerelessaffordable than the lowest-priced generic equivalents. In the Philippines, for example, originator brand atenolol would push an additional 22% of the population below US$1.25 per day, whereas for the lowest priced generic equivalent this demographicshiftis7%.Givenrelatedprevalencefigures,substantialnumbersofpeopleareaffectedbytheunaffordability ofmedicines. Conclusions: Comparing medicine prices to available inco