Mari Armstrong-Hough1, Srish Sharma2, Sandeep P Kishore3,4, Ann R Akiteng5, Jeremy I Schwartz5,6. 1. School of Global Public Health, New York University, New York, NY, United States of America. 2. Wake Forest School of Medicine, Winston-Salem, NC, United States of America. 3. Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America. 4. Young Professionals Chronic Disease Network, New York, New York, United States of America. 5. Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda. 6. Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Sarah Eg Moor; Andrew K Tusubira; Dallas Wood; Ann R Akiteng; Deron Galusha; Baylah Tessier-Sherman; Evelyn Hsieh Donroe; Christine Ngaruiya; Tracy L Rabin; Nicola L Hawley; Mari Armstrong-Hough; Brenda D Nakirya; Rachel Nugent; Robert Kalyesubula; Christine Nalwadda; Isaac Ssinabulya; Jeremy I Schwartz Journal: BMJ Open Date: 2022-07-21 Impact factor: 3.006