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. 2014 Feb 12;9(2):e87576.
doi: 10.1371/journal.pone.0087576. eCollection 2014.

Essential medicines are more available than other medicines around the globe

Yaser T Bazargani  1 , Margaret Ewen  2 , Anthonius de Boer  1 , Hubert G M Leufkens  1 , Aukje K Mantel-Teeuwisse  1
Affiliations

Essential medicines are more available than other medicines around the globe

Yaser T Bazargani et al. PLoS One. .

Abstract

Background: The World Health Organization (WHO) promotes the development of national Essential Medicines Lists (EMLs) in order to improve the availability and use of medicines considered essential within health care systems. However, despite over 3 decades of international efforts, studies show an inconsistent pattern in the availability of essential medicines. We evaluated and compared the availability of essential medicines, and medicines not included in national EMLs, at global and regional levels.

Methods: Medicine availability in the public and private sector were calculated based on data obtained from national and provincial facility-based surveys undertaken in 23 countries using the WHO/HAI methodology. The medicines were grouped according to their inclusion ('essential') or exclusion (termed 'non-essential') in each country's EML current at the time of the survey. Availability was calculated for originator brands, generics and any product type (originator brands or generics) and compared between the two groups. Results were aggregated by WHO regions, World Bank country income groups, a wealth inequality measure, and therapeutic groups.

Findings: Across all sectors and any product type, the median availability of essential medicines was suboptimal at 61·5% (IQR 20·6%-86·7%) but significantly higher than non-essential medicines at 27·3% (IQR 3·6%-70·0%). The median availability of essential medicines was 40·0% in the public sector and 78·1% in the private sector; compared to 6·6% and 57·1% for non-essential medicines respectively. A reverse trend between national income level categories and the availability of essential medicines was identified in the public sector.

Interpretation: EMLs have influenced the provision of medicines and have resulted in higher availability of essential medicines compared to non-essential medicines particularly in the public sector and in low and lower middle income countries. However, the availability of essential medicines, especially in the public sector does not ensure equitable access.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Availability (median, interquartile range, maximum-minimum) of any product type (originator brand/generic) of essential and non-essential medicines by World Bank income level*.
* LIC: Low income countries, LMIC: Lower-middle income countries, UMIC: Upper-middle income countries.
Figure 2
Figure 2. Median availability of any product type (originator brand/generic) of essential and non-essential medicines by ATC categories.
*Ectoparasiticides, including scabicides, insecticides and repellents, **Anti-inflammatory and anti-rheumatic products, ***Agents acting on the renin-angiotensin system.
See this image and copyright information in PMC

References

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    1. UN, Millennium development goals, MDG8: Develop a global partnership for development, Target8E: “In cooperation with pharmaceutical companies, provide access to affordable essential medicines in developing countries”. Available: http://www.un.org/millenniumgoals/global.shtml. Accessed 2012 Dec 2.
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