Availability, price, and affordability of essential medicines to manage noncommunicable diseases : a national survey from Nepal

The aim of this study was to evaluate the availability, price, and affordability of essential noncommunicable disease (NCD) medicines in Nepal. A cross-sectional survey was conducted in Nepal in 2015 using World Health Organization/Health Action International (WHO/HAI) methodology. We collected data on the availability and price of 60 essential NCD medicines from medicine distribution outlets in both the public and private health care sectors in 6 regions. Essential NCD medicines were more available in the private sector (78%) than the public sector (60%). Furosemide tablets were the cheapest (NPR 0.6/10 tablets) and streptokinase injections were the most expensive (NPR 2200/vial) drugs. There was no significant difference (P > .05) in availability and affordability of essential NCD medicines across the 6 survey areas. Treating selected NCD conditions with medicines was generally affordable, with 1 month of treatment costing no more than a day’s wage of the lowest paid unskilled government worker. The lower availability of NCD medicines in the public sector limits the effectiveness of the government’s policy of providing free health services at public facilities. Although NCD medicines were generally affordable, future health policy should aim to ensure improved equitable access to NCD medicines, particularly in public facilities

The Ursinus Weekly, February 7, 1944

Sally Deibler sells $1400 in bonds as fourth loan drive reaches new high • Loughead charms top crowd at festive quarterdeck hop • Typical student is quiet and reserved at Ursinus College • Dr. James Dean gives talk on central nervous system • Cap is aiding war effort, seeks air-minded recruits • French Club will feature songs, games at meeting • Joh Ziegler addresses student body at vespers • Community club plans public forum on labor relations topic, Feb. 8 • Y party to feature ace novelty act • Don\u27t be be a Joe or Maisie Zilch, try studying now for those exams • Phys-edders meet tonight • Perkiomen AAUW to hear speech on four freedoms • Ursinus debaters to meet Kutztown team tomorrow • War prisoners receive thousands of books • Improved girls\u27 team defeats Albright, Rosemont sextettes • Juniata downs bears in close contest, 64-52 • Hauser and Moore set pace as bears take Swarthmore • Lynnewood downs south in first inter-dorm game • Ursinus wrestlers to meet Muhlenberg this Saturday • Jack Bradford has sandwich shop where the elite meet to eat - meathttps://digitalcommons.ursinus.edu/weekly/1724/thumbnail.jp

Comparative assessment of medicine procurement prices in the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA)

Objectives: The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), the main primary healthcare provider for 4.9 million Palestinian refugees, spent USD18.3 million on essential medicines dispensed free-of-charge through clinics in five areas of operation (‘fields’): Gaza, Jordan, Lebanon, Syria, and the West Bank (2010). Faced with budget contraints and an increasing demand for medicines to treat chronic conditions, the objective of our study was to assess UNRWA’s medicine procurement prices to see if savings could be possible. Methods: In July 2011, data was collected from UNRWA headquarters in Jordan. Price analyses focused on the top 80 medicines by value, accounting for 93% of pharmaceutical expenditure from the General Fund, with comparisons to international, regional and national references. Prices were also compared for the few medicines procured both through UNRWA’s central tender (centrally) and by the fields directly (locally). Results: Central procurement prices did not differ markedly from reference prices: median ratios of UNRWA prices to Management Sciences for Health’s International Drug Price Indicator Guide, Jordan’s Joint Procurement Department, Gulf Cooperation Council, and IDA Foundation bulk packs were 0.99, 1.00, 0.98 and 1.12 respectively. Applying the lowest comparator price to five comparatively higher priced medicines would yield savings of USD1.4 million. Local procurements were generally less cost-effective than central tender procurement, with notable differences across fields and medicines. Conclusions: Overall, UNRWA’s procurement prices were competitive despite the relatively small quantities procured. Regular monitoring of procurement prices and quantities is needed in order to make informed decisions. Our evaluation also underscores the heavy burden of antidiabetic medicines and antimicrobials on UNRWA procurement expenditure

Quantifying the Impoverishing Effects of Purchasing Medicines: A Cross-Country Comparison of the Affordability of Medicines in the Developing World

Laurens Niëns and colleagues estimate the impoverishing effects of four medicines in 16 low- and middle-income countries using the impoverishment method as a metric of affordability and show that medicine purchases could impoverish large numbers of people

Availability, prices, and affordability of selected essential cancer medicines in a middle-income country - the case of Mexico

BACKGROUND: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. We assessed the availability and affordability of essential cancer medicines in Mexico, and compared their prices against those in other countries of the region. METHODS: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. RESULTS: Of the various medicines, mean availability in public and private sector outlets was 61.2 and 67.5%, respectively. In the public sector, medicines covered by the public health insurance "People's Health Insurance" were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. CONCLUSIONS: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector

Baseline assessment of WHO's target for both availability and affordability of essential medicines to treat non-communicable diseases

Background: WHO has set a voluntary target of 80% availability of affordable essential medicines, including generics, to treat major non-communicable diseases (NCDs), in the public and private sectors of countries by 2025. We undertook a secondary analysis of data from 30 surveys in low- and middle-income countries, conducted from 2008-2015 using the World Health Organization (WHO)/Health Action International (HAI) medicine availability and price survey methodology, to establish a baseline for this target. Methods Data for 49 medicines (lowest priced generics and originator brands) to treat cardiovascular diseases (CVD), diabetes, chronic obstructive pulmonary diseases (COPD) and central nervous system (CNS) conditions were analysed to determine their availability in healthcare facilities and pharmacies, their affordability for those on low incomes (based on median patient prices of each medicine), and the percentage of medicines that were both available and affordable. Affordability was expressed as the number of days' wages of the lowestpaid unskilled government worker needed to purchase 30 days' supply using standard treatment regimens. Paying more than 1 days' wages was considered unaffordable. Findings In low-income countries, 15.2% and 18.9% of lowest-priced generics met WHO's target in the public and private sectors, respectively, and 2.6% and 5.2% of originator brands. In lower-middle income countries, 23.8% and 23.2% of lowest priced generics, and 0.8% and 1.4% of originator brands, met the target in the public and private sectors, respectively. In upper-middle income countries, the situation was better for generics but still suboptimal as 36.0% and 39.4% met the target in public and private sectors, respectively. For originator brands in upper-middle income countries, none reached the target in the public sector and 13.7% in the private sector. Across the therapeutic groups for lowest priced generics, CVD medicines in low-income countries (11.9%), and CNS medicines in lower-middle (10.2%) and upper-middle income countries (33.3%), were least available and affordable in the public sector. In the private sector for lowest priced generics, CNS medicines were least available and affordable in all three country income groups (11.4%, 5.8% and 29.3% in low-, lower-middle and upper-middle income countries respectively). Interpretation This data, which can act as a baseline for the WHO target, shows low availability and/or poor affordability is resulting in few essential NCD medicines meeting the target in low- and middle-income countries. In the era of Sustainable Development Goals, and as countries work to achieve Universal Health Coverage, increased commitments are needed by governments to improve the situation through the development of evidence-informed, nationallycontextualised interventions, with regular monitoring of NCD medicine availability, patient prices and affordability.IS

Using comparative genomics to reorder the human genome sequence into a virtual sheep genome

Using BAC-end sequences, a sparse marker map and the sequences of the human, dog and cow genomes, an accurate and detailed sub-gene level map of the sheep genome has been constructed

Wafer Level Characterisation of Microelectrodes for Electrochemical Sensing Applications

This work presents a system for the in-line wafer-level characterisation of electrochemical sensors. Typically, such sensors are first diced and packaged before being electro-chemically tested. By integrating their characterisation into the manufacturing process, the production of electrochemical sensors becomes more efficient and less expensive as they can be parametrically tested midway through the fabrication process, without the need to package them. This enables malfunctioning or failed devices to be identified before dicing and reduces costs as only functional devices are packaged (in many cases this can be more expensive than the sensor fabrication). This study describes wafer-level characterisation of a simple electrochemical sensor design using a photoresist hydrophobic corralling film for the electrolyte and a probe station for contacting to individual dies