Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014
Abstract
1. Introduction
2. Methods
3. Results
3.1. Essential Medicine Lists
3.2. National Reimbursement Lists
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017, 390, 1151–1210. [Google Scholar] [CrossRef]
- GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017, 390, 1211–1259. [Google Scholar] [CrossRef]
- FitzGerald, J.M.; Sadatsafavi, M. The importance of measuring asthma control in emerging economies. Int. J. Tuberc. Lung Dis. 2014, 18, 254. [Google Scholar] [CrossRef] [PubMed]
- Babar, Z.U.; Lessing, C.; Macé, C.; Bissell, K. The availability, pricing and affordability of three essential asthma medicines in 52 low- and middle-income countries. Pharmacoeconomics 2013, 31, 1063–1082. [Google Scholar] [CrossRef] [PubMed]
- Cameron, A.; Ewen, M.; Ross-Degnan, D.; Ball, D.; Laing, R. Medicine prices, availability, and affordability in 36 developing and middle-income countries: A secondary analysis. Lancet 2009, 373, 240–249. [Google Scholar] [CrossRef]
- Cameron, A.; Roubos, I.; Ewen, M.; Mantel-Teeuwisse, A.K.; Leufkens, H.G.; Laing, R.O. Differences in the availability of medicines for chronic and acute conditions in the public and private sectors of developing countries. Bull. World Health Organ. 2011, 89, 412–421. [Google Scholar] [CrossRef] [PubMed]
- Zar, H.J.; Levin, M.E. Challenges in treating pediatric asthma in developing countries. Paediatr. Drugs 2012, 14, 353–359. [Google Scholar] [PubMed]
- Beran, D.; Zar, H.J.; Perrin, C.; Menezes, A.M.; Burney, P.; Forum of International Respiratory Societies working group c. Burden of asthma and chronic obstructive pulmonary disease and access to essential medicines in low-income and middle-income countries. Lancet Respir. Med. 2015, 3, 159–170. [Google Scholar] [CrossRef]
- Bissell, K.; Perrin, C.; Beran, D. Access to essential medicines to treat chronic respiratory disease in low-income countries. Int. J. Tuberc. Lung Dis. 2016, 20, 717–728. [Google Scholar] [CrossRef]
- Bissell, K.; Perrin, C. Access to affordable, quality-assured asthma medicines. In Global Asthma Report; Global Asthma Network: Auckland, New Zealand, 2014; pp. 52–57. ISBN 978-0-473-29125-9. [Google Scholar]
- Ravinetto, R.; Vandenbergh, D.; Macé, C.; Pouget, C.; Renchon, B.; Rigal, J.; Schiavetti, B.; Caudron, J.-M. Fighting poor-quality medicines in low- and middle-income countries: The importance of advocacy and pedagogy. J. Pharm. Policy Pract. 2016, 9, 36. [Google Scholar] [CrossRef]
- World Health Organization. Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020; World Health Organization: Geneva, Switzerland, 2013. [Google Scholar]
- World Health Organization. Global Status Report on Noncommunicable Diseases; World Health Organization: Geneva, Switzerland, 2014. [Google Scholar]
- Hogerzeil, H.V.; Liberman, J.; Wirtz, V.J.; Kishore, S.P.; Selvaraj, S.; Kiddell-Monroe, R.; Mwangi-Powell, F.N.; Von Schoen-Angerer, T.; Selvaraj, S. Promotion of access to essential medicines for non-communicable diseases: Practical implications of the UN political declaration. Lancet 2013, 381, 680–689. [Google Scholar] [CrossRef]
- World Health Organization. Assessing National Capacity for the Prevention and Control of Noncommunicable Diseases: Report of the 2015 Global Survey; World Health Organization: Geneva, Switzerland, 2016; ISBN 978-92-4-156536-3. [Google Scholar]
- World Health Organization. The World Medicines Situation 2011—Medicine Expenditures; World Health Organization: Geneva, Switzerland, 2011. [Google Scholar]
- World Health Organization. 18th Model List of Essential Medicines; World Health Organization: Geneva, Switzerland, 2013. [Google Scholar]
- World Health Organization. Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care in Low-Resource Settings; World Health Organization: Geneva, Switzerland, 2013. [Google Scholar]
- Ait-Khaled, N.; Enarson, D.A.; Chiang, C.-Y.; Marks, G.; Bissell, K. Management of Asthma: A Guide to the Essentials of Good Clinical Practice; International Union Against Tuberculosis and Lung Disease: Paris, France, 2008. [Google Scholar]
- Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2018; Global Initiative for Asthma, 2018; Available online: https://ginasthma.org/gina-reports/ (accessed on 15 February 2019).
- World Health Organization. 20th Model List of Essential Medicines; World Health Organization: Geneva, Switzerland, 2017. [Google Scholar]
- Lai, C.K.W.; Beasley, R.; Crane, J.; Foliaki, S.; Shah, J.; Weiland, S.; the ISAAC Phase Three Study Group. Global variation in the prevalence and severity of asthma symptoms: Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 2009, 64, 476–483. [Google Scholar] [CrossRef] [PubMed]
- World Bank. World Bank Country and Lending Groups. Country Classification 2014. Available online: https://datahelpdesk.worldbank.org/knowledgebase/ (accessed on 1 February 2015).
- Perehudoff, S.K.; Alexandrov, N.V.; Hogerzeil, H.V. Access to essential medicines in 195 countries: A human rights approach to sustainable development. Glob. Public Health 2018, 1–14. [Google Scholar] [CrossRef] [PubMed]
- Perehudoff, S.K.; Laing, R.O.; Hogerzeil, H.V. Access to essential medicines in national constitutions. Bull. World Health Organ. 2010, 88, 800. [Google Scholar] [CrossRef] [PubMed]
- Laing, R.; Waning, B.; Gray, A.; Ford, N.; t Hoen, E. 25 years of the WHO essential medicines lists: Progress and challenges. Lancet 2003, 361, 1723–1729. [Google Scholar] [CrossRef]
- United Nations. Sustainable Development Goals 2015. Available online: https://sustainabledevelopment.un.org/sdgs (accessed on 5 January 2017).
- World Health Organization. Key Components of a Well Functioning Health System; World Health Organization: Geneva, Switzerland, 2010. [Google Scholar]
- Gray, A.L.; Wirtz, V.J.; t Hoen, E.F.; Reich, M.R.; Hogerzeil, H.V. Essential medicines are still essential. Lancet 2015, 386, 1601–1603. [Google Scholar] [CrossRef]
- World Health Organization. WHO Moves to Improve Access to Lifesaving Medicines for Hepatitis C, Drug-Resistant TB and Cancers [Press Release]; World Health Organization: Geneva, Switzerland, 2015. [Google Scholar]
- Bigdeli, M.; Jacobs, B.; Tomson, G.; Laing, R.; Ghaffar, A.; Dujardin, B.; Van Damme, W. Access to medicines from a health system perspective. Health Policy Plan. 2013, 28, 692–704. [Google Scholar] [CrossRef] [PubMed]
- Ade, G.; Gninafon, M.; Tawo, L.; Ait-Khaled, N.; Enarson, D.A.; Chiang, C.-Y. Management of asthma in Benin: The challenge of loss to follow-up. Public Health Action. 2013, 3, 76–80. [Google Scholar] [CrossRef] [PubMed]
- El Sony, A.I.; Chiang, C.-Y.; Malik, E.; Hassanain, S.A.; Hussein, H.; Khamis, A.H.; Bassilli, A.F.; Enarson, D.A. Standard case management of asthma in Sudan: A pilot project. Public Health Action. 2013, 3, 247–252. [Google Scholar] [CrossRef]
- Kan, X.H.; Chiang, C.-Y.; Enarson, D.A.; Rao, H.L.; Chen, Q.; Ait-Khaled, N. Asthma as a hidden disease in rural China: Opportunities and challenges of standard case management. Public Health Action 2012, 2, 87–91. [Google Scholar] [CrossRef]
- Frost, L.J.; Reich, M.R. Access: How Do Good Health Technologies Get to Poor People in Poor Countries; Harvard Center for Population and Development Studies: Cambridge, MA, USA, 2008. [Google Scholar]
- Davidsen, J.R.; Sondergaard, J.; Hallas, J.; Siersted, H.C.; Knudsen, T.B.; Lykkegaard, J.; Andersen, M. Impact of socioeconomic status on the use of inhaled corticosteroids in young adult asthmatics. Respir. Med. 2011, 105, 683–690. [Google Scholar] [CrossRef] [PubMed]
- Duong, M.; Moles, R.J.; Chaar, B.; Chen, T.F.; World Hospital Pharmacy Research Consortium. Essential Medicines in a High Income Country: Essential to Whom? PLoS ONE 2015, 10, e0143654. [Google Scholar] [CrossRef] [PubMed]
- Taglione, M.S.; Ahmad, H.; Slater, M.; Aliarzadeh, B.; Glazier, R.H.; Laupacis, A.; Persaud, N. Development of a Preliminary Essential Medicines List for Canada. CMAJ Open 2017, 5, E137–E143. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Eom, G.; Grootendorst, P.; Duffin, J. The case for an essential medicines list for Canada. CMAJ 2016, 188, E499–E503. [Google Scholar] [CrossRef] [PubMed]
- Pearce, N.; Asher, I.; Billo, N.; Bissell, K.; Ellwood, P.; El Sony, A.; García-Marcos, L.; Chiang, C.-Y.; Mallol, J.; Marks, G.; et al. Asthma in the global NCD agenda: A neglected epidemic. Lancet Respir. Med. 2013, 1, 96–98. [Google Scholar] [CrossRef]
- Asher, I.; Bissell, K.; Chiang, C.-Y.; El Sony, A.; Ellwood, P.; García-Marcos, L.; Marks, G.B.; Mortimer, K.; Pearce, N.; Strachan, D. Calling time on asthma deaths in tropical regions-how much longer must people wait for essential medicines? Lancet Respir. Med. 2019, 7, 13–15. [Google Scholar] [CrossRef]
- Robertson, J.; Macé, C.; Forte, G.; de Joncheere, K.; Beran, D. Medicines availability for non-communicable diseases: The case for standardized monitoring. Glob. Health 2015, 11, 18. [Google Scholar] [CrossRef] [PubMed]
- Wirtz, V.J.; Hogerzeil, H.V.; Gray, A.L.; Bigdeli, M.; de Joncheere, C.P.; Ewen, M.A.; Gyansa-Lutterodt, M.; Jing, S.; Luiza, V.L.; Mbindyo, R.M.; et al. Essential medicines for universal health coverage. Lancet 2017, 389, 403–476. [Google Scholar] [CrossRef]
- Enarson, D.A. Fostering a spirit of critical thinking: The ISAAC story. Int. J. Tuberc. Lung Dis. 2005, 9, 1. [Google Scholar] [PubMed]
- World Health Organization. Measuring Medicine Prices, Availability, Affordability and Price Components, 2nd ed.; World Health Organization, Health Action International: Geneva, Switzerland, 2008; Available online: http://www.who.int/medicines/areas/access/OMS_Medicine_prices.pdf (accessed on 10 December 2018).
High-Income Countries and Territories | Have EML | Any ICS on EML | S on EML | Have NRL | Any ICS on NRL | S on NRL |
---|---|---|---|---|---|---|
Australia | N | n/a | n/a | Y | Y | Y |
Austria | N | n/a | n/a | Y | Y | Y |
Belgium | Y | N | Y | Y | Y | Y |
Canada | Y | Y | Y | Y | Y | Y |
Channel Islands | Y | Y | Y | Y | Y | Y |
Chile | Y | Y | Y | Y | Y | Y |
Croatia | Y | Y | Y | Y | Y | Y |
Cyprus | N | n/a | n/a | Y | Y | Y |
Denmark | Y | Y | N | Y | N | N |
Faroe Islands | Y | Y | Y | Y | Y | Y |
Finland | N | n/a | n/a | Y | Y | Y |
France | N | n/a | n/a | Y | Y | Y |
French Polynesia | N | n/a | n/a | Y | Y | Y |
Germany | N | n/a | n/a | Y | Y | Y |
Hong Kong | N | n/a | n/a | Y | Y | Y |
Ireland | N | n/a | n/a | Y | Y | Y |
Israel | Y | Y | N | Y | Y | N |
Italy | Y | Y | Y | Y | Y | Y |
Japan | N | n/a | n/a | Y | Y | Y |
Korea, South | Y | Y | Y | N | n/a | n/a |
Kuwait | Y | Y | Y | Y | Y | Y |
Latvia | Y | N | Y | Y | N | Y |
Malta | N | n/a | n/a | Y | Y | Y |
Netherlands | N | n/a | n/a | Y | Y | Y |
New Caledonia | N | n/a | n/a | Y | Y | Y |
New Zealand | N | n/a | n/a | Y | Y | Y |
Norway | N | n/a | n/a | Y | Y | Y |
Oman | Y | Y | Y | N | n/a | n/a |
Poland | Y | Y | Y | Y | Y | Y |
Portugal | Y | N | N | Y | Y | Y |
Reunion Island | N | n/a | n/a | Y | Y | Y |
Russia | Y | Y | Y | Y | Y | Y |
Saudi Arabia | Y | Y | Y | N | n/a | n/a |
Singapore | Y | Y | Y | Y | Y | Y |
Spain | N | n/a | n/a | Y | Y | Y |
Trinidad and Tobago | Y | Y | Y | Y | Y | Y |
United Arab Emirates | Y | Y | Y | Y | Y | Y |
United Kingdom | Y | Y | Y | Y | Y | Y |
United States | N | n/a | n/a | N | n/a | n/a |
Uruguay | Y | N | Y | N | n/a | n/a |
Vatican City | N | n/a | n/a | N | n/a | n/a |
Total Y/total HICs (41) | 22 | 35 | ||||
Total Y/total HICs with EML (22) | 18 | 19 | ||||
Total Y/total HICs with NRL (35) | 33 | 33 | ||||
Total as % | 54 | 82 | 86 | 85 | 94 | 94 |
Low- and Middle-Income Countries | Have EML | Any ICS on EML | S on EML | Have NRL | Any ICS on NRL | S on NRL |
---|---|---|---|---|---|---|
Albania | Y | Y | Y | Y | Y | Y |
Algeria | Y | Y | Y | Y | Y | Y |
Argentina | Y | N | N | Y | Y | Y |
Armenia | Y | N | Y | Y | N | Y |
Belarus | Y | Y | Y | Y | Y | Y |
Benin | Y | N | N | N | n/a | n/a |
Bolivia | Y | Y | Y | Y | N | Y |
Bosnia and Herzegovina | Y | N | Y | Y | N | Y |
Brasil | Y | Y | Y | Y | N | N |
Bulgaria | Y | Y | Y | Y | Y | Y |
Burkina Faso | Y | Y | Y | Y | N | N |
Cameroon | Y | N | N | N | n/a | n/a |
China | Y | Y | Y | Y | Y | Y |
Colombia | Y | Y | Y | N | n/a | n/a |
Congo Dem Rep | Y | Y | Y | N | n/a | n/a |
Costa Rica | Y | Y | Y | Y | Y | Y |
Ecuador | Y | Y | Y | Y | Y | Y |
Egypt | Y | N | N | Y | N | N |
El Salvador | Y | Y | Y | Y | Y | Y |
Fiji | Y | Y | Y | Y | Y | N |
Gambia | Y | N | N | N | n/a | n/a |
Georgia | Y | N | N | N | n/a | n/a |
Ghana | Y | Y | Y | Y | Y | Y |
Grenada | Y | Y | Y | N | n/a | n/a |
Hungary | Y | Y | Y | Y | Y | Y |
India | Y | Y | Y | Y | Y | Y |
Indonesia | Y | Y | Y | Y | N | Y |
Iran | Y | Y | Y | Y | Y | Y |
Jamaica | Y | Y | Y | Y | Y | Y |
Jordan | Y | Y | Y | Y | Y | Y |
Kenya | Y | N | N | N | n/a | n/a |
Kosovo | Y | N | Y | Y | N | N |
Lao PDR | Y | N | Y | Y | N | N |
Macedonia | Y | Y | Y | Y | Y | Y |
Malawi | Y | Y | Y | N | n/a | n/a |
Malaysia | Y | Y | Y | N | n/a | n/a |
Mexico | Y | Y | Y | Y | Y | Y |
Mongolia | Y | Y | Y | Y | N | Y |
Nicaragua | Y | Y | Y | Y | Y | Y |
Nigeria | Y | Y | Y | N | n/a | n/a |
Niue | Y | Y | Y | N | n/a | n/a |
Pakistan | Y | N | N | N | n/a | n/a |
Palau | Y | Y | Y | N | n/a | n/a |
Palestine | Y | Y | Y | N | n/a | n/a |
Panama | Y | Y | Y | Y | Y | Y |
Peru | Y | Y | Y | Y | Y | Y |
Philippines | Y | Y | Y | Y | Y | Y |
Romania | Y | Y | Y | Y | Y | Y |
Samoa | Y | Y | Y | Y | N | N |
Senegal | Y | N | N | Y | N | N |
Serbia | Y | Y | Y | Y | Y | Y |
Sierra Leone | Y | Y | Y | N | n/a | n/a |
South Africa | Y | Y | Y | Y | Y | Y |
Sri Lanka | Y | Y | Y | N | n/a | n/a |
Sudan | Y | Y | Y | Y | Y | Y |
Syrian Arab Republic | Y | N | Y | Y | Y | Y |
Taiwan | N | n/a | n/a | Y | Y | Y |
Thailand | Y | Y | Y | Y | Y | Y |
Togo | Y | Y | Y | Y | Y | Y |
Tokelau | Y | Y | Y | N | n/a | n/a |
Tonga | Y | Y | Y | N | n/a | n/a |
Tunisia | Y | Y | Y | Y | Y | Y |
Turkey | N | n/a | n/a | Y | Y | Y |
Tuvalu | Y | Y | Y | N | n/a | n/a |
Uganda | Y | Y | Y | N | n/a | n/a |
Ukraine | Y | Y | Y | Y | N | N |
Vanuatu | Y | Y | Y | N | n/a | n/a |
Vietnam | Y | N | Y | Y | N | Y |
Zambia | Y | Y | Y | N | n/a | n/a |
Zimbabwe | Y | Y | Y | N | n/a | n/a |
Total Y/total LMICs (70) | 68 | 46 | ||||
Total Y/total LMICs with EML (68) | 53 | 59 | ||||
Total Y/total LMICs with NRL (46) | 32 | 37 | ||||
Total as % | 97 | 78 | 87 | 66 | 70 | 80 |
High-Income Countries and Territories | Beclometasone 50 μg | Beclometasone 100 μg | Budesonide 100 μg | Budesonide 200 μg | Salbutamol 100 μg | |||||
---|---|---|---|---|---|---|---|---|---|---|
EML | NRL | EML | NRL | EML | NRL | EML | NRL | EML | NRL | |
Australia | n/a | Y | n/a | Y | n/a | N | n/a | N | n/a | Y |
Austria | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
Belgium | N | Y | N | N | N | N | N | Y | Y | Y |
Canada | Y | Y | Y | Y | N | N | N | N | Y | Y |
Channel Islands | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Chile | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Croatia | Y | Y | Y | Y | N | N | N | N | Y | Y |
Cyprus | n/a | N | n/a | Y | n/a | N | n/a | N | n/a | Y |
Denmark | N | N | Y | N | N | N | Y | N | N | N |
Faroe Islands | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Finland | n/a | Y | n/a | Y | n/a | N | n/a | N | n/a | Y |
France | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
French Polynesia | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
Germany | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
Hong Kong | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
Ireland | n/a | Y | n/a | Y | n/a | N | n/a | N | n/a | Y |
Israel | Y | Y | Y | Y | Y | Y | Y | Y | N | N |
Italy | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Japan | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
Korea, South | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a |
Kuwait | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Latvia | N | N | N | N | N | N | N | N | Y | Y |
Malta | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a | Y |
Netherlands | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
New Caledonia | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
New Zealand | n/a | Y | n/a | Y | n/a | N | n/a | N | n/a | Y |
Norway | n/a | Y | n/a | Y | n/a | N | n/a | N | n/a | Y |
Oman | Y | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Poland | N | N | Y | Y | N | N | Y | Y | Y | Y |
Portugal | N | Y | N | Y | N | Y | N | Y | N | Y |
Reunion Island | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
Russia | Y | Y | Y | Y | N | N | N | N | Y | Y |
Saudi Arabia | Y | n/a | N | n/a | N | n/a | Y | n/a | Y | n/a |
Singapore | Y | Y | N | N | N | N | N | N | Y | Y |
Spain | n/a | Y | n/a | N | n/a | Y | n/a | Y | n/a | Y |
Trinidad and Tobago | Y | Y | Y | Y | Y | N | Y | N | Y | Y |
United Arab Emirates | N | N | Y | Y | Y | Y | Y | Y | Y | Y |
United Kingdom | Y | Y | Y | Y | N | N | N | N | Y | Y |
United States | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Uruguay | N | n/a | N | n/a | N | n/a | N | n/a | Y | n/a |
Vatican City | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Total Y/total HICs with EML (22) | 15 | 16 | 9 | 12 | 19 | |||||
Total Y/total HICs with NRL (35) | 30 | 29 | 18 | 21 | 33 | |||||
Total as % | 68 | 86 | 73 | 83 | 41 | 51 | 55 | 60 | 86 | 94 |
Low- and Middle-Income Countries | Beclometasone 50 μg | Beclometasone 100 μg | Budesonide 100 μg | Budesonide 200 μg | Salbutamol 100 μg | |||||
---|---|---|---|---|---|---|---|---|---|---|
EML | NRL | EML | NRL | EML | NRL | EML | NRL | EML | NRL | |
Albania | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Algeria | N | N | N | N | Y | Y | Y | Y | Y | Y |
Argentina | N | N | N | N | N | Y | N | Y | N | Y |
Armenia | N | N | N | N | N | N | N | N | Y | Y |
Belarus | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Benin | N | n/a | N | n/a | N | n/a | N | n/a | N | n/a |
Bolivia | Y | N | Y | N | Y | N | Y | N | Y | Y |
Bosnia and Herzegovina | N | N | N | N | N | N | N | N | Y | Y |
Brasil | Y | N | N | N | N | N | N | N | Y | N |
Bulgaria | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Burkina Faso | Y | N | N | N | N | N | Y | N | Y | N |
Cameroon | N | n/a | N | n/a | N | n/a | N | n/a | N | n/a |
China | Y | Y | N | N | N | N | N | N | Y | Y |
Colombia | Y | n/a | N | n/a | N | n/a | N | n/a | Y | n/a |
Congo Dem Rep | N | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Costa Rica | N | N | Y | Y | N | N | N | N | Y | Y |
Ecuador | Y | Y | Y | Y | N | N | N | N | Y | Y |
Egypt | N | N | N | N | N | N | N | N | N | N |
El Salvador | Y | Y | N | N | N | N | N | N | Y | Y |
Fiji | N | N | Y | Y | N | N | N | N | Y | N |
Gambia | N | n/a | N | n/a | N | n/a | N | n/a | N | n/a |
Georgia | N | n/a | N | n/a | N | n/a | N | n/a | N | n/a |
Ghana | N | N | Y | Y | Y | Y | Y | Y | Y | Y |
Grenada | Y | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Hungary | N | N | N | N | Y | Y | Y | Y | Y | Y |
India | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Indonesia | N | N | N | N | Y | N | Y | N | Y | Y |
Iran | Y | Y | N | N | Y | Y | Y | Y | Y | Y |
Jamaica | Y | Y | Y | Y | N | N | Y | Y | Y | Y |
Jordan | Y | Y | Y | Y | N | N | N | N | Y | Y |
Kenya | N | n/a | N | n/a | N | n/a | N | n/a | N | n/a |
Kosovo | N | N | N | N | N | N | N | N | Y | N |
Lao PDR | N | N | N | N | N | N | N | N | Y | N |
Macedonia | Y | Y | N | N | N | N | Y | Y | Y | Y |
Malawi | Y | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Malaysia | N | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a |
Mexico | N | Y | N | Y | Y | Y | Y | Y | Y | Y |
Mongolia | Y | N | Y | N | N | N | N | N | Y | Y |
Nicaragua | Y | Y | Y | Y | N | N | N | N | Y | Y |
Nigeria | Y | n/a | N | n/a | N | n/a | N | n/a | Y | n/a |
Niue | N | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Pakistan | N | n/a | N | n/a | N | n/a | N | n/a | N | n/a |
Palau | N | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Palestine | N | n/a | N | n/a | N | n/a | Y | n/a | Y | n/a |
Panama | Y | Y | N | N | N | N | Y | Y | Y | Y |
Peru | Y | Y | N | N | N | N | Y | Y | Y | Y |
Philippines | Y | Y | Y | Y | N | N | Y | Y | Y | Y |
Romania | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Samoa | N | N | Y | N | N | N | N | N | Y | N |
Senegal | N | N | N | N | N | N | N | N | N | N |
Serbia | Y | N | Y | Y | Y | N | Y | Y | Y | Y |
Sierra Leone | Y | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
South Africa | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Sri Lanka | Y | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Sudan | Y | N | N | N | N | N | N | Y | Y | Y |
Syrian Arab Republic | N | Y | N | Y | N | Y | N | Y | Y | Y |
Taiwan | n/a | N | n/a | N | n/a | N | n/a | Y | n/a | Y |
Thailand | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Togo | Y | Y | Y | Y | N | N | N | N | Y | Y |
Tokelau | Y | n/a | N | n/a | N | n/a | N | n/a | Y | n/a |
Tonga | N | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Tunisia | Y | Y | N | N | N | N | N | Y | Y | Y |
Turkey | n/a | Y | n/a | Y | n/a | Y | n/a | Y | n/a | Y |
Tuvalu | Y | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Uganda | Y | n/a | N | n/a | N | n/a | N | n/a | Y | n/a |
Ukraine | N | N | N | N | Y | N | Y | N | Y | N |
Vanuatu | Y | n/a | N | n/a | N | n/a | N | n/a | Y | n/a |
Vietnam | N | N | N | N | N | N | N | N | Y | Y |
Zambia | Y | n/a | N | n/a | N | n/a | N | n/a | Y | n/a |
Zimbabwe | Y | n/a | Y | n/a | N | n/a | N | n/a | Y | n/a |
Total Y/total LMICs with EML (68) | 38 | 31 | 17 | 24 | 59 | |||||
Total Y/total LMICs with NRL (46) | 23 | 20 | 15 | 24 | 37 | |||||
Total as % | 56 | 50 | 46 | 43 | 25 | 33 | 35 | 52 | 87 | 80 |
High-Income Countries and Territories (41) N (%) | Low- and Middle-Income Countries (70) N (%) | Total N (%) | p-Value * | |
---|---|---|---|---|
Essential Medicines List (EML) | ||||
Have EML | 22 (54) | 68 (97) | 90 (81) | <0.001 |
Any inhaled corticosteroid (ICS) | 18 (82) | 53 (78) | 71 (79) | 0.7 |
Salbutamol | 19 (86) | 59 (87) | 78 (87) | 0.9 |
Beclometasone 50 µg | 15 (68) | 38 (56) | 53 (59) | 0.3 |
Beclometasone 100 µg | 16 (73) | 31 (46) | 47 (52) | 0.03 |
Budesonide 100 µg | 9 (41) | 17 (25) | 26 (29) | 0.2 |
Budesonide 200 µg | 12 (55) | 24 (35) | 36 (40) | 0.1 |
National Reimbursement List (NRL) | ||||
Have NRL | 35 (85) | 46 (66) | 81 (73) | 0.02 |
Any ICS | 33 (94) | 32 (70) | 65 (80) | 0.006 |
Salbutamol | 33 (94) | 37 (80) | 70 (86) | 0.07 |
Beclometasone 50 µg | 30 (86) | 23 (50) | 53 (65) | <0.001 |
Beclometasone 100 µg | 29 (83) | 20 (43) | 49 (60) | <0.001 |
Budesonide 100 µg | 18 (51) | 15 (33) | 33 (41) | 0.9 |
Budesonide 200 µg | 21 (60) | 24 (52) | 45 (56) | 0.5 |
Any ICS and Salbutamol | 32 (91) | 31 (67) | 63 (78) | 0.01 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Bissell, K.; Ellwood, P.; Ellwood, E.; Chiang, C.-Y.; Marks, G.B.; El Sony, A.; Asher, I.; Billo, N.; Perrin, C.; the Global Asthma Network Study Group. Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014. Int. J. Environ. Res. Public Health 2019, 16, 605. https://doi.org/10.3390/ijerph16040605
Bissell K, Ellwood P, Ellwood E, Chiang C-Y, Marks GB, El Sony A, Asher I, Billo N, Perrin C, the Global Asthma Network Study Group. Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014. International Journal of Environmental Research and Public Health. 2019; 16(4):605. https://doi.org/10.3390/ijerph16040605
Chicago/Turabian StyleBissell, Karen, Philippa Ellwood, Eamon Ellwood, Chen-Yuan Chiang, Guy B. Marks, Asma El Sony, Innes Asher, Nils Billo, Christophe Perrin, and the Global Asthma Network Study Group. 2019. "Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014" International Journal of Environmental Research and Public Health 16, no. 4: 605. https://doi.org/10.3390/ijerph16040605
APA StyleBissell, K., Ellwood, P., Ellwood, E., Chiang, C.-Y., Marks, G. B., El Sony, A., Asher, I., Billo, N., Perrin, C., & the Global Asthma Network Study Group. (2019). Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014. International Journal of Environmental Research and Public Health, 16(4), 605. https://doi.org/10.3390/ijerph16040605