Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014

Karen Bissell, 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
Additional contact information
Karen Bissell: School of Population Health, University of Auckland, Auckland 1023, New Zealand
Philippa Ellwood: Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland 1023, New Zealand
Eamon Ellwood: Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland 1023, New Zealand
Chen-Yuan Chiang: Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
Guy B. Marks: South Western Sydney Clinical School, University of New South Wales, Sydney 2085, Australia
Asma El Sony: The Epidemiological Laboratory (Epi-Lab), for Public Health and Research, Khartoum, Sudan
Innes Asher: Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland 1023, New Zealand
Nils Billo: Independent Consultant, 80220 Joensuu, Finland
Christophe Perrin: Farmalex, 75008 Paris, France
the Global Asthma Network Study Group: Membership of the Global Asthma Network Study Group is provided in the Acknowledgements.

IJERPH, 2019, vol. 16, issue 4, 1-15

Abstract: Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013–2020 sets an 80% target for essential NCD medicines’ availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013–2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses—41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system’s capacity to address NCDs.

Keywords: essential medicines; access; noncommunicable diseases; asthma; inhaled corticosteroids; bronchodilators; national reimbursement list (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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