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Access to affordable medicines and diagnostic tests for asthma and COPD in sub Saharan Africa : the Ugandan perspective

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Date
08/12/2017
Author
Kibirige, Davis
Kampiire, Leaticia
Atuhe, David
Mwebaze, Raymond
Katagira, Winceslaus
Muttamba, Winters
Nantanda, Rebecca
Worodria, William
Kirenga, Bruce
Keywords
Administration, inhalation
Adrenal cortex hormones/economics
Adrenergic beta-agonists/economics
Albuterol/economics
Anti-asthmatic agents/supply & distribution
Asthma/diagnosis
Budesonide, Formoterol Fumarate drug combination/economics
Diagnostic techniques, respiratory system/statistics & numerical data
Drug combinations
Drug costs
Fluticasone-Salmeterol drug combination/economics
Health services accessibility
Humans
Leukotriene antagonists/economics
Muscarinic antagonists/economics
Pulmonary disease, chronic obstructive/diagnosis
Respiratory function tests
Spirometry
Uganda
RA0421 Public health. Hygiene. Preventive Medicine
RM Therapeutics. Pharmacology
3rd-DAS
Metadata
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Abstract
Background: Equitable access to affordable medicines and diagnostic tests is an integral component of optimal clinical care of patients with asthma and chronic obstructive pulmonary disease (COPD). In Uganda, we lack contemporary data about the availability, cost and affordability of medicines and diagnostic tests essential in asthma and COPD management. Methods: Data on the availability, cost and affordability of 17 medicines and 2 diagnostic tests essential in asthma and COPD management were collected from 22 public hospitals, 23 private and 85 private pharmacies. The percentage of the available medicines and diagnostic tests, the median retail price of the lowest priced generic brand and affordability in terms of the number of days' wages it would cost the least paid public servant were analysed. Results: The availability of inhaled short acting beta agonists (SABA), oral leukotriene receptor antagonists (LTRA), inhaled LABA-ICS combinations and inhaled corticosteroids (ICS) in all the study sites was 75%, 60.8%, 46.9% and 45.4% respectively. None of the study sites had inhaled long acting anti muscarinic agents (LAMA) and inhaled long acting beta agonist (LABA)-LAMA combinations. Spirometry and peak flow-metry as diagnostic tests were available in 24.4% and 6.7% of the study sites respectively. Affordability ranged from 2.2 days' wages for inhaled salbutamol to 17.1 days' wages for formoterol/budesonide inhalers and 27.8 days' wages for spirometry. Conclusion: Medicines and diagnostic tests essential in asthma and COPD care are not widely available in Uganda and remain largely unaffordable. Strategies to improve access to affordable asthma and COPD medicines and diagnostic tests should be implemented in Uganda.
Citation
Kibirige , D , Kampiire , L , Atuhe , D , Mwebaze , R , Katagira , W , Muttamba , W , Nantanda , R , Worodria , W & Kirenga , B 2017 , ' Access to affordable medicines and diagnostic tests for asthma and COPD in sub Saharan Africa : the Ugandan perspective ' , BMC Pulmonary Medicine , vol. 17 , 179 . https://doi.org/10.1186/s12890-017-0527-y
Publication
BMC Pulmonary Medicine
Status
Peer reviewed
DOI
https://doi.org/10.1186/s12890-017-0527-y
ISSN
1471-2466
Type
Journal article
Rights
Copyright © The Author(s). 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Description
Funding: This study was supported by a small grant from Uganda Diabetes Association, a diabetes professional association for diabetic patients and healthcare practitioners.
Collections
  • University of St Andrews Research
URI
http://hdl.handle.net/10023/21704

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