Author:
Fathi Mahdieh,Moradi Najmeh,Yousefi Nazila,Peiravian Farzad,Shobeiri Nikta
Abstract
Abstract
Background
A heavy financial burden is imposed on patients suffering from chronic diseases due to medicine out-of-pocket payments.
Objectives
This study focuses on assessing the affordability of medications used for chronic respiratory diseases (CRDs) such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) in Iran, specifically on the category R medicines listed in the 2017 Iran drug list (IDL) that are used for the treatment of these diseases, based on the anatomical therapeutic chemical (ATC) drug code.
Methods
The affordability of medicines in mono and combination therapy approaches was assessed in CRDs using the World Health Organization/Health Action International (WHO/HAI) methodology. Accordingly, if out-of-pocket payment for 30-days of pharmacotherapy exceeds one day for the lowest-paid unskilled government worker (LPGW), it’s considered non-affordable.
Results
Based on the monotherapy approach, our finding demonstrates that all generic medicines of category R were affordable. However, branded drugs such as Symbicort®, Pulmicort Respules®, Flusalmex®, Seretide®, Fluticort Plus®, Seroflo®, and Salmeflo® cost between 1.2 and 2.5 days’ wage of LPGW and considered unaffordable despite 70% insurance coverage. Moreover, based on the affordability ratio in the combination therapy approach, all medicines used in asthma, COPD, and CF patients with mild respiratory problems are affordable except omalizumab (inj), which is non-affordable due to its high price and no insurance coverage.
Conclusion
Results showed that the existing insurance coverage does not protect households from hardship, so more considerations are needed such as different insurance schedules and patient support programs.
Publisher
Springer Science and Business Media LLC
Subject
Pulmonary and Respiratory Medicine
Reference41 articles.
1. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 Diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of Disease Study 2010. Lancet. 2012;380(9859):2197–223.
2. Li X, Cao X, Guo M, Xie M, Liu X. Trends and risk factors of mortality and disability adjusted life years for chronic Respiratory Diseases from 1990 to 2017: systematic analysis for the global burden of Disease Study 2017. BMJ. 2020;368:m234.
3. Naghavi M, Abolhassani F, Pourmalek F, Lakeh MM, Jafari N, Vaseghi S, et al. The burden of Disease and injury in Iran 2003. Popul Health Metr. 2009;7(1):9.
4. Asthma (Internet]. (cited 2022 Sep 7]. Available from: https://www.who.int/news-room/fact-sheets/detail/asthma.
5. Asthma. — Level 3 cause | Institute for Health Metrics and Evaluation (Internet]. (cited 2021 Aug 23]. Available from: http://www.healthdata.org/results/gbd_summaries/2019/asthma-level-3-cause.