Availability, prices and affordability of the World Health Organization’s essential medicines for children in Guatemala
Several World Health Organization (WHO) initiatives aim to improve the accessibility of safe and effective medicines for children. A first step in achieving this goal is to obtain a baseline measure of access to essential medicines. The objective of this project was to measure the availability, prices, and affordability of children’s medicines in Guatemala.
An adaption of the standardized methodology developed by the World Health Organization and Health Action International (HAI) was used to conduct a cross sectional survey to collect data on availability and final patient prices of medicines in public and private sector medicine outlets during April and May of 2010.
A subset of the public sector, Programa de Accesibilidad a los Medicamentos (PROAM), had the lowest average availability (25%) compared to the private sector (35%). In the private sector, highest and lowest priced medicines were 22.7 and 10.7 times more expensive than their international reference price comparison. Treatments were generally unaffordable, costing as much as 15 days wages for a course of ceftriaxone.
Analysis of the procurement, supply and distribution of specific medicines is needed to determine reasons for lack of availability. Improvements to accessibility could be made by developing an essential medicines list for children and including these medicines in national purchasing lists.
- World Health Organization: Communicable Disease Cluster: Removing obstacles to healthy development: report on infectious diseases. http://www.who.int/infectious-disease-report/pages/textonly.html
- The state of the world's children 2008. UNICEF, New York
- The millenium development goals report 2010. United Nations, New York
- Rajaratnam, JK, Marcus, JR, Flaxman, AD, Wang, H, Levin-Rector, A, Dwyer, L, Costa, M, Lopez, AD, Murray, CJ (2010) Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970–2010: a systematic analysis of progress towards Millennium Development Goal 4. Lancet 375: pp. 1988-2008 CrossRef
- Robertson, J, Forte, G, Trapsida, JM, Hill, S (2009) What essential medicines for children are on the shelf?. Bull World Health Organ 87: pp. 231-237 CrossRef
- Overview of methods for medicines availability and pricing surveys: Better Medicines for Children Project. http://www.who.int/childmedicines/progress/ChildMeds_pricing_surveys.pdf
- Health Action International; World Health Organization: Meassuring medicine prices, availability, affordability and price components. http://www.haiweb.org/medicineprices/manual/documents.html
- Pan American Health Organization: Health in the Americas: Guatemala. http://www.paho.org/hia/archivosvol2/paisesing/Guatemala%20English.pdf
- Ley de accesibilidad a los medicamentos.
- Ley de contrataciones del estado.
- Shaffer, ER, Brenner, JE (2009) A trade agreement's impact on access to generic drugs. Health Aff (Millwood) 28: pp. w957-w968 CrossRef
- Ventas sociales y farmacias privadas: Ministerio de Salud. http://www.mspas.gob.gt/
- Jefatura del departamento de regulación y control de productos farmacéuticos y afines. 2001. http://www.medicamentos.com.gt/index.php/legislacion-vigente/normas-tecnicas?start=40
- Jefatura del departamento de regulación y control de productos farmacéuticos y afines. 2002. http://www.medicamentos.com.gt/index.php/legislacion-vigente/normas-tecnicas?start=40
- Jefatura del departamento de regulación y control de productos farmacéuticos y afines. 2003. http://www.medicamentos.com.gt/index.php/legislacion-vigente/normas-tecnicas?start=40
- Madden, JM, Meza, E, Ewen, M, Laing, RO, Stephens, P, Ross-Degnan, D (2010) Measuring medicine prices in Peru: validation of key aspects of WHO/HAI survey methodology. Rev Panam Salud Publica 27: pp. 291-299 CrossRef
- WHO model list of essential medicines for children: 2nd ed. WHO, Geneva, Switzerland
- OANDA: http://www.oanda.com/currency/converter/
- Management Sciences for Health: International drug price indicator guide. http://erc.msh.org/mainpage.cfm?file=1.0.htm&&module=DMP&language=English
- Ridge, AL, Bero, LA, Hill, SR (2010) Identifying barriers to the availability and use of Magnesium Sulphate Injection in resource poor countries: a case study in Zambia. BMC Health Serv Res 10: pp. 340 CrossRef
- Priority Medicines for Maternal and Child Health: A Global Survey of National Essential Medicines Lists. [http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0038055]
- Mendis, S, Fukino, K, Cameron, A, Laing, R, Filipe, A, Khatib, O, Leowski, J, Ewen, M (2007) The availability and affordability of selected essential medicines for chronic diseases in six low- and middle-income countries. Bull World Health Organ 85: pp. 279-288 CrossRef
- van Mourik, MS, Cameron, A, Ewen, M, Laing, RO (2010) Availability, price and affordability of cardiovascular medicines: a comparison across 36 countries using WHO/HAI data. BMC Cardiovasc Disord 10: pp. 25 CrossRef
- Cameron, A, Roubos, I, Ewen, M, Mantel-Teeuwisse, AK, Leufkens, HG, Laing, RO (2011) Differences in the availability of medicines for chronic and acute conditions in the public and private sectors of developing countries. Bull World Health Organ 89: pp. 412-421 CrossRef
- Cameron, A, Ewen, M, Ross-Degnan, D, Ball, D, Laing, R (2009) Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet 373: pp. 240-249 CrossRef
- Gwatkin, DR, Rutstein, S, Johnson, K, Suliman, E, Wagstaff, A, Amouzou, A (2007) Socio-economic differences in health, nutrition, and population within developing countries: an overview. Niger J Clin Pract 10: pp. 272-282
- Strand, TA, Chandyo, RK, Bahl, R, Sharma, PR, Adhikari, RK, Bhandari, N, Ulvik, RJ, Molbak, K, Bhan, MK, Sommerfelt, H (2002) Effectiveness and efficacy of zinc for the treatment of acute diarrhea in young children. Pediatrics 109: pp. 898-903 CrossRef
- Goel, P, Ross-Degnan, D, Berman, P, Soumerai, S (1996) Retail pharmacies in developing countries: a behavior and intervention framework. Soc Sci Med 42: pp. 1155-1161 CrossRef
- Worldbank: Data by country. http://data.worldbank.org/country/guatemala
- Niens, LM, Cameron, A, Van de Poel, E, Ewen, M, Brouwer, WB, Laing, R (2010) Quantifying the impoverishing effects of purchasing medicines: a cross-country comparison of the affordability of medicines in the developing world. PLoS Med 7: pp. e1000333 CrossRef
- WHO model formulary for children. World Health Organization, Geneva, Switzerland
- Child growth standards.
- Availability, prices and affordability of the World Health Organization’s essential medicines for children in Guatemala
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Globalization and Health
- Online Date
- July 2012
- Online ISSN
- BioMed Central
- Additional Links
- Essential medicines for children
- National formulary
- World Health Organization
- Author Affiliations
- 1. Department of Clinical Pharmacy, University of California, San Francisco, CA, 94143-0622, USA
- 2. La Universidad del Valle de Guatemala, Vista Hermosa III, Guatemala City, Guatemala, 01015
- 3. Cedar Associates, Menlo Park, CA, 94025, USA
- 4. Department of Clinical Pharmacy, Institute for Health Policy Studies, University of California, San Francisco, CA, 94118, USA