Abstract
BackgroundDespite the burgeoning burden of diabetes mellitus (DM) and cardiovascular diseases (CVD) in low and middle income countries (LMIC), access to affordable essential medicines and diagnostic tests for DM and CVD still remain a challenge in clinical practice. The Access to Cardiovascular diseases, Chronic Obstructive pulmonary disease, Diabetes mellitus and Asthma Drugs and diagnostics (ACCODAD) study aimed at providing contemporary information about the availability, cost and affordability of medicines and diagnostic tests integral in the management of DM and CVD in Uganda.MethodsThe study assessed the availability, cost and affordability of 37 medicines and 19 diagnostic tests in 22 public hospitals, 23 private hospitals and 100 private pharmacies in Uganda. Availability expressed as a percentage, median cost of the available lowest priced generic medicine and the diagnostic tests and affordability in terms of the number of days’ wages it would cost the least paid public servant to pay for one month of treatment and the diagnostic tests were calculated.ResultsThe availability of the medicines and diagnostic tests in all the study sites ranged from 20.1% for unfractionated heparin (UFH) to 100% for oral hypoglycaemic agents (OHA) and from 6.8% for microalbuminuria to 100% for urinalysis respectively. The only affordable tests were blood glucose, urinalysis and serum ketone, urea, creatinine and uric acid. Parenteral benzathine penicillin, oral furosemide, glibenclamide, bendrofluazide, atenolol, cardiac aspirin, digoxin, metformin, captopril and nifedipine were the only affordable drugs.ConclusionThis study demonstrates that the majority of medicines and diagnostic tests essential in the management of DM and CVD are generally unavailable and unaffordable in Uganda. National strategies promoting improved access to affordable medicines and diagnostic tests and primary prevention measures of DM and CVD should be prioritised in Uganda.
Highlights
Despite the burgeoning burden of diabetes mellitus (DM) and cardiovascular diseases (CVD) in low and middle income countries (LMIC), access to affordable essential medicines and diagnostic tests for DM and CVD still remain a challenge in clinical practice
To the best of our knowledge, this is the largest study in Uganda to comprehensively investigate the availability, cost and affordability of a substantial number of medicines and diagnostic tests that play a fundamental role in optimal DM and CVD management in clinical practice
In the study reported from Western Cameroon, high availability defined as availability ≥80% was only noted with 6 (27%) of the surveyed medicines
Summary
Despite the burgeoning burden of diabetes mellitus (DM) and cardiovascular diseases (CVD) in low and middle income countries (LMIC), access to affordable essential medicines and diagnostic tests for DM and CVD still remain a challenge in clinical practice. The prevalence of diabetes mellitus (DM) and cardiovascular diseases (CVD) has significantly reached epidemic levels especially in the low and middle income countries (LMIC) [1, 2]. This poses a colossal public health threat. Improved access to affordable essential medicines and diagnostic tests is an integral component of optimal management of DM and CVD [12] This directly reduces morbidity and mortality due to DM and CVD
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