Abstract
The out-of-pocket payments for prescription medications can impose a financial burden on patients from low- and middle- incomes and who suffer from chronic diseases. The present study aims at evaluating the affordability of cardiovascular disease (CVD) medication in Iran. This includes measuring affordability through World Health Organization/Health Action International (WHO/HAI) methodology. In this method, affordability is characterized as the number of days’ wages of the lowest-paid unskilled government worker. The different medication therapy scenarios are defined in mono-and combination therapy approaches. This method adds on to WHO/HAI methodology to discover new approaches to affordability assessments. The results show the differences in the medicines affordability when different approaches are used in mono-and combination therapy between 6 main sub-therapeutic groups of CVD. It indicates the medicine affordability is not a static concept and it changes dynamically between CVD therapeutic subgroups when it used alone or in combination with other medicines regarding patients’ characteristics and medical conditions. Hypertension and anti-arrhythmia therapeutic groups had the most non-affordability and hyperlipidemia had the most affordable medicines. Therefore, affordability can be considered as a dynamic concept, which not only affected by the medicine price but significantly affected by a patient’s characteristics, the number of medical conditions, and insurance coverage.
Highlights
Cardiovascular disease (CVD) is responsible for more than 12% of the global disease burden and this burden continues to rise [1,2]
When medicine affordability at the patient level is important, the defined daily dose (DDD) may not be appropriate. To overcome this limitation alongside to standard approach, the dose/schedule adjusted medication therapy scenarios regarding individuals’ medical conditions and characteristics and clinical response to the treatment was introduced in mono-and combination therapy as an appropriate and logical option to have a rational picture of affordability of cardiovascular disease (CVD) medication therapy in the country
To the best of our knowledge, this is a first attempt to investigate the affordability of medication therapy in a specific disease in different treatment scenarios in Iran
Summary
Cardiovascular disease (CVD) is responsible for more than 12% of the global disease burden and this burden continues to rise [1,2]. Note that mortality from CVD has increased since 2007 worldwide [3], and approximately 25 million people in the world, who suffer from CVDs, will die. Res. Public Health 2020, 17, 1710; doi:10.3390/ijerph17051710 www.mdpi.com/journal/ijerph
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