Abstract

In the previous commentary paper, we discussed the growing expenditure on medicines due to the continued launch of new premium priced medicines, especially for oncology and orphan diseases, growth in non-communicable diseases (NCDs) assisted by aging populations with associated increased use of medicines as well as changing clinical guidelines.[1-5] As a result, global sales of medicines are likely to exceed $1.5 trillion by 2023, with compounded annual growth rates estimated at 3 to 6% per annum.[6] This is a concern not only for high income countries struggling to fund new premium priced medicines for cancer and orphan diseases but also for lower- and middle-income countries (LMICs) where expenditure on medicines can account for over 60% of total healthcare expenditure affecting key issues such as access and affordability.[7-9] There are also concerns how governments can attain or retain universal healthcare given ongoing pressures on available resources, enhanced by the COVID-19 pandemic and its unintended consequences, and concomitantly strive to reduce morbidity and mortality of NCDs as part of agreed Sustainable Development Goals (SDGs).[10-13] In addition, address concerns with rising rates of antimicrobial resistance (AMR) increasing morbidity, mortality, and costs, as a result of inappropriate prescribing and dispensing of antibiotics especially in ambulatory care

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