探索影响低收入和中等收入国家获得非传染性疾病药物的因素:系统性审查
Bryan Wong1, Lisa Wight2, Cindy Gauvreau3
1University of Toronto, Toronto, Ontario, Canada.
BMJ public health
|February 2, 2026
概括
在低收入和中等收入国家 (LMICs) 获得非传染性疾病 (NCD) 药物受到诸如可用性和负担能力等因素的阻碍. 解决这些问题需要改进预测,使用仿制药,质量控制,并通过全民医疗覆盖扩大资金.
科学领域:
- 全球健康 全球健康
- 卫生系统研究 卫生系统研究
- 药品接入 药品接入 药品接入
背景情况:
- 非传染性疾病 (NCDs) 在低收入和中等收入国家 (LMICs) 中构成重大负担.
- 获得必需的NCD药物是管理这些疾病的关键组成部分.
- 了解NCD药物获取的多方面的障碍对于改善健康结果至关重要.
研究的目的:
- 系统地审查影响LMICs获得非传染性疾病 (NCD) 药物的因素.
- 确定有关NCD药物获取的研究现有的差距.
- 综合有关获取维度的证据:可访问性,可接受性,可用性,价格,可负担性和质量.
主要方法:
- 按照PRISMA指南进行系统审查.
- 搜索了MEDLINE,EMBASE和Cochrane控制试验中央注册表,截至2024年6月.
- 包括定性,定量和混合方法研究,报告LMIC中NCD药物获取情况,通过叙事合成分析数据.
主要成果:
- 包括涵盖118个国家的157篇文章,重点关注心血管疾病,糖尿病和呼吸系统疾病.
- 可用性和可负担性是最经常报告的访问维度.
- 影响获取的关键决定因素包括卫生设施类型,药物类型 (仿制药与原始药物),药品质量,患者的社会经济地位和地理位置.
结论:
- 在LMICs的NCD药物获取的各个方面存在重大挑战,COVID-19大流行加剧了这一问题.
- 建议包括改善预测以减少缺货,增加使用质量保证的仿制药,加强监管和药物监管系统,并通过全民医疗覆盖扩大融资.
- 解决这些决定因素对于确保公平获得NCD药物至关重要.
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