Heart drugs of­ten un­avail­able or un­af­ford­able

Kuwait Times - - HEALTH & SCIENCE -

NEW YORK: Car­dio­vas­cu­lar dis­ease drugs are of­ten un­avail­able or un­af­ford­able in many com­mu­ni­ties around the world, par­tic­u­larly in poorer coun­tries, a re­cent study sug­gests. Four types of medicines are rec­om­mended to help pre­vent deaths from car­dio­vas­cu­lar dis­ease: as­pirin, beta block­ers to con­trol heart rhythm and lower high blood pres­sure (like atenolol or meto­pro­lol, for ex­am­ple), drugs such as ACE in­hibitors to re­lax blood ves­sels and im­prove blood flow (like cap­to­pril or enalapril, for in­stance) and statins to lower choles­terol (such as sim­vas­tatin or ator­vas­tatin, or oth­ers).

To as­sess how easy it might be for peo­ple get to all four medicines, re­searchers looked at whether lo­cal phar­ma­cies stocked all of the drugs and, if so, whether the com­bined cost was less than 20 per­cent of house­hold in­come re­main­ing af­ter ba­sic sub­sis­tence needs have been met. The four medicines were avail­able and af­ford­able in most ur­ban and ru­ral com­mu­ni­ties in high­in­come coun­tries, re­searchers re­ported in The Lancet. But ex­cept for In­dia, all of four drugs were avail­able in low-in­come coun­tries in only 25 per­cent of ur­ban ar­eas and 3 per­cent of ru­ral com­mu­ni­ties.

Trans­porta­tion cost

In ad­di­tion, th­ese drugs were po­ten­tially un­af­ford­able in 60 per­cent of low-in­come coun­tries out­side of In­dia. “The real un­af­ford­abil­ity is even worse than what our pa­per sug­gests be­cause it’s not just the pills, it is the amount of time off work, the cost to see the doc­tor, and the trans­porta­tion cost,” said se­nior au­thor Salim Yusuf, ex­ec­u­tive di­rec­tor of the Pop­u­la­tion Health Re­search In­sti­tute and pro­fes­sor at McMaster Univer­sity in Hamil­ton, On­tario. An es­ti­mated 17 mil­lion peo­ple world­wide die of car­dio­vas­cu­lar dis­ease each year, Yusuf and col­leagues note. The World Health Or­ga­ni­za­tion wants medicines for pre­vent­ing car­dio­vas­cu­lar dis­ease to be avail­able in 80 per­cent of com­mu­ni­ties and used by 50 per­cent of el­i­gi­ble in­di­vid­u­als by 2025. To see how the cur­rent re­al­ity mea­sures up to this goal, the re­search team an­a­lyzed data on al­most 95,000 house­holds from nearly 600 com­mu­ni­ties in 18 coun­tries - in­clud­ing about 7,000 peo­ple with car­dio­vas­cu­lar dis­ease. In up­per mid­dle-in­come coun­tries, the four medicines were avail­able in 80 per­cent of ur­ban and 73 per­cent of ru­ral com­mu­ni­ties, the anal­y­sis found. But the drugs were un­af­ford­able in 25 per­cent of th­ese coun­tries.

For lower mid­dle-in­come na­tions, the drugs were all avail­able in 62 per­cent of ur­ban and 37 per­cent of ru­ral ar­eas but un­af­ford­able in one third of the coun­tries. Ac­cess was bet­ter in In­dia than in a typ­i­cal low-in­come coun­try, the study found. Here, the medicines were avail­able in 89 per­cent of ur­ban and 81 per­cent of ru­ral com­mu­ni­ties - and af­ford­able for 59 per­cent of house­holds. Louis Niessen and Ja­hangir Khan, health econ­o­mists at the Cen­ter for Ap­plied Health Re­search and De­liv­ery at the Liver­pool School of Trop­i­cal Medicine in the UK, write in an ed­i­to­rial that the find­ings high­light a prob­lem that goes far be­yond just the ac­ces­si­bil­ity of medicines for car­dio­vas­cu­lar dis­ease. That’s be­cause fam­i­lies may lose work due to car­dio­vas­cu­lar events, or suf­fer from ad­di­tional diseases or in­juries that are chal­leng­ing to treat due to the cost or the un­avail­abil­ity of care close to home, they wrote. “Our fail­ure to pro­vide health care for many leads to a lot of hu­man suf­fer­ing and loss of im­por­tant adults in our lives as they die pre­ma­turely, up to ten to twenty years too early or re­main with dis­abil­ity from stroke or from a more clas­si­cal trop­i­cal con­di­tion,”Niessen said by email. — Reuters

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