Access to medicines

Three submarkets of the pharmaceutical market can be distinguished innovative patented products sold by prescription, products whose patent has expired and are sold by prescription, and products sold without a prescription. The public regulation of prices in the first of these submarkets, and often also in the second, is a fact that can be observed in most Western countries, with certain notable exceptions such as the USA. Concern about the particular characteristics of the pharmaceutical market (for example, the existence of patents and the pharmaceutical industry s rate of return), together with the desire to provide the majority of the population with access to medicines, regardless of their ability to pay (in many countries the public sector is the main buyer in this market), has led to the fairly widespread adoption of more or less strict price intervention and control policies for pharmaceuticals. 

The scheduling of drugs is performed under State and Territory (henceforth referred to as State) legislation controlling access to medicines, but is coordinated at a national level to ensure uniformity except in exceptional circumstances. 

Guidehnes detailing the four avenues available for access to medicines not registered or listed on the ARTG are available through the following URLs ... 

Table 1. Key points for policy makers Access to medicines snpported by tbe principles of the essential medicines...

Lack of access to medicines and inappropriate doses result in serious morbidity and mortality, particularly for childhood infections and chronic diseases, such as hypertension, diabetes, epilepsy and mental disorders. Inappropriate use and over-use of medicines waste resources - often out-of-pocket payments by patients - and result in significant patient harm in terms of poor patient outcomes and adverse drug reactions. Furthermore, over-use of antimicrobials is leading to increased antimicrobial resistance and non-sterile injections to the transmission of hepatitis, HIV/AIDS and other blood-borne diseases. Finally, irrational over-use of medicines can stimulate inappropriate patient demand, and lead to reduced access and attendance rates due to medicine stock-outs and loss of patient confidence in the health system. 

Reinhardt, Erika. Access to Medicines. UN Chronicle 43, no. 3 (Septem-ber/November 2006) 56-57. The UN offers a way to increase access to desperately needed medications among poor people throughout the world. Countries can take advantage of flexibility built into international patent and trade agreements to buy high-priority medicines for HIV/ AIDS. However, the article criticizes national trademark laws than hinder these types of public health efforts in developing nations. 

What are dietary supplements How might they get in the way of pharmaceutical industry creations Where is the line to be drawn between nature and big business What plants are there that might serve as health adjuncts I truly think that we are being had by the powers that be, who are authorized to control our access to medicines. Today we cannot eat ABC because it contains an outlawed drug. Tomorrow we cannot eat DEF because it is suspected of containing an outlawed drug. The day after tomorrow, we cannot eat GHI because it has not... 

As the chapter summaries demonstrate, this volume may help us to foster conditions in which our biomedical R D capacities are truly serving the majority of people living on this planet. More R D development must be undertaken to achieve this. Strong political will - in other words, resolute commitment by governments - is required. Lastly, we hope this volume inspires you to think differently about some of these topics if you are already familiar with them. If you are not, we hope it helps you to better understand them. For that, no matter how trivial, is a vital first step in helping to improve access to medicines globally. 

The pharmaceutical industry produces social goods characterized by high fixed costs, high information and regulatory costs, and relatively low marginal costs of production. While the existing patent system provides for limited monopoly power to reward innovation, it concurrently restricts access to medicines. The industry must balance their... 

Through Ramsey pricing the industry endeavors to recover the high costs of R D, while adjusting prices across national markets to maximize consumer welfare. Although this helps to enhance access to medicines, it does not help to bring drugs to market... 

However, product development PPPs, as currently constituted, actually have a limited capacity to ensure access by individuals in poor populations to any products that may emerge from their efforts. Most product development PPPs attempt to assure future access through interactions with various partners "downstream" to product development itself (Widdus 2004). Access to anticipated products of such PPPs in developing countries may not be timely if there is no way to deliver the product via the health system (e.g., for vaccines to adolescents, or microbicides to the poorest women). Certain product development PPPs have created advocacy and "access to medicines" activities as parts of their missions (Widdus 2004 Ziemba 2004). 

Grace, C. 2004. The Effect of Changing Intellectual Property on Pharmaceutical Industry Prospects in India and China Considerations for Access to Medicines. Issues Paper Access to Medicines. London DFID Health Systems Resource Centre. Available at http //www.dfid.gov.uk/pubs/ files/indiachinadomproduce.pdf [Accessed May 10, 2005]... 

Moran, M. and N. Ford. 2003. The G8 and Access to Medicines No More Broken Promises. Lancet 361 9369. 

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