Affordability assessment from a static to dynamic concept: A scenario�based assessment of cardiovascular medicines

Zarei, L. and Karimzadeh, I. and Moradi, N. and Peymani, P. and Asadi, S. and Babar, Z.-U.-D. (2020) Affordability assessment from a static to dynamic concept: A scenario�based assessment of cardiovascular medicines. International Journal of Environmental Research and Public Health, 17 (5).


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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 daysʹ 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. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: amiodarone; bisoprolol; bosentan; captopril; cardiovascular agent; digoxin; diltiazem; eplerenone; esmolol; flecainide; furosemide; glyceryl trinitrate; hydralazine; indapamide; isosorbide; labetalol; lidocaine; metoprolol; mexiletine; minoxidil; nicorandil; nicotinic acid; nifedipine; procainamide; propafenone; quinidine; rosuvastatin; unindexed drug; valsartan; verapamil, cardiovascular disease; cost analysis; health care; hypertension; medicine; wage; World Health Organization, acute coronary syndrome; angina pectoris; Article; combination drug therapy; controlled study; cross-sectional study; drug cost; government employee; health insurance; heart failure; hyperlipidemia; hypertension; Iran; monotherapy; salary, Iran
Subjects: WG Cardiovascular System
QV Pharmacology
Depositing User: eprints admin
Date Deposited: 07 Sep 2020 05:46
Last Modified: 07 Sep 2020 05:46

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