Impact of national drug pricing policy 2018 on access to medicines in Lahore Division, Pakistan: A pre-post survey study using WHO/HAI methodology

Objective: To evaluate the impact of new national drug pricing policy (NDPP) 2018 on the access to medicines in terms of prices, availability, and affordability. Design: Two cross-sectional surveys were undertaken before and after the launch of NDPP 2018, using a modified WHO/HAI methodology. Setting: Four districts of Lahore division, Pakistan. Participants: 16 public sector hospitals and 16 private sector retail pharmacies. Measures: The pre- and post-survey data on prices and availability of Lowest Price Generics (LPGs) and Originator Brands (OBs) of 50 medicines were obtained by visiting the same public and private sector health facilities (n=32). Out of 50, 46 surveyed medicines were from National Essential Medicines List (NEML). Inflation-adjusted median unit prices (MUPs) and median price ratios (MPRs) from 2019 were used for price comparison. Affordability was calculated in terms of number of days’ wages required to get a standard treatment by the lowest paid uns...研究目标：评估2018年国家药品定价新政策（National Drug Pricing Policy, NDPP）在价格、可获得性与可负担性维度对药品可及性的影响。 研究设计：采用改良版世界卫生组织/健康行动国际（World Health Organization/Health Action International, WHO/HAI）调研方法，在2018年国家药品定价新政策实施前后各开展一次横断面调查。 研究场景：巴基斯坦拉合尔分区下辖的四个行政区。 研究对象：16家公立医疗机构与16家私营零售药房，共计32家卫生服务机构。 研究指标：通过回访同一批公立及私营卫生机构（n=32），收集50种药品的最低价格仿制药（Lowest Price Generics, LPGs）与原研品牌药（Originator Brands, OBs）在政策实施前后的价格与可获得性调研数据。50种调研药品中有46种收录于国家基本药物目录（National Essential Medicines List, NEML）。以2019年经通胀调整的中位数单位价格（median unit prices, MUPs）及中位数价格比（median price ratios, MPRs）开展价格对比分析。可负担性则以最低收入工薪阶层完成标准治疗所需的工作日数进行计算……