Journal of Pharmacoeconomics and Pharmaceutical Management 2016. 2(1/2):25-29.

Evaluation of equity in access to pharmaceutical services in selected cites of Isfahan Province, Iran
Majid Davari, Mohammad Reza Maracy, Abolfazl Aslani, Zahra Bakhshizadeh, Elahe Khorasani

Abstract


Background: Equity is one of the pivotal aims and priorities of the pharmaceutical system. The World Health Organization report in 2000 clarifies the important role of equity in health-care systems. Equity and efficiency are prominent features of health-care system operation. Pharmaceuticals play an important role in the cycle of health services. The aim of this study was to evaluate the equity in access to pharmaceutical services in selected cities of Isfahan Province, Iran.
Methods: This research is a cross-sectional analytical study. A valid, reliable questionnaire including 25 questions was prepared to measure patients’ access to their prescribed medicines and also to determine their socioeconomic status (SES). Totally 800 questionnaires were completed by patients who attended pharmacies in selected cities of Isfahan Province. Equity in access was evaluated using concentration and Lorenz curves.
Results: Nearly 66% of the samples were categorized in moderate-to-extremely poor SES. The highest rate of access to pharmaceutical services was found in Borkhar and Meymeh (98.9%) and the least was in Natanz (90.5%). The concentration index (CI) for access to pharmaceutical services was 0.029 in Isfahan Province, and thus equitable access to pharmaceutical services was estimated to be about 97% in this province.
Conclusion: The CI for access to pharmaceutical services was 0.029 in Isfahan Province. The findings show that the pattern of accessibility is not significantly different between the cities with various development indicators and is not related with various SES. This could be considered as one of the positive features of pharmaceutical policy in Iran.


Keywords


Equity; Pharmaceutical services; Concentration curve; Isfahan; Iran

Full Text:

PDF

References


(1) Bennett S, Creese A, Monasch R. Health insurance schemes for people outside formal sector employment. Geneva, Switzerland: World Health Organization; 1998.

(2) Nolan B, Turbat V. Cost Recovery in Public Health Services in Sub-Saharan Africa. Washington DC: World Bank Publications; 1995.

(3) Ward PR, Noyce PR, Leger AS. Exploring the equity of GP practice prescribing rates for selected coronary heart disease drugs: a multiple regression analysis with proxies of healthcare need. Int J Equity Health 2005; 4(1): 3.

(4) Layte R, Nolan B. Equity in the Utilisation of Health Care in Ireland. Econ Soc Rev 2004; 35(2): 111-34.

(5) McIntyre D, Mooney G. The economics of health equity. Cambridge, UK: Cambridge University Press; 2007.

(6) Roy K, Howard DH. Equity in out-of-pocket payments for hospital care: evidence from India. Health Policy 2007; 80(2): 297-307.

(7) Williams JA, Byles JE, Inder KJ. Equity of access to cardiac rehabilitation: the role of system factors. Int J Equity Health 2010; 9: 2.

(8) Davari M, Khorasani E, Bakhshizade Z, Jafarian Jazi M, Ghaffari DarabM, Maracy MR. A single model for determining socioeconomic status in health studies; a crucial step to make the results more comparable. Value Health 2014; 17(7): A730.

(9) Khorasani E, Keyvanara M, Karimi S, Jazi MJ. Views of health system experts on macro factors of induced demand. Int J Prev Med 2014; 5(10): 1286-98.

(10) Karimi S, Khorasani E, Keyvanara M, Afshari S. Factors affecting physicians' behaviors in induced demand for health services. Int J Educ Psychol Res 2015; 1(1): 43-51.

(11) World Health Organization. The World Health Report 2000: Health systems: Improving performance. Geneva, Switzerland: World Health Organization; 2000.

(12) Waning B, Maddix J, Tripodis Y, Laing R, Leufkens HG, Gokhale M. Towards equitable access to medicines for the rural poor: analyses of insurance claims reveal rural pharmacy initiative triggers price competition in Kyrgyzstan. Int J Equity Health 2009; 8: 43.

(13) Quick JD. Ensuring access to essential medicines in the developing countries: a framework for action. Clin Pharmacol Ther 2003; 73(4): 279-83.

(14) Quick JD. Essential medicines twenty-five years on: closing the access gap. Health Policy Plan 2003; 18(1): 1-3.

(15) Davari M. Pharmacoeconomics; an appropriate tool for policy makers or just a new field of research in Iran? Iran J Pharm Res 2012; 11(1): 1-2.

(16) Davari M, Walley T, Haycox A. Pharmaceutical policy and market in Iran: past experiences and future challenges. J Pharm Health Serv Res 2011; 2(1): 47-51.

(17) van Doorslaer E, Wagstaff A, Rutten F. Equity in the finance and delivery of health care: an international perspective. Oxford, UK: Oxford University Press; 1993.

(18) Cameron A, Ewen M, Ross-Degnan D, Ball D, Laing R. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. The lancet 2009; 373(9659): 240-9.

(19) Ghasemi M, Moayadfar R, Mirzayi M. Identification of the country's less developed regions (Isfahan). Isfahan, Iran: Isfahan Governor; 2008.

(20) Kakwani NC. Applications of lorenz curves in economic analysis. Econometrica 1977; 45(3): 719-28.

(21) Konings P, Harper S, Lynch J, Hosseinpoor AR, Berkvens D, Lorant V, et al. Analysis of socioeconomic health inequalities using the concentration index. Int J Public Health 2010; 55(1): 71-4.

(22) Davari M, Khorasani E, Bakhshizade Z, Jafarian JM, Ghaffari DM, Maracy MR. Measuring equity in access to pharmaceutical services using concentration curve; model development. Iran J Pharm Res 2015; 14(4): 1317-26.


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.