Introduction: Glaucoma is a group of chronically progressive disorders of the optic nerve and a worldwide leading cause of irreversible vision loss. Eye chronic diseases including glaucoma are major public health problems around the world, rapidly increasing with a growing and aging population. The treatment of chronic diseases lasts a lifetime. The purpose of this study is to assess the availability, prices and affordability of the medicines for glaucoma management in private pharmacies of Nampula City in Mozambique. Material and Methods: The standardized methodology designed by the World Health Organization and Health Action International was employed to conduct the study about the availability, price and affordability of glaucoma medicines in Nampula City from October to November 2021. Data were collected in 39 private pharmacies using a survey with fifteen glaucoma Medicines. Results: The Average of medicines availability was 46.6% (0.0% - 71.8%) with a mean of 8.86. The availability level demonstrated that 14 (93.3%) of all surveyed glaucoma medicines were very low and 1 (6.67%) was fairly high. Timolol was the most available medicine, found in 28 (71.8%) while apraclonidine, carteolol, levobunolol, carbachol, brinzolamide, bimatoprost, travoprost and unoprostone were not available. The medicine with the lowest price was latanoprost (2.84 USD) and the higher was acetazolamide (23.58 USD). None of the surveyed medicines were considered affordable. Conclusion: The majority of surveyed glaucoma medicines were not available and they were totally unaffordable against the defined thresholds. Policy strategy and technical options should be driven and implemented by the government to ensure the availability and affordability of glaucoma medicines at various levels of the Mozambican healthcare system.
References
[1]
Khanal, S., Veerman, L., Ewen, M., Nissen, L. and Hollingworth, S. (2019) Availability, Price, and Affordability of Essential Medicines to Manage Noncommunicable Diseases: A National Survey from Nepal. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 56, 1-8.
https://doi.org/10.1177/0046958019887572
[2]
Kang, J.M. and Tanna, A.P. (2021) Glaucoma. The Medical Clinics of North America, 105, 493-510. https://doi.org/10.1016/j.mcna.2021.01.004
[3]
Weinreb, R.N., Aung, T. and Medeiros, F.A. (2014) The Pathophysiology and Treatment of Glaucoma: A Review. JAMA, 311, 1901-1911.
https://doi.org/10.1001/jama.2014.3192
[4]
Kyari, F., Adekoya, B., Abdull, M.M., Mohammed, A.S. and Garba, F. (2018) The Current Status of Glaucoma and Glaucoma Care in Sub-Saharan Africa. Asia-Pacific Journal of Ophthalmology (Philadelphia, Pa.), 7, 375-386.
[5]
Meier-Gibbons, F. and Töteberg-Harms, M. (2020) Influence of Cost of Care and Adherence in Glaucoma Management: An Update. Journal of Ophthalmology, 2020, Article ID: 5901537. https://doi.org/10.1155/2020/5901537
[6]
He, S., Stankowska, D.L., Ellis, D.Z., Krishnamoorthy, R.R. and Yorio, T. (2018) Targets of Neuroprotection in Glaucoma. Journal of Ocular Pharmacology and Therapeutics: The Official Journal of the Association for Ocular Pharmacology and Therapeutics, 34, 85-106. https://doi.org/10.1089/jop.2017.0041
[7]
Bluwol E. (2016) Traitement des glaucomes [Glaucoma Treatment]. La Revue du praticien, 66, 508-513.
[8]
Schuster, A.K., Erb, C., Hoffmann, E.M., Dietlein, T. and Pfeiffer, N. (2020) The Diagnosis and Treatment of Glaucoma. Deutsches Arzteblatt international, 117, 225-234.
https://doi.org/10.3238/arztebl.2020.0225
[9]
Conlon, R., Saheb, H. and Ahmed, I.I. (2017) Glaucoma Treatment Trends: A Review. Canadian Journal of Ophthalmologye, 52, 114-124.
https://doi.org/10.1016/j.jcjo.2016.07.013
[10]
Xu, C., Guo, R., Huang, D., Ji, J. and Liu, W. (2020) Daily Costs and Cost Effectiveness of Glaucoma Fixed Combinations in China. Journal of Ophthalmology, 2020, Article ID: 2406783. https://doi.org/10.1155/2020/2406783
[11]
Malta, D.C., Bernal, R.T.I., Lima, M.G., Araújo, S.S.C., Silva, M.M.A., Freitas, M.I.F., et al. (2017) Doenças crônicas não transmissíveis e a utilização de serviços de saúde: Análise da Pesquisa Nacional de Saúde no Brasil. Revista de Saúde Pública, 51, 4s.
[12]
Lazcano-Gomez, G., Ramos-Cadena, M., Torres-Tamayo, M., Hernandez de Oteyza, A., Turati-Acosta, M. and Jimenez-Román, J. (2016) Cost of Glaucoma Treatment in a Developing Country over a 5-Year Period. Medicine, 95, e5341.
https://doi.org/10.1097/MD.0000000000005341
[13]
Newman-Casey, P.A., Salman, M., Lee, P.P. and Gatwood, J.D. (2020) Cost-Utility Analysis of Glaucoma Medication Adherence. Ophthalmology, 127, 589-598.
https://doi.org/10.1016/j.ophtha.2019.09.041
[14]
Babar, Z.U.D., Ibrahim, M.I.M., Singh, H., Bukahri, N.I. and Creese, A. (2007) Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia. PLOS Medicine, 4, e82.
https://doi.org/10.1371/journal.pmed.0040082
[15]
Mhlanga, B.S. and Suleman, F. (2014) Price, Availability and Affordability of Medicines. African Journal of Primary Health Care & Family Medicine, 6, a604.
https://doi.org/10.4102/phcfm.v6i1.604
[16]
World Health Organization, Health Action International (2008) Measuring Medicine Prices, Affordability, Availability and Price Components. 2nd Edition, Geneva.
http://apps.who.int/medicinedocs/documents/s14868e/s14868e.pdf
[17]
Dorj, G., Sunderland, B., Sanjjav, T., Dorj, G. and Gendenragchaa, B. (2018) Availability, Affordability and Costs of Pediatric Medicines in Mongolia. BMC Pediatrics, 18, Article No. 149. https://doi.org/10.1186/s12887-018-1123-x
[18]
Kaiser, A.H., Hehman, L., Forsberg, B.C., Simangolwa, W.M. and Sundewall, J. (2019) Availability, Prices and Affordability of Essential Medicines for Treatment of Diabetes and Hypertension in Private Pharmacies in Zambia. PLoS ONE, 14, e0226169.
https://doi.org/10.1371/journal.pone.0226169
[19]
Negri, L., Ferreras, A. and Iester, M. (2019) Timolol 0.1% in Glaucomatous Patients: Efficacy, Tolerance, and Quality of Life. Journal of Ophthalmology, 2019, Article ID: 4146124. https://doi.org/10.1155/2019/4146124
[20]
Oliveira, L.C.F., Nascimento, M.A.A. and Lima, I.M.S.O. (2019) O acesso a medicamentos em sistemas universais de saúde—perspectivas e desafios. Saúde em Debate, 43, 286-298. https://doi.org/10.1590/0103-11042019s523
[21]
Mendes, L.V., et al. (2014) Disponibilidade de medicamentos nas unidades básicas de saúde e fatores relacionados: Uma abordagem transversal. Saúde em Debate, 38, 109-123. https://doi.org/10.5935/0103-1104.2014S009
[22]
Nascimento, R.C.R.M., Álvares, J., Guerra Junior, A.A., Gomes, I.C., Costa, E.A., Leite, S.N., et al. (2017) Disponibilidade de medicamentos essenciais na atenção primária do Sistema Único de Saúde. Revista de Saúde Pública, 51, 10s.
[23]
Ewen, M., Zweekhorst, M. and Regeer, B. (2017) Baseline Assessment of WHO’s Target for Both Availability and Affordability of Essential Medicines to Treat Non-Communicable Diseases. PLoS ONE, 12, e0171284.
https://doi.org/10.1371/journal.pone.0171284
[24]
Usifoh, S.F. (2015) Availability and Affordability of Antiglaucoma Drugs in Benin City, Nigeria. Value in Health, 18, A185. https://doi.org/10.1016/j.jval.2015.03.1069
