Improving Access to Essential Medicines for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa Workshop Summary (2014) / Chapter Skim
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3 Challenge: Inappropriate Selection
3 Challenge: Inappropriate Selection
Pages 31-42
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From page 31... ...
• Promotion of evidence-based selection of medicines through the development of training programs. NOTE: The items in this list were addressed by individual participants and were identified and summarized for this report by the rapporteurs.
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From page 32... ...
. Hogerzeil noted the absence of evidencebased treatment guidelines and said these, too, should be considered as important as the medicines included in a country's essential medicines list.
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From page 33... ...
• Percentage of population covered by national health service or health insurance. Reliable systems • Average availability of 30 selected essential medicines in pub lic and private health facilities.
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From page 34... ...
Lastly, Hogerzeil stated that MNS disorders often require chronic treatment that may lead to catastrophic health expenditures, defined as more than 20 percent of income, and poverty due to unaffordable health care costs. 1 The United Nations Millennium Development Goals are eight goals that all 191 UN Member States have agreed to try to achieve by the year 2015.
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From page 35... ...
Availability of generic supply in the public sector can be the most cost-effective way of supplying essential medicines, Hogerzeil said. However, low and/or variable availability of generic products in the public sector can drive patients to purchase products from the private sector, with a tendency toward branded products or branded generics that are three to six times the price.
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From page 36... ...
In summary, Hogerzeil said that universal access to essential care for MNS disorders might be: • Based on the expansion of outpatient care; • Performed by trained paramedical personnel; • Supported by evidence-based treatment guidelines and a national list of essential medicines; • Supplied as generic medicines; and • Reimbursed within social health insurance schemes. 5 See http://apps.who.int/iris/bitstream/10665/93143/1/EMLc_4_eng.pdf?
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From page 37... ...
BOX 3-2 Highlights of Lessons Learned from Example Programs: Inappropriate Selection Country Programs National Health Insurance Scheme (NHIS) , Ghana • Creation of an essential medicines list and national treatment guidelines for mental, neurological, and substance use (MNS)
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From page 38... ...
Likewise, deficiencies in training and supervision allow inappropriate selection to persist Pande noted. The principles of chronic disease management apply equally to MNS disorders as they do to conditions such as diabetes and hypertension.
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From page 39... ...
Several participants also discussed the value of the WHO essential medicines list and mhGAP treatment guidelines as starting points for developing country-specific lists and guidelines. Pande noted that adoption of the WHO list and mhGAP guidelines might result in greater use of evidence-based approaches to treating MNS disorders.
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From page 40... ...
. resources might Availability of require a more adequate resources limited focus on to promote a fewer MNS national strategy, disorders.a,b,c,d,f including specific budget allocations to implement the national strategy.c,f 1 This table presents challenges and opportunities discussed by one or more workshop participants.
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From page 41... ...
Lack of evidence- Use the WHO Development of Uninterrupted Health care Inclusion of costbased approaches list of essential national medicines access to essential providers; funders; effective for developing medicines and lists and treatment medicines and Ministry of medicines due to essential medicine mhGAP guidelines for each treatments. Health; Ministry a lack of lists and treatment treatment level of provider Availability of of finance; resources.
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From page 42... ...
Increase are selected and and continued Development of medications for in percentage of why. Desirability awareness of training to provide MNS disorders.e providers having of a Webevidence to update an evidence base to received continuing based/mobile individual country support selection education each e-learning lists.c of medicines year.c resource.
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