Affordability Assessment from a Static to Dynamic Concept: A Scenario-Based Assessment of Cardiovascular Medicines

Leila Zarei , Iman Karimzadeh, Najmeh Moradi , Payam Peymani , Sara Asadi , Zaheer-Ud-Din Babar

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The out-of-pocket payments for prescription medications can impose financial burden on patients from low- and middle- income and who suffer from chronic diseases. The present study aimed at evaluating the affordability of Cardiovascular diseases (CVDs) medication in Iran. This includes measuring affordability through World Health Organization/Health Action International (WHO/HAI) methodology. In this method, affordability was characterized as the number of days' 28 wages of the lowest-paid unskilled government worker. The different medication therapy scenarios were defined in mono-and combination therapy approaches. This method adds on to WHO/HAI methodology to discover new approaches to affordability assessment. The results show the differences in the medicines affordability when different approaches were used in mono-and combination therapy between 6 main sub-therapeutic groups of CVD. It indicates the medicine affordability isn’t a static concept and it changed dynamically between CVD therapeutic subgroups when it used alone or in combination of other medicines regarding patients’ characteristics and medical conditions. The hypertension and anti-arrhythmia therapeutic groups had the most non36 affordable and hyperlipidemia had most affordable medicines. Therefore, the affordability can be considered as a dynamic concept, which not only affected by the medicine price, but significantly affected by patient’s characteristics, number of medical conditions, and insurance coverage.
Original languageEnglish
Article number1710
Number of pages20
JournalInternational Journal of Environmental Research and Public Health
Issue number5
Publication statusPublished - 5 Mar 2020


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