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

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


The out‐of‐pocket payments for prescription medications can impose a financial burden on patients from low‐ and middle‐ incomes and who suffer from chronic diseases. The present study aims at evaluating the affordability of cardiovascular disease (CVD) medication in Iran. This includes measuring affordability through World Health Organization/Health Action International (WHO/HAI) methodology. In this method, affordability is characterized as the number of daysʹ wages of the lowest‐paid unskilled government worker. The different medication therapy scenarios are defined in mono‐and combination therapy approaches. This method adds on to WHO/HAI methodology to discover new approaches to affordability assessments. The results show the differences in the medicines affordability when different approaches are used in mono‐and combination therapy between 6 main sub‐therapeutic groups of CVD. It indicates the medicine affordability is not a static concept and it changes dynamically between CVD therapeutic subgroups when it used alone or in combination with other medicines regarding patients’ characteristics and medical conditions. Hypertension and anti‐arrhythmia therapeutic groups had the most non-affordability and hyperlipidemia had the most affordable medicines. Therefore, affordability can be considered as a dynamic concept, which not only affected by the medicine price but significantly affected by a patient’s characteristics, the 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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