Health policy and systems research in access to medicines: a prioritized agenda for low- and middle-income countriesReportar como inadecuado

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Health Research Policy and Systems

, 11:37

First Online: 14 October 2013Received: 20 March 2013Accepted: 26 September 2013


ObjectivesTo identify priority policy issues in access to medicines ATM relevant for low- and middle-income countries, to identify research questions that would help address these policy issues, and to prioritize these research questions in a health policy and systems research HPSR agenda.

MethodsThe study involved i country- and regional-level priority-setting exercises performed in 17 countries across five regions, with a desk review of relevant grey and published literature combined with mapping and interviews of national and regional stakeholders; ii interviews with global-level stakeholders; iii a scoping of published literature; and iv a consensus building exercise with global stakeholders which resulted in the formulation and ranking of HPSR questions in the field of ATM.

ResultsA list of 18 priority policy issues was established following analysis of country-, regional-, and global-level exercises. Eighteen research questions were formulated during the global stakeholders’ meeting and ranked according to four ranking criteria innovation, impact on health and health systems, equity, and lack of research. The top three research questions were: i In risk protection schemes, which innovations and policies improve equitable access to and appropriate use of medicines, sustainability of the insurance system, and financial impact on the insured? ii How can stakeholders use the information available in the system, e.g., price, availability, quality, utilization, registration, procurement, in a transparent way towards improving access and use of medicines? and iii How do policies and other interventions into private markets, such as information, subsidies, price controls, donation, regulatory mechanisms, promotion practices, etc., impact on access to and appropriate use of medicines?

ConclusionsOur HPSR agenda adopts a health systems perspective and will guide relevant, innovative research, likely to bear an impact on health, health systems and equity.

KeywordsAccess to medicines Health systems Health systems research Priority setting AbbreviationsAHPSRAlliance for Health Policy and Systems Research

ATMAccess to medicines

HPSRHealth Policy and Systems Research

KIIsKey informant interviews

LMICsLow- and middle-income countries.

Electronic supplementary materialThe online version of this article doi:10.1186-1478-4505-11-37 contains supplementary material, which is available to authorized users.

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Autor: Maryam Bigdeli - Dena Javadi - Joelle Hoebert - Richard Laing - Kent Ranson - The Alliance for Health Policy and Systems Rese


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