Factors Related to the Evaluation of Essential Medicines Use in Health Facilities in Indonesia
Main Article Content
Keywords
medicines use, health policy, health care facilities, drug utilization
Abstract
Background: Indonesia has recently implemented a national policy to ensure equitable access to medicines, promote their rational use, and maintain a reliable and quality supply, specifically for essential medicines. Several organizations have conducted evaluations on essential medicines use but have yielded varying results and cannot reflect the actual situation. Objectives: This study aims to discover the current situation regarding essential medicines and identify the most important factors to be considered during future indicator-based evaluations in health facilities in Indonesia. Methods: This qualitative study was carried out using FGDs and interview from January to February 2022. The sample population consisted of ten experts selected based on predetermined criteria. The discussions were recorded and transcribed verbatim in the original language, thematically coded with Nvivo, and analyzed for common themes. Results: This study found 32 factors related to the use of essential medicines in Indonesia, divided into three categories of components, namely access, medicine handling quality, and rational use. Furthermore, a total of 10, 8, and 14 main factors were related to access, handling quality, and rational use, respectively. The discussion provided various perspectives on measuring drug use, specifically essential medicines. Based on expert opinions, evaluating the utilization of essential medicines by relying on existing guidelines was insufficient due to superficiality and irrelevance within the Indonesian health system. Conclusion: Based on the results, one of the crucial factors to consider during evaluation was the accessibility of medicines, which encompassed their availability in health facilities and affordability to patients. In the era of social health insurance, medication costs had become affordable in Indonesia. However, the country’s geographical conditions presented a significant challenge that affected the accessibility of essential medicine. Another major factor was the quality handling and rational use of medicines, which was closely related to the presence of health professionals in health care facilities.
References
1. Klatman EL, Ogle GD. Universal health coverage and diabetes care affordable to all. Diabetes Voice. 2017;63(2):4-5.https:// www.idf.org/e-library/diabetes-voice/issues/125-july-2017-improving-access-to-diabetes-care.html?layout=article&aid=345.
2. Saeed A, Saeed H, Saleem Z, et al. Impact of National Drug Pricing Policy 2018 on access to medicines in Lahore division, Pakistan: A pre-post survey study using WHO/HAI methodology. BMJ Open. 2020;10(10). https://doi.org/10.1136/ bmjopen-2019-034720
3. Moye-Holz D, van Dijk JP, Reijneveld SA, et al. Policy approaches to improve availability and affordability of medicines in Mexico - an example of a middle income country. Global Health. 2017;13(1):1-10. https://doi.org/10.1186/s12992-017-0281-1
4. Ministry of Health of Indonesia. Kebijakan Obat Nasional (National Medicines Policy). Jakarta: Minsitry Of Health Republic Indonesia; 2006.
5. Republik Indonesia. Undang-Undang Kesehatan. 2009:15-16. http://www.ghbook.ir/ i n d e x . p h p ? n ame = ن ی و ن ی ا ه ه ن اسر وگن ه رف & o p t i o n = c om_ d b o o k & t a s k = r e a d o n l i n e & b o o k _ id=13650&page=73&chkhashk=ED9C9491B4&Itemid=218&lang=fa&tmpl=component
6. Ministry of Health of Indonesia. Daftar Obat Esensial Nasional (DOEN) (National Essential Medicines List). Jakarta: Minsitry Of Health Republic Indonesia; 2017.
7. Doherty P, Kirsa S, Chao S, et al. SHPA Standards Of Practice For Drug Use Evaluation In Australian Hospitals: Shpa Committee Of Specialty Practice In Drug Use Evaluation,. J Pharm Pract Res. 2004;43(3):220-223.
8. Beran D. The Impact of Health Systems on Diabetes Care in Low and Lower Middle Income Countries. Curr Diab Rep. 2015;15(4):1-13. https://doi.org/10.1007/s11892-015-0591-8
9. Mendis S, Fukino K, Cameron A. The availability and affordability of selected essential medicines for chronic diseases in six lowand middle-income countries. Bull World Health Organ. 2007;85(4):279-288. https://doi.org/10.2471/blt.06.033647
10. Bazargani YT, Ewen M, De Boer A, et al. Essential medicines are more available than other medicines around the globe. PLoS One. 2014;9(2):1-7. https://doi.org/10.1371/journal.pone.0087576.
11. Akhmad AD, Kristina SARI, Endarti DWI. A Systematic review of pharmaceutical situation on access , quality , and rational drug use. Int J Pharm Res. 2021;13(2):243-257.
12. WHO. Indicators for Monitoring National Drug Policies. Geneva; 1999.
13. WHO. WHO Operational Package for Assessing , Monitoring and Evaluating Country Pharmaceutical Situations Guide for Coordinators and Data Collectors.; 2007.
14. WHO. Guidelines on the Conduct of Surveys of the Quality of Medicines. World Health Organization; 2016. http://apps.who. int/medicinedocs/documents/s22404en/s22404en.pdf
15. WHO (World Health Organization). How to Investigate Drug Use in Health Facili. 1993:92.
16. WHO, Health Action International. Measuring Medicine Price, Availability, Affordability, and Price Component. 2nd ed. WHOHAI; 2008.
17. WHO. WHO Household Survey to Measure Access to and Use of Medicines Long Version Instructions for Data Collection in Jordan.; 2009. http://www.who.int/medicines/areas/coordination/data_collection_manual_jordan_2009.pdf
18. Akerman M, de Freitas O. National survey on access, use and Promotion of Rational Use of Medicines (PNAUM): Evaluation of pharmaceutical services in the primary health care. Rev Saude Publica. 2017;51:1s-5s. https://doi.org/10.11606/S1518- 8787.201705100supl2ed
19. Ritz LS, Adam T, Laing R. A bibliometric study of publication patterns in access to medicines research in developing countries. South Med Rev. 2010;3(1):2-6.
20. Faraco EB, Guimarães L, Anderson C, et al. The pharmacy workforce in public primary healthcare centers: Promoting access and information on medicines. Pharm Pract (Granada). 2020;18(4):1-7. https://doi.org/10.18549/PharmPract.2020.4.2048
21. De Carvalho MN, Gil CRR, Dallacosta EMO, et al. Necessidade e dinâmica da força de trabalho na atenção básica de saúde no Brasil. Cienc e Saude Coletiva. 2018;23(1):295-302. https://doi.org/10.1590/1413-81232018231.08702015
22. Biswas T, Pervin S, Tanim MIA, et al. Bangladesh policy on prevention and control of non-communicable diseases: A policy analysis. BMC Public Health. 2017;17(1):1-11. https://doi.org/10.1186/s12889-017-4494-2
23. Kasonde L, Tordrup D, Naheed A, et al. Evaluating medicine prices, availability and affordability in Bangladesh using World Health Organisation and Health Action International methodology. BMC Health Serv Res. 2019;19(1):1-12. https://doi. org/10.1186/s12913-019-4221-z
24. Ministry of Health of Indonesia. Indonesian Health Profile 2018. Jakarta: Minsitry Of Health Republic Indonesia; 2019.
25. Ewen M, Zweekhorst M, Regeer B, et al. Baseline assessment of WHO’s target for both availability and affordability of essential medicines to treat non-communicable diseases. PLoS One. 2017;12(2):1-13. https://doi.org/10.1371/journal.pone.0171284
26. Puspitasari HP, Aslani P, Krass I. Retos en el manejo de enfermedades crónicas no declarables por los farmacéuticos comunitarios indonesios. Pharm Pract (Granada). 2015;13(3):1-12. https://doi.org/10.18549/PharmPract.2015.03.578
27. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-115. https://doi.org/https://doi. org/10.1111/j.1365-2648.2007.04569.x
28. Denzin N., Lincoln S. Handbook of Qualitative Research. Bahasa Ind. (Qudsy S., ed.). Yogyakarta: Pustaka Pelajar; 2009.
29. Smith MA. Primary Care Teams and Pharmacist Staffing Ratios: Is There a Magic Number? Ann Pharmacother. 2018;52(3):290- 294. https://doi.org/10.1177/1060028017735119
30. Gray SF, Evans D. Developing the public health workforce: Training and recognizing specialists in public health from backgrounds other than medicine: Experience in the UK. Public Health Rev. 2018;39(1):1-9. https://doi.org/10.1186/s40985-018-0091-x
31. Kennie-Kaulbach N, Farrell B, Ward N, et al. Pharmacist provision of primary health care: A modified Delphi validation of pharmacists’ competencies. BMC Fam Pract. 2012;13:27. https://doi.org/10.1186/1471-2296-13-27
32. Ekpenyong A, Udoh A, Kpokiri E, et al. An analysis of pharmacy workforce capacity in Nigeria. J Pharm Policy Pract. 2018;11(1):1- 9. https://doi.org/10.1186/s40545-018-0147-9
33. Bates I, John C, Bruno A, et al. An analysis of the global pharmacy workforce capacity. Hum Resour Health. 2016;14(1):1-7. https://doi.org/10.1186/s12960-016-0158-z
34. Guan X, Liang H, Xue Y, et al. An analysis of China’s national essential medicines policy. J Public Health Policy. 2011;32(3):305- 319. https://doi.org/10.1057/jphp.2011.34
35. Amariles P, Ceballos M, González-Giraldo C. Primary health care policy and vision for community pharmacy and pharmacists in colombia. Pharm Pract (Granada). 2020;18(4):1-7. https://doi.org/10.18549/PharmPract.2020.4.2159
36. Wang Y, Zhu Y, Shi H, et al. The effect of the full coverage of essential medicines policy on utilization and accessibility of primary healthcare service for rural seniors: A time series study in qidong, China. Int J Environ Res Public Health. 2019;16(22). https:// doi.org/10.3390/ijerph16224316
37. Anselmi L, Lagarde M, Hanson K. Health service availability and health seeking behaviour in resource poor settings: evidence from Mozambique. Health Econ Rev. 2015;5(1). https://doi.org/10.1186/s13561-015-0062-6
38. Khuluza F, Haefele-Abah C. The availability, prices and affordability of essential medicines in Malawi: A cross-sectional study. PLoS One. 2019;14(2):1-22. https://doi.org/10.1371/journal.pone.0212125
39. Kotwani A. Where are we now: Assessing the price, availability and affordability of essential medicines in Delhi as India plans free medicine for all. BMC Health Serv Res. 2013;13(1):1. https://doi.org/10.1186/1472-6963-13-285
40. Kristina SA, Endarti D, Widayanti AW. PDG14 Evaluating Accessibility of Essential Medicines in Indonesia: A Survey on Availabilityand Price in Public and Private Health Sectors. Value Heal Reg Issues. 2020;22:S40. https://doi.org/10.1016/j.vhri.2020.07.204
41. Cameron A, Ewen M, Ross-Degnan D, et al. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet. 2009;373(9659):240-249. https://doi.org/10.1016/S0140-6736(08)61762-6
42. Latifah E. Availability of Key Drugs at Referral Hospitals in Yogyakarta, Indonesia. Int Med J. 2020;25(06):2501-2511.
43. Kuwawenaruwa A, Wyss K, Wiedenmayer K, et al. The effects of medicines availability and stock-outs on household’s utilization of healthcare services in Dodoma region, Tanzania. Health Policy Plan. 2020;35(3):323-333. https://doi.org/10.1093/heapol/ czz173
44. Bhuvan KC, Heydon S, Norris P. Access to and use of medicines in the Annapurna region of Western Nepal and possible impacting factors. J Pharm Policy Pract. 2019;12(1):1-12. https://doi.org/10.1186/s40545-019-0172-3
45. Yang L, Liu C, Ferrier JA, et al. Organizational barriers associated with the implementation of national essential medicines policy: A cross-sectional study of township hospitals in China. Soc Sci Med. 2014;145:201-208. https://doi.org/10.1016/j. socscimed.2015.08.044
46. Chao J, Gu J, Zhang H, et al. The impact of the national essential medicines policy on rational drug use in primary care institutions in Jiangsu province of China. Iran J Public Health. 2018;47(1):24-32.
47. Xi X, Chen P, Yang F, et al. Evaluating the accessibility of essential medicines in China. J Med Econ. 2018;21(8):784-792. https:// doi.org/10.1080/13696998.2018.1474744
48. Satibi S, Rifqi Rokhman M, Aditama H. Developing consensus indicators to assess pharmacy service quality at primary health centres in Yogyakarta, Indonesia. Malaysian J Med Sci. 2019;26(4):110-121. https://doi.org/10.21315/mjms2019.26.4.13.
49. Anggriani Y, Ramadaniati HU, Sarnianto P, et al. The Impact of Pharmaceutical Policies on Medicine Procurement Pricing in Indonesia Under the Implementation of Indonesia’s Social Health Insurance System. Value Heal Reg Issues. 2020;21:1-8. https://doi.org/10.1016/j.vhri.2019.05.005
50. Xi X, Chen P, Yang F, et al. Evaluating the accessibility of essential medicines in China. J Med Econ. 2018;21(8):784-792. https:// doi.org/10.1080/13696998.2018.1474744
51. Sun X, Wei J, Yao Y, et al. Availability, prices and affordability of essential medicines for children: A cross-sectional survey in Jiangsu Province, China. BMJ Open. 2018;8(10):1-12. https://doi.org/10.1136/bmjopen-2018-023646
52. Guan X, Hu H, Man C, et al. A survey of availability, price and affordability of essential medicines from 2011 to 2016 in Chinese secondary and tertiary hospitals. Int J Equity Health. 2018;17(1):1-8. https://doi.org/10.1186/s12939-018-0870-5
53. Yang C, Hu S, Zhu Y, et al. Evaluating access to oral anti-diabetic medicines: A cross-sectional survey of prices, availability and affordability in Shaanxi Province, Western China. PLoS One. 2019;14(10):1-13. https://doi.org/10.1371/journal.pone.0223769
54. Guo Z, Guan X, Shi L. The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: A cross-sectional study in China. BMC Health Serv Res. 2017;17(1):1-7. https://doi.org/10.1186/s12913-017-2698-x
55. Zarei L, Peymani P, Moradi N, et al. Affordability of Medication Therapy in Diabetic Patients: A Scenario-Based Assessment in Iran’s Health System Context. Int J Heal Policy Manag. 2022;11(4):443-452. https://doi.org/10.34172/ijhpm.2020.152
56. Orubu ESF, Robert FO, Samuel M, et al. Access to essential cardiovascular medicines for children: A pilot study of availability, price and affordability in Nigeria. Health Policy Plan. 2019;34:III20-III26. https://doi.org/10.1093/heapol/czz057
57. Emmerick ICM, Campos MR, Luiza VL, et al. Retrospective interrupted time series examining hypertension and diabetes medicines usage following changes in patient cost sharing in the “Farmácia Popular” programme in Brazil. BMJ Open. 2017;7(11):1-9. https://doi.org/10.1136/bmjopen-2017-017308
58. Mishore KM, Bekele NA, Yirba TY, et al. Evaluation of Drug Use Pattern in Emergency Department of Dilchora Referral Hospital, Dire Dawa, Ethiopia. Emerg Med Int. 2020;2020:1-6. https://doi.org/10.1155/2020/4173586
59. Govender T, Suleman F, Perumal-Pillay VA. Evaluating the implementation of the standard treatment guidelines (STGs) and essential medicines list (EML) at a public South African tertiary institution and its associated primary health care (PHC) facilities. J Pharm Policy Pract. 2021;14(1):1-14. https://doi.org/10.1186/s40545-021-00390-z
60. Obuaku-Igwe CC. Employment status, medical support and Income as significant factors in Access to Essential Medicines. African Sociol Rev. 2017;21(1):154-175. https://www.google.com/url?client=internal-element-cse&cx=007797540432222069508:kprfz3- g5lc&q=https://www.ajol.info/index.php/asr/article/view/163718/153192&sa=U&ved=2ahUKEwjo38eei4D7AhUzoVwKHaxvBRo4KBAWegQIDhAC& usg=AOvVaw0PdkUqpG3wcUnKAOox1UlI
61. Ribeiro N, Mota-Filipe H, Guerreiro MP, et al. Primary health care policy and vision for community pharmacy and pharmacists in Portugal. Pharm Pract (Granada). 2020;18(3):1-7. https://doi.org/10.18549/PharmPract.2020.3.2043
62. Hermansyah A, Wulandari L, Kristina SA, et al. Primary health care policy and vision for community pharmacy and pharmacists in indonesia. Pharm Pract (Granada). 2020;18(3):1-12. https://doi.org/10.18549/PharmPract.2020.3.2085
63. Varas-Doval R, Gastelurrutia MA, Benrimoj SI, et al. Clinical impact of a pharmacist-led medication review with follow up for aged polypharmacy patients: A cluster randomized controlled trial. Pharm Pract (Granada). 2020;18(4):1-8. https://doi. org/10.18549/PharmPract.2020.4.2133.
64. Moore GD, Kosirog ER, Vande Griend JP, et al. Expansion of clinical pharmacist positions through sustainable funding. Am J Heal Pharm. 2018;75(13):978-981. https://doi.org/10.2146/ajhp170285
65. Tavares NUL, Luiza VL, Oliveira MA, et al. Free access to medicines for the treatment of chronic diseases in Brazil. Rev Saude Publica. 2016;50(suppl 2):1-10. https://doi.org/10.1590/S1518-8787.2016050006118
66. Yezli S, Zaraa S, Yassin Y, et al. Medication utilization pattern among outpatients during the Hajj mass gathering. Saudi Pharm J. 2020;28(9):1122-1128. https://doi.org/10.1016/j.jsps.2020.07.014
67. Bertoldi AD, Helfer AP, Camargo AL, et al. Is the Brazilian pharmaceutical policy ensuring population access to essential medicines? Global Health. 2012;8:1-10. https://doi.org/10.1186/1744-8603-8-6
2. Saeed A, Saeed H, Saleem Z, et al. Impact of National Drug Pricing Policy 2018 on access to medicines in Lahore division, Pakistan: A pre-post survey study using WHO/HAI methodology. BMJ Open. 2020;10(10). https://doi.org/10.1136/ bmjopen-2019-034720
3. Moye-Holz D, van Dijk JP, Reijneveld SA, et al. Policy approaches to improve availability and affordability of medicines in Mexico - an example of a middle income country. Global Health. 2017;13(1):1-10. https://doi.org/10.1186/s12992-017-0281-1
4. Ministry of Health of Indonesia. Kebijakan Obat Nasional (National Medicines Policy). Jakarta: Minsitry Of Health Republic Indonesia; 2006.
5. Republik Indonesia. Undang-Undang Kesehatan. 2009:15-16. http://www.ghbook.ir/ i n d e x . p h p ? n ame = ن ی و ن ی ا ه ه ن اسر وگن ه رف & o p t i o n = c om_ d b o o k & t a s k = r e a d o n l i n e & b o o k _ id=13650&page=73&chkhashk=ED9C9491B4&Itemid=218&lang=fa&tmpl=component
6. Ministry of Health of Indonesia. Daftar Obat Esensial Nasional (DOEN) (National Essential Medicines List). Jakarta: Minsitry Of Health Republic Indonesia; 2017.
7. Doherty P, Kirsa S, Chao S, et al. SHPA Standards Of Practice For Drug Use Evaluation In Australian Hospitals: Shpa Committee Of Specialty Practice In Drug Use Evaluation,. J Pharm Pract Res. 2004;43(3):220-223.
8. Beran D. The Impact of Health Systems on Diabetes Care in Low and Lower Middle Income Countries. Curr Diab Rep. 2015;15(4):1-13. https://doi.org/10.1007/s11892-015-0591-8
9. Mendis S, Fukino K, Cameron A. The availability and affordability of selected essential medicines for chronic diseases in six lowand middle-income countries. Bull World Health Organ. 2007;85(4):279-288. https://doi.org/10.2471/blt.06.033647
10. Bazargani YT, Ewen M, De Boer A, et al. Essential medicines are more available than other medicines around the globe. PLoS One. 2014;9(2):1-7. https://doi.org/10.1371/journal.pone.0087576.
11. Akhmad AD, Kristina SARI, Endarti DWI. A Systematic review of pharmaceutical situation on access , quality , and rational drug use. Int J Pharm Res. 2021;13(2):243-257.
12. WHO. Indicators for Monitoring National Drug Policies. Geneva; 1999.
13. WHO. WHO Operational Package for Assessing , Monitoring and Evaluating Country Pharmaceutical Situations Guide for Coordinators and Data Collectors.; 2007.
14. WHO. Guidelines on the Conduct of Surveys of the Quality of Medicines. World Health Organization; 2016. http://apps.who. int/medicinedocs/documents/s22404en/s22404en.pdf
15. WHO (World Health Organization). How to Investigate Drug Use in Health Facili. 1993:92.
16. WHO, Health Action International. Measuring Medicine Price, Availability, Affordability, and Price Component. 2nd ed. WHOHAI; 2008.
17. WHO. WHO Household Survey to Measure Access to and Use of Medicines Long Version Instructions for Data Collection in Jordan.; 2009. http://www.who.int/medicines/areas/coordination/data_collection_manual_jordan_2009.pdf
18. Akerman M, de Freitas O. National survey on access, use and Promotion of Rational Use of Medicines (PNAUM): Evaluation of pharmaceutical services in the primary health care. Rev Saude Publica. 2017;51:1s-5s. https://doi.org/10.11606/S1518- 8787.201705100supl2ed
19. Ritz LS, Adam T, Laing R. A bibliometric study of publication patterns in access to medicines research in developing countries. South Med Rev. 2010;3(1):2-6.
20. Faraco EB, Guimarães L, Anderson C, et al. The pharmacy workforce in public primary healthcare centers: Promoting access and information on medicines. Pharm Pract (Granada). 2020;18(4):1-7. https://doi.org/10.18549/PharmPract.2020.4.2048
21. De Carvalho MN, Gil CRR, Dallacosta EMO, et al. Necessidade e dinâmica da força de trabalho na atenção básica de saúde no Brasil. Cienc e Saude Coletiva. 2018;23(1):295-302. https://doi.org/10.1590/1413-81232018231.08702015
22. Biswas T, Pervin S, Tanim MIA, et al. Bangladesh policy on prevention and control of non-communicable diseases: A policy analysis. BMC Public Health. 2017;17(1):1-11. https://doi.org/10.1186/s12889-017-4494-2
23. Kasonde L, Tordrup D, Naheed A, et al. Evaluating medicine prices, availability and affordability in Bangladesh using World Health Organisation and Health Action International methodology. BMC Health Serv Res. 2019;19(1):1-12. https://doi. org/10.1186/s12913-019-4221-z
24. Ministry of Health of Indonesia. Indonesian Health Profile 2018. Jakarta: Minsitry Of Health Republic Indonesia; 2019.
25. Ewen M, Zweekhorst M, Regeer B, et al. Baseline assessment of WHO’s target for both availability and affordability of essential medicines to treat non-communicable diseases. PLoS One. 2017;12(2):1-13. https://doi.org/10.1371/journal.pone.0171284
26. Puspitasari HP, Aslani P, Krass I. Retos en el manejo de enfermedades crónicas no declarables por los farmacéuticos comunitarios indonesios. Pharm Pract (Granada). 2015;13(3):1-12. https://doi.org/10.18549/PharmPract.2015.03.578
27. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-115. https://doi.org/https://doi. org/10.1111/j.1365-2648.2007.04569.x
28. Denzin N., Lincoln S. Handbook of Qualitative Research. Bahasa Ind. (Qudsy S., ed.). Yogyakarta: Pustaka Pelajar; 2009.
29. Smith MA. Primary Care Teams and Pharmacist Staffing Ratios: Is There a Magic Number? Ann Pharmacother. 2018;52(3):290- 294. https://doi.org/10.1177/1060028017735119
30. Gray SF, Evans D. Developing the public health workforce: Training and recognizing specialists in public health from backgrounds other than medicine: Experience in the UK. Public Health Rev. 2018;39(1):1-9. https://doi.org/10.1186/s40985-018-0091-x
31. Kennie-Kaulbach N, Farrell B, Ward N, et al. Pharmacist provision of primary health care: A modified Delphi validation of pharmacists’ competencies. BMC Fam Pract. 2012;13:27. https://doi.org/10.1186/1471-2296-13-27
32. Ekpenyong A, Udoh A, Kpokiri E, et al. An analysis of pharmacy workforce capacity in Nigeria. J Pharm Policy Pract. 2018;11(1):1- 9. https://doi.org/10.1186/s40545-018-0147-9
33. Bates I, John C, Bruno A, et al. An analysis of the global pharmacy workforce capacity. Hum Resour Health. 2016;14(1):1-7. https://doi.org/10.1186/s12960-016-0158-z
34. Guan X, Liang H, Xue Y, et al. An analysis of China’s national essential medicines policy. J Public Health Policy. 2011;32(3):305- 319. https://doi.org/10.1057/jphp.2011.34
35. Amariles P, Ceballos M, González-Giraldo C. Primary health care policy and vision for community pharmacy and pharmacists in colombia. Pharm Pract (Granada). 2020;18(4):1-7. https://doi.org/10.18549/PharmPract.2020.4.2159
36. Wang Y, Zhu Y, Shi H, et al. The effect of the full coverage of essential medicines policy on utilization and accessibility of primary healthcare service for rural seniors: A time series study in qidong, China. Int J Environ Res Public Health. 2019;16(22). https:// doi.org/10.3390/ijerph16224316
37. Anselmi L, Lagarde M, Hanson K. Health service availability and health seeking behaviour in resource poor settings: evidence from Mozambique. Health Econ Rev. 2015;5(1). https://doi.org/10.1186/s13561-015-0062-6
38. Khuluza F, Haefele-Abah C. The availability, prices and affordability of essential medicines in Malawi: A cross-sectional study. PLoS One. 2019;14(2):1-22. https://doi.org/10.1371/journal.pone.0212125
39. Kotwani A. Where are we now: Assessing the price, availability and affordability of essential medicines in Delhi as India plans free medicine for all. BMC Health Serv Res. 2013;13(1):1. https://doi.org/10.1186/1472-6963-13-285
40. Kristina SA, Endarti D, Widayanti AW. PDG14 Evaluating Accessibility of Essential Medicines in Indonesia: A Survey on Availabilityand Price in Public and Private Health Sectors. Value Heal Reg Issues. 2020;22:S40. https://doi.org/10.1016/j.vhri.2020.07.204
41. Cameron A, Ewen M, Ross-Degnan D, et al. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet. 2009;373(9659):240-249. https://doi.org/10.1016/S0140-6736(08)61762-6
42. Latifah E. Availability of Key Drugs at Referral Hospitals in Yogyakarta, Indonesia. Int Med J. 2020;25(06):2501-2511.
43. Kuwawenaruwa A, Wyss K, Wiedenmayer K, et al. The effects of medicines availability and stock-outs on household’s utilization of healthcare services in Dodoma region, Tanzania. Health Policy Plan. 2020;35(3):323-333. https://doi.org/10.1093/heapol/ czz173
44. Bhuvan KC, Heydon S, Norris P. Access to and use of medicines in the Annapurna region of Western Nepal and possible impacting factors. J Pharm Policy Pract. 2019;12(1):1-12. https://doi.org/10.1186/s40545-019-0172-3
45. Yang L, Liu C, Ferrier JA, et al. Organizational barriers associated with the implementation of national essential medicines policy: A cross-sectional study of township hospitals in China. Soc Sci Med. 2014;145:201-208. https://doi.org/10.1016/j. socscimed.2015.08.044
46. Chao J, Gu J, Zhang H, et al. The impact of the national essential medicines policy on rational drug use in primary care institutions in Jiangsu province of China. Iran J Public Health. 2018;47(1):24-32.
47. Xi X, Chen P, Yang F, et al. Evaluating the accessibility of essential medicines in China. J Med Econ. 2018;21(8):784-792. https:// doi.org/10.1080/13696998.2018.1474744
48. Satibi S, Rifqi Rokhman M, Aditama H. Developing consensus indicators to assess pharmacy service quality at primary health centres in Yogyakarta, Indonesia. Malaysian J Med Sci. 2019;26(4):110-121. https://doi.org/10.21315/mjms2019.26.4.13.
49. Anggriani Y, Ramadaniati HU, Sarnianto P, et al. The Impact of Pharmaceutical Policies on Medicine Procurement Pricing in Indonesia Under the Implementation of Indonesia’s Social Health Insurance System. Value Heal Reg Issues. 2020;21:1-8. https://doi.org/10.1016/j.vhri.2019.05.005
50. Xi X, Chen P, Yang F, et al. Evaluating the accessibility of essential medicines in China. J Med Econ. 2018;21(8):784-792. https:// doi.org/10.1080/13696998.2018.1474744
51. Sun X, Wei J, Yao Y, et al. Availability, prices and affordability of essential medicines for children: A cross-sectional survey in Jiangsu Province, China. BMJ Open. 2018;8(10):1-12. https://doi.org/10.1136/bmjopen-2018-023646
52. Guan X, Hu H, Man C, et al. A survey of availability, price and affordability of essential medicines from 2011 to 2016 in Chinese secondary and tertiary hospitals. Int J Equity Health. 2018;17(1):1-8. https://doi.org/10.1186/s12939-018-0870-5
53. Yang C, Hu S, Zhu Y, et al. Evaluating access to oral anti-diabetic medicines: A cross-sectional survey of prices, availability and affordability in Shaanxi Province, Western China. PLoS One. 2019;14(10):1-13. https://doi.org/10.1371/journal.pone.0223769
54. Guo Z, Guan X, Shi L. The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: A cross-sectional study in China. BMC Health Serv Res. 2017;17(1):1-7. https://doi.org/10.1186/s12913-017-2698-x
55. Zarei L, Peymani P, Moradi N, et al. Affordability of Medication Therapy in Diabetic Patients: A Scenario-Based Assessment in Iran’s Health System Context. Int J Heal Policy Manag. 2022;11(4):443-452. https://doi.org/10.34172/ijhpm.2020.152
56. Orubu ESF, Robert FO, Samuel M, et al. Access to essential cardiovascular medicines for children: A pilot study of availability, price and affordability in Nigeria. Health Policy Plan. 2019;34:III20-III26. https://doi.org/10.1093/heapol/czz057
57. Emmerick ICM, Campos MR, Luiza VL, et al. Retrospective interrupted time series examining hypertension and diabetes medicines usage following changes in patient cost sharing in the “Farmácia Popular” programme in Brazil. BMJ Open. 2017;7(11):1-9. https://doi.org/10.1136/bmjopen-2017-017308
58. Mishore KM, Bekele NA, Yirba TY, et al. Evaluation of Drug Use Pattern in Emergency Department of Dilchora Referral Hospital, Dire Dawa, Ethiopia. Emerg Med Int. 2020;2020:1-6. https://doi.org/10.1155/2020/4173586
59. Govender T, Suleman F, Perumal-Pillay VA. Evaluating the implementation of the standard treatment guidelines (STGs) and essential medicines list (EML) at a public South African tertiary institution and its associated primary health care (PHC) facilities. J Pharm Policy Pract. 2021;14(1):1-14. https://doi.org/10.1186/s40545-021-00390-z
60. Obuaku-Igwe CC. Employment status, medical support and Income as significant factors in Access to Essential Medicines. African Sociol Rev. 2017;21(1):154-175. https://www.google.com/url?client=internal-element-cse&cx=007797540432222069508:kprfz3- g5lc&q=https://www.ajol.info/index.php/asr/article/view/163718/153192&sa=U&ved=2ahUKEwjo38eei4D7AhUzoVwKHaxvBRo4KBAWegQIDhAC& usg=AOvVaw0PdkUqpG3wcUnKAOox1UlI
61. Ribeiro N, Mota-Filipe H, Guerreiro MP, et al. Primary health care policy and vision for community pharmacy and pharmacists in Portugal. Pharm Pract (Granada). 2020;18(3):1-7. https://doi.org/10.18549/PharmPract.2020.3.2043
62. Hermansyah A, Wulandari L, Kristina SA, et al. Primary health care policy and vision for community pharmacy and pharmacists in indonesia. Pharm Pract (Granada). 2020;18(3):1-12. https://doi.org/10.18549/PharmPract.2020.3.2085
63. Varas-Doval R, Gastelurrutia MA, Benrimoj SI, et al. Clinical impact of a pharmacist-led medication review with follow up for aged polypharmacy patients: A cluster randomized controlled trial. Pharm Pract (Granada). 2020;18(4):1-8. https://doi. org/10.18549/PharmPract.2020.4.2133.
64. Moore GD, Kosirog ER, Vande Griend JP, et al. Expansion of clinical pharmacist positions through sustainable funding. Am J Heal Pharm. 2018;75(13):978-981. https://doi.org/10.2146/ajhp170285
65. Tavares NUL, Luiza VL, Oliveira MA, et al. Free access to medicines for the treatment of chronic diseases in Brazil. Rev Saude Publica. 2016;50(suppl 2):1-10. https://doi.org/10.1590/S1518-8787.2016050006118
66. Yezli S, Zaraa S, Yassin Y, et al. Medication utilization pattern among outpatients during the Hajj mass gathering. Saudi Pharm J. 2020;28(9):1122-1128. https://doi.org/10.1016/j.jsps.2020.07.014
67. Bertoldi AD, Helfer AP, Camargo AL, et al. Is the Brazilian pharmaceutical policy ensuring population access to essential medicines? Global Health. 2012;8:1-10. https://doi.org/10.1186/1744-8603-8-6
Article Sidebar
Published
Mar 6, 2024
Article Details
How to Cite
1.
Factors Related to the Evaluation of Essential Medicines Use in Health Facilities in Indonesia. Pharm Pract (Granada) [Internet]. 2024 Mar. 6 [cited 2025 Jan. 21];22(1):1-11. Available from: https://pharmacypractice.org/index.php/pp/article/view/2907
Section
Original Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
How to Cite
1.
Factors Related to the Evaluation of Essential Medicines Use in Health Facilities in Indonesia. Pharm Pract (Granada) [Internet]. 2024 Mar. 6 [cited 2025 Jan. 21];22(1):1-11. Available from: https://pharmacypractice.org/index.php/pp/article/view/2907