Until now, the lowest cost for treating a patient with severe asthma in Benin was 79 euros per year. By ordering through ADF, this cost will be reduced to 48 euros; and, in El Salvador, the savings per patient are even more dramatic – the cost reduces from 83 to 35 euros per year.
Over the past 15 years, helping low- and middle-income countries manage asthma has been one of The Union’s lung health priorities. “These countries identified the prohibitively high cost of asthma inhalers as a key obstacle to providing asthma care”, said Dr Nils E Billo, Executive Director of The Union. “The ADF was established as a practical, affordable solution to this problem”.
Through ADF, low- and middle-income countries can purchase the quality-assured, affordable asthma medicines they need. The ADF has a quality assurance system based on World Health Organization (WHO) norms and standards. It keeps prices down by having a limited competitive process among selected manufacturers based on yearly estimated volumes.
For both countries, the savings are very significant. For example, in Benin, one CFC-free inhaler of Beclometasone 100μg providing at least 200 doses of medicine will cost a patient around 1,400 CFA francs or 2.13 euros. In El Salvador, the same inhaler will cost the Ministry of Health only 1.59 euros. The costs of the medicines purchased through the ADF vary from country to country due to differences in transportation costs, importation taxes, customs clearance costs and other local factors.
For patients, a more affordable price makes treatment possible. “To give you an idea of how expensive it was for the majority of the population to spend 79 euros on asthma treatment, in Benin, a nurse earns only about 92 euros per month”, said Prof Martin Gninafon, manager of Benin’s National Tuberculosis Programme.
Each country has taken a different approach to financing these medicines. To build a sustainable system that can eventually provide all asthma patients with ongoing access to affordable treatment, Benin’s National Tuberculosis Programme has established a revolving fund and cost recovery system for asthma medicines. In El Salvador, the Ministry of Health looks forward to being able to treat more patients for the same budget.
Although the prices obtained through ADF are more affordable than what many countries had before, ADF will continue to encourage further competition among quality-assured products. “We are convinced that the prices of HFA inhalers will further decrease in the near future, since volumes will become substantial and more competition will occur”, said Cécile Macé, Pharmacist and ADF Coordinator for The Union.
Both countries purchased through the ADF not only to obtain inhalers, but also to improve their management of asthma. In addition to the ADF procurement mechanism, The Union offers a technical package for improving the management of asthma in the general health services. Thus, ADF clients order medicines, but also receive training materials, an information system and a technical guide to help them improve their services.
Benin and El Salvador are now implementing pilot studies based their adaptation of The Union’s Management of Asthma: a guide to the essentials of good clinical practice. The staff involved in the project have completed training courses in collaboration with The Union. They will be evaluating patient outcomes and documenting the reduction in emergency visits and hospitalisations that are sure to occur once patients have medicines and proper care.
While El Salvador and Benin look set to make a real change for their people suffering from asthma, other countries that want to start implementing asthma programmes or integrated approaches to respiratory health will also now have an easily accessible source of affordable medicines through the ADF. Asthma is a chronic lung condition affecting some 300 million people worldwide. Once predominantly found in industrialised countries, the incidence of asthma has increased dramatically in low- and middleincome countries over the past 20 years.
“The Union is pleased to bring new hope to those suffering from asthma, especially in this 2010 Year of the Lung”, said Dr Billo. “A principal goal of the Year of the Lung campaign is to raise awareness of lung disease and the solutions that are available to mitigate its effects on the lives of patients, families and communities”.
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