title: Essential medicines for COPD and asthma in low and middle-income countries.
abstract: Access to medications for chronic disease management is limited in many low and middle-income countries (LMICs), resulting in suboptimal care and avoidable morbidity and mortality. We performed a survey of COPD and asthma medicines that appeared on the national essential medicines lists (NEMLs) of 32 LMICs. Nearly all countries (>90%) had assigned essential medicines for treatment of exacerbations and early stable disease stages, but not for steps 4 (22%) and 5 (6%) controlled asthma management. The number of treatment options was limited, with long-acting β2-agonists (LABA) and combination dosage forms being notably absent. Suboptimal availability of chronic respiratory disease medicines suggests that implementation of NEMLs is the main problem in clinical practice.
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Yaser T
authors.initials: YT
authors.lastname: Bazargani
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Anthonious
authors.initials: A
authors.lastname: de Boer
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Hubert G M
authors.initials: HG
authors.lastname: Leufkens
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Aukje K
authors.initials: AK
authors.lastname: Mantel-Teeuwisse
mesh_terms: D018927:Anti-Asthmatic Agents / Q000600:supply & distribution; D001249:Asthma / Q000188:drug therapy*; D003906:Developing Countries; D005569:Formularies as Topic; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D019141:Respiratory System Agents / Q000600:supply & distribution*
chemical_list: D018927:Anti-Asthmatic Agents; D019141:Respiratory System Agents
keywords: Asthma in primary care; COPD epidemiology