title: Stakeholders' perspectives on access-to-medicines policy and research priorities in Latin America and the Caribbean: face-to-face and web-based interviews.
abstract: BACKGROUND
  This study aims to rank policy concerns and policy-related research issues in order to identify policy and research gaps on access to medicines (ATM) in low- and middle-income countries in Latin America and the Caribbean (LAC), as perceived by policy makers, researchers, NGO and international organization representatives, as part of a global prioritization exercise.
  
  
  METHODS
  Data collection, conducted between January and May 2011, involved face-to-face interviews in El Salvador, Colombia, Dominican Republic, and Suriname, and an e-mail survey with key-stakeholders. Respondents were asked to choose the five most relevant criteria for research prioritization and to score policy/research items according to the degree to which they represented current policies, desired policies, current research topics, and/or desired research topics. Mean scores and summary rankings were obtained. Linear regressions were performed to contrast rankings concerning current and desired policies (policy gaps), and current and desired research (research gaps).
  
  
  RESULTS
  Relevance, feasibility, and research utilization were the top ranked criteria for prioritizing research. Technical capacity, research and development for new drugs, and responsiveness, were the main policy gaps. Quality assurance, staff technical capacity, price regulation, out-of-pocket payments, and cost containment policies, were the main research gaps. There was high level of coherence between current and desired policies: coefficients of determination (R2) varied from 0.46 (Health system structure; r = 0.68, P <0.01) to 0.86 (Sustainable financing; r = 0.93, P <0.01). There was also high coherence between current and desired research on Rational selection and use of medicines (r = 0.71, P <0.05, R2 = 0.51), Pricing/affordability (r = 0.82, P <0.01, R2 = 0.67), and Sustainable financing (r = 0.76, P <0.01, R2 = 0.58). Coherence was less for Health system structure (r = 0.61, P <0.01, R2 = 0.38).
  
  
  CONCLUSIONS
  This study combines metrics approaches, contributing to priority setting methodology development, with country and regional level stakeholder participation. Stakeholders received feedback with the results, and we hope to have contributed to the discussion and implementation of ATM research and policy priorities in LAC.
authors: Thiago Botelho
authors: TB
authors: Azeredo
authors: Nucleus for Pharmaceutical Policies, National School of Public Health, Oswaldo Cruz Foundation, 1480, Rua Leopoldo Bulhões # 624, Manguinhos, 21021-000 Rio de Janeiro, RJ, Brazil. negritudesenior@gmail.com.
authors: Vera Lucia
authors: VL
authors: Luiza
authors: Maria Auxiliadora
authors: MA
authors: Oliveira
authors: Isabel Cristina Martins
authors: IC
authors: Emmerick
authors: Maryam
authors: M
authors: Bigdeli
mesh_terms: D001291:Attitude of Health Personnel; D003105:Colombia; D004293:Dominican Republic; D004544:El Salvador; D055317:Evidence-Based Practice; D006291:Health Policy; D006297:Health Services Accessibility; D006302:Health Services Research / Q000639:trends; D006801:Humans; D004364:Pharmaceutical Preparations / Q000600:supply & distribution*; D012106:Research; D013532:Suriname; D011795:Surveys and Questionnaires
chemical_list: D004364:Pharmaceutical Preparations