title: Ensuring Patient-Centered Access to Cardiovascular Disease Medicines in Low-Income and Middle-Income Countries Through Health-System Strengthening.
abstract: Cardiovascular disease (CVD) is the leading cause of global mortality and is expected to reach 23 million deaths by 2030. Eighty percent of CVD deaths occur in low-income and middle-income countries (LMICs). Although CVD prevention and treatment guidelines are available, translating these into practice is hampered in LMICs by inadequate health care systems that limit access to lifesaving medications. In this review article, we describe the deficiencies in the current LMIC supply chains that limit access to effective CVD medicines, and discuss existing solutions that are translatable to similar settings so as to address these deficiencies.
authors.affiliation: Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, IN 46202, USA.
authors.forename: Dan N
authors.initials: DN
authors.lastname: Tran
authors.affiliation: Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, IN 46202, USA; Department of Pharmacy, Moi Teaching and Referral Hospital, PO Box 3, Eldoret 30100, Kenya.
authors.forename: Benson
authors.initials: B
authors.lastname: Njuguna
authors.affiliation: Department of Medicine, Indiana University School of Medicine, 1120 West Michigan Street, Indianapolis, IN 46202, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Mercer
authors.affiliation: Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, IN 46202, USA; Department of Pharmacy, Moi Teaching and Referral Hospital, PO Box 3, Eldoret 30100, Kenya.
authors.forename: Imran
authors.initials: I
authors.lastname: Manji
authors.affiliation: Department of Medicine, Indiana University School of Medicine, 1120 West Michigan Street, Indianapolis, IN 46202, USA.
authors.forename: Lydia
authors.initials: L
authors.lastname: Fischer
authors.affiliation: Department of Chemistry and Biochemistry, University of Notre Dame, 250 Nieuwland, Notre Dame, IN 46556, USA.
authors.forename: Marya
authors.initials: M
authors.lastname: Lieberman
authors.affiliation: Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, IN 46202, USA. Electronic address: spastaki@gmail.com.
authors.forename: Sonak D
authors.initials: SD
authors.lastname: Pastakia
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D003906:Developing Countries; D006297:Health Services Accessibility / Q000639:trends*; D006801:Humans; D018802:Patient-Centered Care / Q000458:organization & administration*; D011203:Poverty; D012959:Socioeconomic Factors
chemical_list: D002317:Cardiovascular Agents
keywords: Accountability; Adherence; Availability; Cardiovascular disease medicines; Falsified and substandard medicines; Health-system strengthening; Low-income and middle-income countries; Patient-centered access