Evidence map›Paper›PMID 36962898›Full record

ArticlePLOS global public health2022

Availability, affordability and access to essential medications for asthma and chronic obstructive pulmonary disease in three low- and middle-income country settings.

Trishul Siddharthan, Nicole M Robertson, Natalie A Rykiel, Lindsay J Underhill, Nihaal Rahman, Sujan Kafle, Sakshi Mohan, Roma Padalkar, Sarah McKeown, Oscar Flores-Flores and 11 more

Open access · goldFull text read
PubMed Full text at PMC Publisher
In one paragraph

Article in PLOS global public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 13 citations in OpenAlex.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 9 institutions in 5 countries.

Trishul SiddharthanDivision of Pulmonary and Critical Care, School of Medicine, University of Miami, Miami, Florida, United States of America.ORCID https://orcid.org/0000-0001-9914-1839
Nicole M RobertsonCenter for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, Maryland, United States of America.
Natalie A RykielDivision of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
Lindsay J UnderhillDivision of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
Nihaal RahmanCenter for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, Maryland, United States of America.ORCID https://orcid.org/0000-0002-1124-7709
Sujan KafleInstitute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Sakshi MohanCentre for Health Economics, University of York, York, United Kingdom.ORCID https://orcid.org/0000-0002-1268-1769
Roma PadalkarRowan University School of Osteopathic Medicine, Glassboro, New Jersey, United States of America.ORCID https://orcid.org/0000-0002-6981-3822
Sarah McKeownDepartment of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
Oscar Flores-FloresDepartment of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
Shumonta A QuaderiRespiratory Medicine, University College London, London, United Kingdom.
Patricia AlupoMakerere Lung Institute, Makerere University, Kampala, Uganda.
Robert KalyesubulaCollege of Health Sciences, Makerere University, Kampala, Uganda.ORCID https://orcid.org/0000-0003-3211-163X
Bruce KirengaMakerere Lung Institute, Makerere University, Kampala, Uganda.
Jing LuoUniversity of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
Maria Kathia CárdenasCRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
Gonzalo GianellaCRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
J Jaime MirandaCRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
William CheckleyDivision of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
John R HurstRespiratory Medicine, University College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-7246-6040
Suzanne L PollardDivision of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
Johns Hopkins University · USMakerere University · UGUniversidad Peruana Cayetano Heredia · PEUniversity College London · GBRowan University · USTribhuvan University · NPUniversity of Kentucky · USUniversity of Pittsburgh · USUniversity of York · GB

Funding

Effectiveness of Low-dose Theophylline for the Management of Biomass-associated COPD in PeruK23HL146946 · NHLBI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI SIDDHARTHAN, TRISHUL · 2019 to 2023
$985k
NHLBI NIH HHS K23 HL146946
6 · The paper itself

Abstract

introductionDespite the rising burden of chronic respiratory disease globally, and although many respiratory medications are included in the World Health Organization Essential Medications List (WHO-EML), there is limited information concerning the availability and affordability of treatment drugs for respiratory conditions in low- and middle-income countries (LMICs).

methodsAll public and private pharmacies in catchment areas of the Global Excellence in COPD outcomes (GECo) study sites in Bhaktapur, Nepal, Lima, Peru, and Nakaseke, Uganda, were approached in 2017-2019 to assess pricing and availability of medications for the management of asthma and COPD.

resultsWe surveyed all 63 pharmacies in respective study areas in Nepal (95.2% private), 104 pharmacies in Peru (94.2% private) and 53 pharmacies in Uganda (98.1% private). The availability of any medication for respiratory disease was higher in private (93.3%) compared to public (73.3%) pharmacies. Salbutamol (WHO-EML) monotherapy in any formulation was the most commonly available respiratory medication among the three sites (93.7% Nepal, 86.5% Peru and 79.2% Uganda) while beclomethasone (WHO-EML) was only available in Peru (33.7%) and Nepal (22%). LABA-LAMA combination therapy was only available in Nepal (14.3% of pharmacies surveyed). The monthly treatment cost of respiratory medications was lowest in Nepal according to several cost metrics: the overall monthly cost, the median price ratio comparing medication costs to international reference prices at time of survey in dollars, and in terms of days' wages of the lowest-paid government worker. For the treatment of intermittent asthma, defined as 100 mcg Salbutamol/Albuterol inhaler, days' wages ranged from 0.47 days in Nepal and Peru to 3.33 days in Uganda.

conclusionThe availability and pricing of respiratory medications varied across LMIC settings, with medications for acute care of respiratory diseases being more widely available than those for long-term management.

Identifiers

PMID36962898
PMCPMC10021856
OpenAlexW4311691833

What Socratic holds

Textfull text, public
LicenceCC0
measurements read76
reference markers read8
identifiers read6
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.