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Too Costly & Too Scarce

Ewen, M.A.

2016

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Link to publication in VU Research Portal

citation for published version (APA)

Ewen, M. A. (2016). Too Costly & Too Scarce: Price, availability and affordability of medicines in low- and

middle-income countries.

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ϭϱϴ ϮϬ͘ ĂŐ,ĂŵŵĂƌƐŬũŽůĚ&ŽƵŶĚĂƟŽŶ͘DĂŬŝŶŐŶĂƟŽŶĂůĚƌƵŐƉŽůŝĐŝĞƐĂĚĞǀĞůŽƉŵĞŶƚƉƌŝŽƌŝƚǇ͗ĂƐƚƌĂƚĞŐǇƉĂƉĞƌ ĂŶĚƐŝǆĐŽƵŶƚƌǇƐƚŽƌŝĞƐ͘hƉƉƐĂůĂ͗ĂŐ,ĂŵŵĂƌƐŬũŽůĚ&ŽƵŶĚĂƟŽŶ͕ϭϵϵϱ Ϯϭ͘ ͚ƚ,ŽĞŶ͘WƌŝǀĂƚĞWĂƚĞŶƚƐĂŶĚWƵďůŝĐ,ĞĂůƚŚ͘ŵƐƚĞƌĚĂŵ͗,ĞĂůƚŚĐƟŽŶ/ŶƚĞƌŶĂƟŽŶĂů͕ϮϬϭϲ͘ǀĂŝůĂďůĞ at ŚƩƉ͗ͬͬĂĐĐĞƐƐƚŽŵĞĚŝĐŝŶĞƐ͘ŽƌŐͬ ϮϮ͘ tĂƚĂů :͘ WŚĂƌŵĂĐĞƵƟĐĂů ƉĂƚĞŶƚƐ͕ ƉƌŝĐĞƐ ĂŶĚ ǁĞůĨĂƌĞ ůŽƐƐĞƐ͗ WŽůŝĐǇ ŽƉƟŽŶƐ ĨŽƌ /ŶĚŝĂ ƵŶĚĞƌ ƚŚĞ tdK dZ/W^ĂŐƌĞĞŵĞŶƚ͘The World EconomyϮϬϬϬ͖Ϯϯ;ϱͿ͗ϳϯϯͲϱϮ͘

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ϯϵ͘ <ŽƚǁĂŶŝ͕ǁĞŶD͕ĞǇ͕/ǇĞƌ^͕>ĂŬƐŚŵŝW<͕WĂƚĞ͕͕ZĂŵĂŶ<͕^ŝŶŐŚĂů'>͕dŚĂǁĂŶŝs͕dƌŝƉĂƚŚŝ^͕ >ĂŝŶŐZ͘WƌŝĐĞƐĂŶĚĂǀĂŝůĂďŝůŝƚǇŽĨĐŽŵŵŽŶŵĞĚŝĐŝŶĞƐĂƚƐŝǆƐŝƚĞƐŝŶ/ŶĚŝĂƵƐŝŶŐĂƐƚĂŶĚĂƌĚŵĞƚŚŽĚŽůŽŐǇ͘

/ndian : Med ZeƐϮϬϬϳ͖ϭϮϱ͗ϲϰϱʹϱϰ͘

ϰϬ͘ ŚĂŚĂů,^͕^ƚ&Žƌƚ͕E͘ĂŶĚĞƌŽ͕>͘ǀĂŝůĂďŝůŝƚǇ͕ƉƌŝĐĞƐĂŶĚĂīŽƌĚĂďŝůŝƚǇŽĨĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐŝŶ,ĂŝƟ͘J

Glob HealthϮϬϭϯĞĐ͖ϯ;ϮͿ͗ϬϮϬϰϬϱ͘Žŝ͗ϭϬ͘ϳϭϴϵͬũŽŐŚ͘Ϭϯ͘ϬϮϰϬϱ͘

ϰϭ͘ zĂŶŐ,͕ŝď,,͕ŚƵD͕Yŝ'͕ŚĂŶŐy͘WƌŝĐĞƐ͕ĂǀĂŝůĂďŝůŝƚǇĂŶĚĂīŽƌĚĂďŝůŝƚǇŽĨĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐŝŶ rural areas of Hubei Province, China. Health Policy PlanϮϬϭϬ͖Ϯϱ͗ϮϭϵͲϮϮϵ͘

ϰϮ͘ 'ĂŶŐĂ^ĞŶĂƌĂƚŚŶĂ^D>͕DĂŶŶĂƉƉĞƌƵŵĂ͕ZŽŚŝŶŝ&ĞƌŶĂŶĚŽƉƵůůĞD͘DĞĚŝĐŝŶĞƉƌŝĐĞƐ͕ĂǀĂŝůĂďŝůŝƚǇĂŶĚ ĂīŽƌĚĂďŝůŝƚǇŝŶ^ƌŝ>ĂŶŬĂ͘Indian J PharmacolϮϬϭϭ&Ğď͖ϰϯ;ϭͿ͗ϲϬͲϲϯ͘ ϰϯ͘ :ŝĂŶŐ D͕ zĂŶŐ ^͕ zĂŶ <͕ >ŝƵ :͕ ŚĂŽ :͕&ĂŶŐ z͘ DĞĂƐƵƌŝŶŐ ĂĐĐĞƐƐ ƚŽ ŵĞĚŝĐŝŶĞƐ͗ Ă ƐƵƌǀĞǇ ŽĨ ƉƌŝĐĞƐ͕ ĂǀĂŝůĂďŝůŝƚǇĂŶĚĂīŽƌĚĂďŝůŝƚǇŝŶ^ŚĂĂŶǆŝWƌŽǀŝŶĐĞŽĨŚŝŶĂ͘PLoS ONEϴ;ϴͿ͗ĞϳϬϴϯϲ͘ĚŽŝ͗ϭϬ͘ϭϯϳϭͬũŽƵƌŶĂů͘ ƉŽŶĞ͘ϬϬϳϬϴϯϲ͘ ϰϰ͘ :ŝĂŶŐD͕ŚŽƵ͕tƵ>͕^ŚĞŶY͕>ǀ͕tĂŶŐy͕zĂŶŐ^͕&ĂŶŐz͘DĞĚŝĐŝŶĞƉƌŝĐĞƐ͕ĂǀĂŝůĂďŝůŝƚǇ͕ĂŶĚĂīŽƌĚĂďŝůŝƚǇ ŝŶƚŚĞ^ŚĂĂŶǆŝWƌŽǀŝŶĐĞŝŶŚŝŶĂ͗ŝŵƉůŝĐĂƟŽŶƐĨŽƌƚŚĞĨƵƚƵƌĞ͘Int J Clin PharmϮϬϭϱ&Ğď͖ϯϳ;ϭͿ͗ϭϮͲϭϳ͘ ĚŽŝ͗ϭϬ͘ϭϬϬϳͬƐϭϭϬϵϲͲϬϭϰͲϬϬϯϳͲϰ͘

ϰϱ͘ ^ŚĂƌŵĂ͕ZŽƌĚĞŶ>͕ǁĞŶD͕>ĂŝŶŐZ͘ǀĂůƵĂƟŶŐĂǀĂŝůĂďŝůŝƚǇĂŶĚƉƌŝĐĞŽĨĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐŝŶŽƐƚŽŶ ĂƌĞĂ;DĂƐƐĂĐŚƵƐĞƩƐ͕h^ͿƵƐŝŶŐƚŚĞt,Kͬ,/ŵĞƚŚŽĚŽůŽŐǇ͘J Pharm Policy PractϮϬϭϲƉƌϱ͖ϵ͖ϭϮ͘ ĚŽŝ͗ϭϬ͘ϭϭϴϲͬƐϰϬϱϰϱͲϬϭϲͲϬϬϱϵͲϱ͘

ϰϲ͘ ĞƌƚŽůĚŝ ͕ ,ĞůĨĞƌ W͕ ĂŵĂƌŐŽ >͕ dĂǀĂƌĞƐ Eh͕ <ĂŶĂǀŽƐ W͘ /Ɛ ƚŚĞ ƌĂǌŝůŝĂŶ ƉŚĂƌŵĂĐĞƵƟĐĂů ƉŽůŝĐǇ ĞŶƐƵƌŝŶŐƉŽƉƵůĂƟŽŶĂĐĐĞƐƐƚŽĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐ͍Global HealthϮϬϭϮ͖ϴ͗ϲ͘ĚŽŝ͗ϭϬ͘ϭϭϴϲͬϭϳϰϰͲϴϲϬϯͲ ϴͲϲ͘

ϰϳ͘ EŐƵǇĞŶd͕<ŶŝŐŚƚZ͕DĂŶƚ͕DŝŶŚĂŽY͕ƵƚŽŶ͕D͘DĞĚŝĐŝŶĞƉƌŝĐĞƐ͕ĂǀĂŝůĂďŝůŝƚǇĂŶĚĂīŽƌĚĂďŝůŝƚǇŝŶ Vietnam. SoƵthern Med ZeǀieǁϮϬϬϵ͖Ϯ͗ϮͲϵ͘

ϰϴ͘ ^ŽŽŬƐƌŝǁŽŶŐ ͕ zŽŽŶŐƚŚŽŶŐ t͕ ^ƵǁĂƩĂŶĂƉƌĞĞĚĂ ^͕ ŚĂŶũĂƌƵƉŽƌŶ &͘ DĞĚŝĐŝŶĞ ƉƌŝĐĞƐ ŝŶ dŚĂŝůĂŶĚ͗ Ă result of no medicine pricing policy. SoƵthern Med ZeǀieǁϮϬϬϵϮ͖Ϯ͗ϭϬͲϭϰ͘

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ϭϲϬ ϱϱ͘ tŚǇƚĞ W͕ ,Ăůů ͘ ZĞǀŝĞǁ ^ĞƌŝĞƐ ŽĨ WŚĂƌŵĂĐĞƵƟĐĂů WƌŝĐŝŶŐ WŽůŝĐŝĞƐ ĂŶĚ /ŶƚĞƌǀĞŶƟŽŶƐ͗ tŽƌŬŝŶŐ WĂƉĞƌ ϲ͗ dŚĞ ƌŽůĞ ŽĨ ŚĞĂůƚŚ ƚĞĐŚŶŽůŽŐǇ ĂƐƐĞƐƐŵĞŶƚ ŝŶ ŵĞĚŝĐŝŶĞ ƉƌŝĐŝŶŐ ĂŶĚ ƌĞŝŵďƵƌƐĞŵĞŶƚ͘ tŽƌůĚ ,ĞĂůƚŚ KƌŐĂŶŝǌĂƟŽŶĂŶĚ,ĞĂůƚŚĐƟŽŶ/ŶƚĞƌŶĂƟŽŶĂů͕ϮϬϭϰ͘ǀĂŝůĂďůĞĂƚŚƩƉ͗ͬͬŚĂŝǁĞď͘ŽƌŐͬǁŚĂƚͲǁĞͲĚŽͬƉƌŝĐĞͲ ĂǀĂŝůĂďŝůŝƚǇͲĂīŽƌĚĂďŝůŝƚǇͬƌĞƐŽƵƌĐĞƐͲĨŽƌͲƉƌŝĐŝŶŐͲƉŽůŝĐŝĞƐͬ ϱϲ͘ hŶŝƚĞĚ EĂƟŽŶƐ 'ĞŶĞƌĂů ƐƐĞŵďůǇ͘ WŽůŝƟĐĂů ĚĞĐůĂƌĂƟŽŶ ŽĨ ƚŚĞ ,ŝŐŚͲůĞǀĞů DĞĞƟŶŐ ŽĨ ƚŚĞ 'ĞŶĞƌĂů ƐƐĞŵďůǇ ŽŶ ƚŚĞ ƉƌĞǀĞŶƟŽŶ ĂŶĚ ĐŽŶƚƌŽů ŽĨ ŶŽŶͲĐŽŵŵƵŶŝĐĂďůĞ ĚŝƐĞĂƐĞƐ͘ EĞǁ zŽƌŬ͗ hŶŝƚĞĚ EĂƟŽŶƐ 'ĞŶĞƌĂůƐƐĞŵďůǇ͕ϮϬϭϮ͘ŽĐƵŵĞŶƚEŽ͘ϲϲͬϮ ϱϳ͘ tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶ͘'ůŽďĂůĐƟŽŶWůĂŶĨŽƌƚŚĞWƌĞǀĞŶƟŽŶĂŶĚŽŶƚƌŽůŽĨEŽŶĐŽŵŵƵŶŝĐĂďůĞ ŝƐĞĂƐĞƐϮϬϭϯͲϮϬϮϬ͘'ĞŶĞǀĂ͗tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶ͕ϮϬϭϯ͘ ϱϴ͘ /ǇĞŶŐĂƌ^͕dĂǇͲdĞŽ<͕sŽŐůĞƌ^͕ĞǇĞƌW͕tŝŬƚŽƌ^͕ĚĞ:ŽŶĐŚĞƌĞ<ĂŶĚ,ŝůů^͘WƌŝĐĞƐ͕ĐŽƐƚƐĂŶĚĂīŽƌĚĂďŝůŝƚǇ ŽĨ ŶĞǁ ŵĞĚŝĐŝŶĞƐ ĨŽƌ ,ĞƉĂƟƟƐ ŝŶ ϯϬ ĐŽƵŶƚƌŝĞƐ͗ ĂŶ ĞĐŽŶŽŵŝĐ ĂŶĂůǇƐŝƐ͘ W>Ž^ DĞĚ ϮϬϭϲ͖ ϭϯ;ϱͿ͗ ĞϭϬϬϮϬϯϮ͘ĚŽŝ͗ϭϬ͘ϭϯϳϭͬũŽƵƌŶĂů͘ƉŵĞĚ͘ϭϬϬϮϬϯϮ͘ƐϬϬϯ͘ ϱϵ͘ ͚ƚ ,ŽĞŶ ͘ ĐĐĞƐƐ ƚŽ ĐĂŶĐĞƌ ƚƌĞĂƚŵĞŶƚ͗ Ă ƐƚƵĚǇ ŽĨ ŵĞĚŝĐŝŶĞ ƉƌŝĐŝŶŐ ŝƐƐƵĞƐ ǁŝƚŚ ƌĞĐŽŵŵĞŶĚĂƟŽŶƐ ĨŽƌ ŝŵƉƌŽǀŝŶŐ ĂĐĐĞƐƐ ƚŽ ĐĂŶĐĞƌ ŵĞĚŝĐĂƟŽŶ͘ KǆĨĂŵ '͕ ϮϬϭϱ͘ ǀĂŝůĂďůĞ Ăƚ ŚƩƉ͗ͬͬƉŽůŝĐǇͲƉƌĂĐƟĐĞ͘ ŽǆĨĂŵ͘ŽƌŐ͘ƵŬͬƉƵďůŝĐĂƚŝŽŶƐͬĂĐĐĞƐƐͲƚŽͲĐĂŶĐĞƌͲƚƌĞĂƚŵĞŶƚͲĂͲƐƚƵĚǇͲŽĨͲŵĞĚŝĐŝŶĞͲƉƌŝĐŝŶŐͲŝƐƐƵĞƐͲǁŝƚŚͲ ƌĞĐŽŵŵĞŶĚĂƟͲϯϰϰϬϳϬ͘ ϲϬ͘ ĞŶƚƌĞĨŽƌWŚĂƌŵĂĐĞƵƟĐĂůDĂŶĂŐĞŵĞŶƚ͘ĞĮŶŝŶŐĂŶĚŵĞĂƐƵƌŝŶŐĂĐĐĞƐƐƚŽĞƐƐĞŶƟĂůĚƌƵŐƐ͕ǀĂĐĐŝŶĞƐ ĂŶĚŚĞĂůƚŚĐŽŵŵŽĚŝƟĞƐ͗ƌĞƉŽƌƚŽĨƚŚĞt,KͲD^,ĐŽŶƐƵůƚĂƟǀĞŵĞĞƟŶŐ͘ϮϬϬϯ͘&ĞƌŶĞǇͲsŽůƚĂŝƌĞ͕&ƌĂĐĞ͕ ĞĐĞŵďĞƌϭϭͲϭϯ͕ϮϬϬϬ͘ ϲϭ͘ tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶ͘ƋƵŝƚĂďůĞĂĐĐĞƐƐƚŽĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐ͗ĂĨƌĂŵĞǁŽƌŬĨŽƌĐŽůůĞĐƟǀĞĂĐƟŽŶ͘ WŽůŝĐǇWĞƌƐƉĞĐƟǀĞƐŽŶDĞĚŝĐŝŶĞƐϮϬϬϰĐ͖ϴ͗ϭͲϲ͘ ϲϮ͘ &ƌŽƐƚ/:͕ZĞŝĐŚDZ͘,ŽǁĚŽŐŽŽĚŚĞĂůƚŚƚĞĐŚŶŽůŽŐŝĞƐŐĞƚƚŽƉŽŽƌƉĞŽƉůĞŝŶƉŽŽƌĐŽƵŶƚƌŝĞƐ͘ŽƐƚŽŶD͗ ,ĂƌǀĂƌĚĞŶƚƌĞĨŽƌWŽƉƵůĂƟŽŶĂŶĚĞǀĞůŽƉŵĞŶƚ^ƚƵĚŝĞƐ͕ϮϬϭϬ͘ ϲϯ͘ ŝŐĚĞůŝD͕Ăƌƚ:͕dŽŵƐŽŶ'͕>ĂŝŶŐZ͕'ŚĂīĂƌ͕ƵũĂƌĚŝŶ͕sĂŶĂŵŵĞt͘ĐĐĞƐƐƚŽŵĞĚŝĐŝŶĞƐĨƌŽŵĂ ŚĞĂůƚŚƐǇƐƚĞŵƉĞƌƐƉĞĐƟǀĞ͘Health Policy PlanϮϬϭϯ͖Ϯϴ͗ϲϵϮͲϳϬϰ͘

ϲϰ͘ ĞƌĂŶ͕zƵĚŬŝŶ:^͘ŝĂďĞƚĞƐĐĂƌĞŝŶƐƵďͲ^ĂŚĂƌĂŶĨƌŝĐĂ͘LancetϮϬϬϲ͖ϯϲϴ͗ϭϲϴϵͲϭϲϵϱ͘ ϲϱ͘ /ŶĨŽƌŵĂƟŽŶĂďŽƵƚƚŚĞ/^^^ƚƵĚǇŝƐĂǀĂŝůĂďůĞĂƚŚƩƉ͗ͬͬŚĂŝǁĞď͘ŽƌŐͬǁŚĂƚͲǁĞͲĚŽͬĂĐĐŝƐƐͬ

ϲϲ͘ hEZt͘dŚĞĂŶŶƵĂůƌĞƉŽƌƚƉĨƚŚĞĞƉĂƌƚŵĞŶƚŽĨ,ĞĂůƚŚ͘ŵŵĂŶ͗hEZt͕ϮϬϭϬ͘ǀĂŝůĂďůĞĂƚŚƩƉ͗ͬͬ ǁǁǁ͘ƵŶƌǁĂ͘ŽƌŐͬƵƐĞƌĮůĞƐͬϮϬϭϭϬϱϮϬϲϮϮϮϬ͘ƉĚĨ

ϲϳ͘ <ĂƉůĂŶt͕Zŝƚǌ>^͕sŝƚĞůůŽD͘>ŽĐĂůƉƌŽĚƵĐƟŽŶŽĨŵĞĚŝĐĂůƚĞĐŚŶŽůŽŐŝĞƐĂŶĚŝƚƐĞīĞĐƚŽŶĂĐĐĞƐƐŝŶůŽǁ ĂŶĚŵŝĚĚůĞŝŶĐŽŵĞĐŽƵŶƚƌŝĞƐ͗ĂƐǇƐƚĞŵĂƟĐƌĞǀŝĞǁŽĨƚŚĞůŝƚĞƌĂƚƵƌĞ. SoƵth Med Zeǀ. ϮϬϭϭĞĐ͖ϰ;ϮͿ͗ ϱϭͲϲϭ͘ĚŽŝ͗ϭϬ͘ϱϲϱϱͬƐŵƌ͘ǀϰŝϮ͘ϭϬϬϮ͘

ϲϴ͘ ^ǁĞŝůĞŚt͕:ĂƌĂĚĂƚE͕DƵƐƚĂĨĂ͘ŶƟďŝŽƟĐĚƌƵŐĐŽƐƚǀĂƌŝĂƟŽŶƐŝŶWĂůĞƐƟŶĞ͗ƉŚǇƐŝĐŝĂŶƐĂŶĚƉĂƟĞŶƚƐ dilemma. nͲNaũah hniǀ. J. ZeƐ. ϮϬϬϰ͖ϭϴ;ϭͿ͗ϳϯͲϳϵ͘

ϲϵ͘ <ƵĂŶƉŽƚŚ:͘WĂƚĞŶƚƐĂŶĚĂĐĐĞƐƐƚŽĂŶƟƌĞƚƌŽǀŝƌĂůŵĞĚŝĐŝŶĞƐŝŶsŝĞƚŶĂŵĂŌĞƌtŽƌůĚdƌĂĚĞKƌŐĂŶŝǌĂƟŽŶ accession. J World Intell PropϮϬϬϳ͖ϭϬ͗ϮϬϭͲϮϮϰ͘

ϳϬ͘ ŚŽǁĚƵƌǇE͕<ĂďŝƌZ͘WĞƌƉŝůůƉƌŝĐĞĚŝīĞƌĞŶĐĞƐĂĐƌŽƐƐƚŚĞƌĂƉĞƵƟĐĐĂƚĞŐŽƌŝĞƐ͗ĂƐƚƵĚǇŽĨƚŚĞĞƐƐĞŶƟĂů ĚƌƵŐďƌĂŶĚƐŵĂƌŬĞƚĞĚďǇŵƵůƟŶĂƟŽŶĂůĂŶĚůŽĐĂůƉŚĂƌŵĂĐĞƵƟĐĂůĐŽŵƉĂŶŝĞƐŝŶĂŶŐůĂĚĞƐŚ͘African J

MarŬeƟnŐ MŐtϮϬϬϵ͖ϭ͗ϮϮϬͲϮϮϲ͘

ϳϭ͘ ^ŚĂĮĞ͕,ĂƐƐĂůŝD͘WƌŝĐĞĐŽŵƉĂƌŝƐŽŶďĞƚǁĞĞŶŝŶŶŽǀĂƚŽƌĂŶĚŐĞŶĞƌŝĐŵĞĚŝĐŝŶĞƐƐŽůĚďǇĐŽŵŵƵŶŝƚǇ pharmacies in the state of Penang, Malaysia. J Generic MedϮϬϬϴ͖ϲ͗ϯϱͲϰϮ͘

ϳϮ͘ tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶ͘DĞĚŝĐŝŶĞƐ^ƚƌĂƚĞŐǇϮϬϬϴͲϮϬϭϯ͘'ĞŶĞǀĂ͗tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶ͕ϮϬϬϴ͘ ϳϯ͘ DĂĚĚĞŶ :D͕ ĚƐŽŶ D͕ ǁĞŶ D͕ >ĂŝŶŐ Z͕ ^ƚĞƉŚĞŶƐ W͕ ZŽƐƐͲĞŐŶĂŶ ͘ DĞĂƐƵƌŝŶŐ ŵĞĚŝĐŝŶĞ ƉƌŝĐĞƐ ŝŶ

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ϭϲϭ

ϳϰ͘ DĞŶĚŝƐ^͕&ƵŬŝŶŽ<͕ĂŵĞƌŽŶ͕>ĂŝŶŐZ͕&ŝůŝƉĞ:ƌ͕KƵƐƐĂŵĂ<͕>ĞŽǁƐŬŝ:͕ǁĞŶD͘dŚĞĂǀĂŝůĂďŝůŝƚǇ ĂŶĚĂīŽƌĚĂďŝůŝƚǇŽĨƐĞůĞĐƚĞĚĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐĨŽƌĐŚƌŽŶŝĐĚŝƐĞĂƐĞƐŝŶƐŝǆůŽǁͲĂŶĚŵŝĚĚůĞͲŝŶĐŽŵĞ countries. ulleƟn World Health OrŐan ϮϬϬϳ͖ϴϱ;ϰͿ͗ϮϳϵͲϮϴϳ͘

ϳϱ͘ DƵƐŽŬĞ ͕ ^ŽĚĞŵĂŶŶ D͘ ǀĂŝůĂďŝůŝƚǇ ŽĨ ĞƐƐĞŶƟĂů ŵĞĚŝĐŝŶĞƐ ĂĐƌŽƐƐ ůĞǀĞůƐ ŽĨ ĐĂƌĞ ŝŶ 'ƵůƵ ŝƐƚƌŝĐƚ͕ EŽƌƚŚĞƌŶhŐĂŶĚĂ͘Am J Pharm SciϮϬϭϲ͖ϰ;ϭͿ͗ϭϭͲϭϰĚŽŝ͗ϭϬ͘ϭϮϲϵϭͬĂũƉƐͲϰͲϭͲϯ͘

ϳϲ͘ DŚůĂŶŐĂ^͕^ƵůĞŵĂŶ&͘WƌŝĐĞ͕ĂǀĂŝůĂďŝůŝƚǇĂŶĚĂīŽƌĚĂďŝůŝƚǇŽĨŵĞĚŝĐŝŶĞƐ͘Afr J Prm Health Care Fam

MedϮϬϭϰ͖ϲ;ϭͿ͕ƌƚ͘ηϲϬϰ͕ϲƉĂŐĞƐ͘ĚŽŝ͗ϭϬ͘ϰϭϬϮͬƉŚĐĨŵ͘ǀϲŝϭ͘ϲϬϰ ϳϳ͘ sĂŶDŽƵƌŝŬD^D͕ĂŵĞƌŽŶ͕ǁĞŶD͕>ĂŝŶŐZK͘ǀĂŝůĂďŝůŝƚǇ͕ƉƌŝĐĞĂŶĚĂīŽƌĚĂďŝůŝƚǇŽĨĐĂƌĚŝŽǀĂƐĐƵůĂƌ ŵĞĚŝĐŝŶĞƐ͗ Ă ĐŽŵƉĂƌŝƐŽŶ ĂĐƌŽƐƐ ϯϲ ĐŽƵŶƚƌŝĞƐ ƵƐŝŶŐ t,Kͬ,/ ĚĂƚĂ͘ BMC Cardiovascular DisordersϮϬϭϬ͖ϭϬ͗ϮϱĚŽŝ͗ϭϬ͘ϭϭϴϲͬϭϰϳϭͲϮϮϲϭͲϭϬͲϮϱ͘ ϳϴ͘ sŽůŵĂŶ ͘ ŝƌĞĐƚ ĐŽƐƚƐ ĂŶĚ ĂǀĂŝůĂďŝůŝƚǇ ŽĨ ĚŝĂďĞƚĞƐ ŵĞĚŝĐŝŶĞƐ ŝŶ ůŽǁͲŝŶĐŽŵĞ ĂŶĚ ŵŝĚĚůĞͲŝŶĐŽŵĞ ĐŽƵŶƚƌŝĞƐ͘'ĞŶĞǀĂ͗tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶĂŶĚ,ĞĂůƚŚĐƟŽŶ/ŶƚĞƌŶĂƟŽŶĂů͕ϮϬϬϴ ϳϵ͘ ĂŵĞƌŽŶ͕ĂŶƐĂů͕ƵĂd͕,ŝůů^Z͕DŽƐŚĞ^>͕DĂŶƚĞůͲdĞĞƵǁŝƐƐĞ<͕^ĂǆĞŶĂ͕^͘DĂƉƉŝŶŐƚŚĞĂǀĂŝůĂďŝůŝƚǇ͕ ƉƌŝĐĞ͕ĂŶĚĂīŽƌĚĂďŝůŝƚǇŽĨĂŶƟĞƉŝůĞƉƟĐĚƌƵŐƐŝŶϰϲĐŽƵŶƚƌŝĞƐ͘EpilepsiaϮϬϭϮ͗ϭͲϴ͘ĚŽŝ͗ϭϬ͘ϭϭϭϭͬũ͘ϭϱϮϴͲ ϭϭϲϳ͘ϮϬϭϮ͘Ϭϯϰϰϲ͘ǆ ϴϬ͘ ĂŵĞƌŽŶ ͕ ZŽƵďŽƐ /͕ ǁĞŶ D͕ DĂŶƚĞůͲdĞĞƵǁŝƐƐĞ <͕ >ĞƵŅĞŶƐ ,'D͕ >ĂŝŶŐ ZK͘ ŝīĞƌĞŶĐĞƐ ŝŶ ƚŚĞ ĂǀĂŝůĂďŝůŝƚǇŽĨŵĞĚŝĐŝŶĞƐĨŽƌĐŚƌŽŶŝĐĂŶĚĂĐƵƚĞĐŽŶĚŝƟŽŶƐŝŶƚŚĞƉƵďůŝĐĂŶĚƉƌŝǀĂƚĞƐĞĐƚŽƌƐŽĨĚĞǀĞůŽƉŝŶŐ countries. Bull World Health Organ ϴϵ;ϲͿ͗ϮϳϵͲϮϴϳ͘

ϴϭ͘ hŶŝƚĞĚEĂƟŽŶƐD''ĂƉdĂƐŬ&ŽƌĐĞZĞƉŽƌƚ͘D''ŽĂůϴ͘dĂŬŝŶŐƐƚŽĐŬŽĨƚŚĞŐůŽďĂůƉĂƌƚŶĞƌƐŚŝƉĨŽƌ ĚĞǀĞůŽƉŵĞŶƚ͘EĞǁzŽƌŬ͗hŶŝƚĞĚEĂƟŽŶƐ͕ϮϬϭϱ͘ ϴϮ͘ /ŶƚĞůůĞĐƚƵĂůWƌŽƉĞƌƚǇtĂƚĐŚ͘t,KŝƌĞĐƚŽƌƋƵĞƐƟŽŶƐ/WZŝŐŚƚƐ͕ĚƌƵŐƉƌŝĐĞƐ͕ŝŶĚƵƐƚƌǇŝŶŇƵĞŶĐĞ͘ϮϬϭϱ͘ Available at ŚƩƉ͗ͬͬǁǁǁ͘ŝƉͲǁĂƚĐŚ͘ŽƌŐͬϮϬϭϱͬϭϭͬϭϮͬǁŚŽͲĚŝƌĞĐƚŽƌͲƋƵĞƐƟŽŶƐͲŝƉͲƌŝŐŚƚƐͲĚƌƵŐͲƉƌŝĐĞƐͲ ŝŶĚƵƐƚƌǇͲŝŶŇƵĞŶĐĞͬ ϴϯ͘ ŝ:ƵůŝŽ͕&ŝƌƚŚ:͕ƌŽĚŝĞD͘<ĂŝƐĞƌ,ĞĂůƚŚdƌĂĐŬŝŶŐWŽůů͗:ƵŶĞϮϬϭϱ͘dŚĞ,ĞŶƌǇ:͘<ĂŝƐĞƌ&ĂŵŝůǇ&ŽƵŶĚĂƟŽŶ͘ ǀĂŝůĂďůĞĂƚ͗ŚƩƉ͗ͬͬŬī͘ŽƌŐͬŚĞĂůƚŚͲĐŽƐƚƐͬƉŽůůͲĮŶĚŝŶŐͬŬĂŝƐĞƌͲŚĞĂůƚŚͲƚƌĂĐŬŝŶŐͲƉŽůůͲũƵŶĞͲϮϬϭϱͬ ϴϰ͘ Drug Watch ŚƩƉƐ͗ͬͬǁǁǁ͘ĚƌƵŐǁĂƚĐŚ͘ĐŽŵͬŵĂŶƵĨĂĐƚƵƌĞƌͬ ϴϱ͘ t,Kͬ,/ ƉƌŝĐĞ ĚĂƚĂďĂƐĞ͗ ƐƵƌǀĞǇƐ ŝŶ ^ŚĂĂŶǆŝ WƌŽǀŝŶĐĞ ŝŶ ϮϬϭϬ͕ ϮϬϭϮ ĂŶĚ ϮϬϭϰ͕ ^ŚĂŶŐŚĂŝ WƌŽǀŝŶĐĞ ϮϬϬϲ ĂŶĚ ^ŚĂŶĚŽŶŐ WƌŽǀŝŶĐĞ ϮϬϬϰ͘ ǀĂŝůĂďůĞ Ăƚ ŚƩƉ͗ͬͬŚĂŝǁĞď͘ŽƌŐͬǁŚĂƚͲǁĞͲĚŽͬƉƌŝĐĞͲĂǀĂŝůĂďŝůŝƚǇͲ ĂīŽƌĚĂďŝůŝƚǇͬƉƌŝĐĞͲĂǀĂŝůĂďŝůŝƚǇͲĚĂƚĂͬ ϴϲ͘ DŝŶŝƐƚƌǇ ŽĨ ,ĞĂůƚŚ͘ ϮϬϬϴď͘ ŚŝŶĂ ,ĞĂůƚŚ ^ƚĂƟƐƟĐĂů zĞĂƌďŽŽŬ ϮϬϬϴ͘ ǀĂŝůĂďůĞ Ăƚ ŚƩƉ͗ͬͬϲϭ͘ϰϵ͘ϭϴ͘ϲϱͬ ƉƵďůŝĐĮůĞƐͬďƵƐŝŶĞƐƐͬŚƚŵůĮůĞƐͬǌǁŐŬǌƚͬƉƚũŶũͬǇĞĂƌϮϬϬϴͬϰ͘Śƚŵ ϴϳ͘ tĞŶŚƵŝD͕tĞŶ͘dŚĞǌĞƌŽŵĂƌŬͲƵƉƉŽůŝĐǇĨŽƌĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐĂƚƉƌŝŵĂƌǇůĞǀĞůĨĂĐŝůŝƟĞƐ͘ŚŝŶĂĐĂƐĞ ƐƚƵĚǇ͘'ĞŶĞǀĂ͗tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶ͕ϮϬϭϱ͘ǀĂŝůĂďůĞĂƚŚƩƉ͗ͬͬǁǁǁ͘ǁŚŽ͘ŝŶƚͬŚĞĂůƚŚͺĮŶĂŶĐŝŶŐͬ ĚŽĐƵŵĞŶƚƐͬĸĐŝĞŶĐǇͺŚĞĂůƚŚͺƐǇƐƚĞŵƐͺŚŝŶĂͬĞŶͬ ϴϴ͘ ǁĞŶD͕:ŽŽƐƐĞ,:͕ĞƌĂŶ͕>ĂŝŶŐZ͘/ŶƐƵůŝŶƉƌŝĐĞƐ͕ĂǀĂŝůĂďŝůŝƚǇĂŶĚĂīŽƌĚĂďŝůŝƚǇŝŶϭϱůŽǁͲĂŶĚŵŝĚĚůĞͲ ŝŶĐŽŵĞĐŽƵŶƚƌŝĞƐ͘,ĞĂůƚŚĐƟŽŶ/ŶƚĞƌŶĂƟŽŶĂů͕ϮϬϭϲ;ĨŽƌƚŚĐŽŵŝŶŐͿ ϴϵ͘ <ŽƚǁĂŶŝ͕>ĞǀŝƐŽŶ>͘WƌŝĐĞĐŽŵƉŽŶĞŶƚƐĂŶĚĂĐĐĞƐƐƚŽŵĞĚŝĐŝŶĞƐŝŶĞůŚŝ͕/ŶĚŝĂ͘ǀĂŝůĂďůĞĂƚŚƩƉ͗ͬͬ ĂƉƉƐ͘ǁŚŽ͘ŝŶƚͬŵĞĚŝĐŝŶĞĚŽĐƐͬĚŽĐƵŵĞŶƚƐͬƐϭϵϮϬϴĞŶͬƐϭϵϮϬϴĞŶ͘ƉĚĨ ϵϬ͘ tĂŶŝŶŐ ͕ DĂĚĚŝǆ : ĂŶĚ ^ŽƵĐǇ >͘ ĂůĂŶĐŝŶŐ ŵĞĚŝĐŝŶĞ ƉƌŝĐĞƐ ĂŶĚ ďƵƐŝŶĞƐƐ ƐƵƐƚĂŝŶĂďŝůŝƚǇ͗ ĂŶĂůǇƐĞƐ ŽĨ ƉŚĂƌŵĂĐǇ ĐŽƐƚƐ͕ ƌĞǀĞŶƵĞƐ ĂŶĚ ƉƌŽĮƚ ƐŚĞĚ ůŝŐŚƚ ŽŶ ƌĞƚĂŝů ŵĞĚŝĐŝŶĞ ŵĂƌŬͲƵƉƐ ŝŶ ƌƵƌĂů <ǇƌŐǇǌƐƚĂŶ͘

BMC Health Services Zesearch ϮϬϭϬ͖ ϭϬ͗ ϮϬϱ͘ ǀĂŝůĂďůĞ Ăƚ ŚƩƉ͗ͬͬǁǁǁ͘ďŝŽŵĞĚĐĞŶƚƌĂů͘ĐŽŵͬϭϰϳϮͲ

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ϵϮ͘ ƵƌŽƉĞĂŶ ŽŵŵŝƐƐŝŽŶ tŽƌŬŝŶŐ ŽĐƵŵĞŶƚ͗ ĞǀĞůŽƉŝŶŐ ĐŽƵŶƚƌŝĞƐ͛ ĚƵƟĞƐ ĂŶĚ ƚĂǆĞƐ ŽŶ ĞƐƐĞŶƟĂů medicines used in the treatment of the major communicable diseases. Brussels, European Commission, ϮϬϬϯ͘ ϵϯ͘ >ĞǀŝƐŽŶ>͕>ĂŝŶŐZ͘dŚĞŚŝĚĚĞŶĐŽƐƚƐŽĨĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐ͘ƐƐĞŶƟĂůƌƵŐƐDŽŶŝƚŽƌϮϬϬϯ͖ϯϯ͗ϮϬͲϮϭ͘ Available at ŚƩƉ͗ͬͬĂƉƉƐ͘ǁŚŽ͘ŝŶƚͬŵĞĚŝĐŝŶĞĚŽĐƐͬĞŶͬĚͬ:ƐϰϵϰϭĞͬϰ͘ϴ͘Śƚŵůη:ƐϰϵϰϭĞ͘ϰ͘ϴ ϵϰ͘ DŝůůĞƌZ'͕^ĞĐƌĞƐƚD͕^ŚĂƌŵĂZ<͕^ŽŶŐĞƌd:͕KƌĐŚĂƌĚd:͘/ŵƉƌŽǀĞŵĞŶƚƐŝŶƚŚĞůŝĨĞĞǆƉĞĐƚĂŶĐǇŽĨƚǇƉĞϭ ĚŝĂďĞƚĞƐ͗ƚŚĞWŝƩƐďƵƌŐƉŝĚĞŵŝŽůŽŐǇŽĨŝĂďĞƚĞƐŽŵƉůŝĐĂƟŽŶƐƐƚƵĚǇĐŽŚŽƌƚ͘DiabetesϮϬϭϮ͖ϲϭ͗ϮϵϴϳͲ ϵϮ͘ ϵϱ͘ tŝƌƚǌ s͘ /ŶƐƵůŝŶ DĂƌŬĞƚ WƌŽĮůĞ͘ ŵƐƚĞƌĚĂŵ͗ ,ĞĂůƚŚ ĐƟŽŶ /ŶƚĞƌŶĂƟŽŶĂů͕ ϮϬϭϲ͘ ǀĂŝůĂďůĞ Ăƚ ŚƩƉ͗ͬͬ ŚĂŝǁĞď͘ŽƌŐͬǁƉͲĐŽŶƚĞŶƚͬƵƉůŽĂĚƐͬϮϬϭϲͬϬϰͬ/^^ͺ/ŶƐƵůŝŶͲDĂƌŬĞƚͲWƌŽĮůĞͺ&/E>͘ƉĚĨ ϵϲ͘ ǇůƐƚW͕^ŝŵĞŽŶƐ^͘ŽĞƐƚŚĞŵĂƌŬĞƚƐŚĂƌĞŽĨŐĞŶĞƌŝĐŵĞĚŝĐŝŶĞƐŝŶŇƵĞŶĐĞƚŚĞƉƌŝĐĞůĞǀĞů͍ƵƌŽƉĞĂŶ analysis. PharmacoEconomic.ϮϬϭϭ͖Ϯϵ;ϭϬͿ͗ϴϳϱͲϴϮ͘ĚŽŝ͗ϭϬ͘ϮϭϲϱͬϭϭϱϴϱϵϳϬͲϬϬϬϬϬϬϬϬϬͲϬϬϬϬϬ͘ ϵϳ͘ KůƐŽŶ >D͕ tĞŶĚůŝŶŐ t͘ dŚĞ ĞīĞĐƚ ŽĨ ŐĞŶĞƌŝĐ ĚƌƵŐ ĐŽŵƉĞƟƟŽŶ ŽŶ ŐĞŶĞƌŝĐ ĚƌƵŐ ƉƌŝĐĞƐ ĚƵƌŝŶŐ ƚŚĞ ,ĂƚĐŚͲtĂǆŵĂŶϭϴϬͲĚĂǇĞǆĐůƵƐŝǀŝƚǇƉĞƌŝŽĚ͘tŽƌŬŝŶŐƉĂƉĞƌEŽ͘ϯϭϳƉƌŝůϮϬϭϯ͕ƵƌĞĂƵŽĨĐŽŶŽŵŝĐƐ &ĞĚĞƌĂůdƌĂĚĞŽŵŵŝƐƐŝŽŶ͕tĂƐŚŝŶŐƚŽŶ͕h^͘ǀĂŝůĂďůĞĂƚŚƩƉƐ͗ͬͬǁǁǁ͘ŌĐ͘ŐŽǀͬƐŝƚĞƐͬĚĞĨĂƵůƚͬĮůĞƐͬ ĚŽĐƵŵĞŶƚƐͬƌĞƉŽƌƚƐͬĞƐƚŝŵĂƚŝŶŐͲĞĨĨĞĐƚͲĞŶƚƌǇͲŐĞŶĞƌŝĐͲĚƌƵŐͲƉƌŝĐĞƐͲƵƐŝŶŐͲŚĂƚĐŚͲǁĂǆŵĂŶͲĞǆĐůƵƐŝǀŝƚǇͬ ǁƉϯϭϳ͘ƉĚĨ ϵϴ͘ ĞƌĂŶ͘/ŵƉƌŽǀŝŶŐĂĐĐĞƐƐƚŽŝŶƐƵůŝŶ͗ǁŚĂƚĐĂŶďĞĚŽŶĞ͍Diabetes ManageϮϬϭϭ͖ϭ͗ϲϳͲϳϲ͘ ϵϵ͘ ǁĞŶD͕ :ŽŽƐƐĞ,:ĂŶĚƐŚŝŐďŝĞW͘/ŶƐƵůŝŶWƌŝĐĞƐWƌŽĮůĞ͘ŵƐƚĞƌĚĂŵ͗,ĞĂůƚŚĐƟŽŶ/ŶƚĞƌŶĂƟŽŶĂů͕ϮϬϭϲ͘ Available at ŚƩƉ͗ͬͬŚĂŝǁĞď͘ŽƌŐͬǁƉͲĐŽŶƚĞŶƚͬƵƉůŽĂĚƐͬϮϬϭϲͬϬϰͬ/^^ͲWƌŝĐĞƐͲƌĞƉŽƌƚͺ&/E>Ͳϭ͘ƉĚĨ ϭϬϬ͘ tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶ͘dĞŶĨĂĐƚƐŽŶĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐ͘&ĂĐƚEŽ͘ϭ͘ǀĂŝůĂďůĞĂƚŚƩƉ͗ͬͬǁǁǁ͘ǁŚŽ͘ ŝŶƚͬĨĞĂƚƵƌĞƐͬĨĂĐƞŝůĞƐͬĞƐƐĞŶƟĂůͺŵĞĚŝĐŝŶĞƐͬĞƐƐĞŶƟĂůͺŵĞĚŝĐŝŶĞƐͺĨĂĐƚƐͬĞŶͬ ϭϬϭ͘ tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶ͘dĞŶĨĂĐƚƐŽŶĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐ͘&ĂĐƚEŽ͘ϱ͘ǀĂŝůĂďůĞĂƚŚƩƉ͗ͬͬǁǁǁ͘ǁŚŽ͘ ŝŶƚͬĨĞĂƚƵƌĞƐͬĨĂĐƞŝůĞƐͬĞƐƐĞŶƟĂůͺŵĞĚŝĐŝŶĞƐͬĞƐƐĞŶƟĂůͺŵĞĚŝĐŝŶĞƐͺĨĂĐƚƐͬĞŶͬ ϭϬϮ͘ ŝǆŝƚ Z͕ sŝŶĂǇ D͕ :ĂǇĂƐƌĞĞ d͕ hďĞĚƵůůĂ ^͕ DĂŶŽŚĂƌ s^͕ ŚĂŶĚƌĂƐĞŬŚĂƌ E͘ ǀĂŝůĂďŝůŝƚǇ ŽĨ ĞƐƐĞŶƟĂů ŵĞĚŝĐŝŶĞƐ͗ƉƌŝŵĂƌǇŚĞĂůƚŚĐĂƌĞƉĞƌƐƉĞĐƟǀĞ͘Indian J PharmacolϮϬϭϭ͖ϰϯ;ϱͿ͗ϱϵϵͲϲϬϬ͘ ϭϬϯ͘ 'ŝƚĂŶũĂůŝ͕DĂŶŝŬĂŶĚĂŶ^͘ǀĂŝůĂďŝůŝƚǇŽĨĮǀĞĞƐƐĞŶƟĂůŵĞĚŝĐŝŶĞƐĨŽƌĐŚŝůĚƌĞŶŝŶƉƵďůŝĐŚĞĂůƚŚĨĂĐŝůŝƟĞƐ ŝŶ/ŶĚŝĂ͗ƐŶĂƉƐŚŽƚƐƵƌǀĞǇ͘J Pharmacol PharmacotherϮϬϭϭ͖Ϯ;ϮͿ͗ϵϱͲϵϵ͘ ϭϬϰ͘ ĂůĂƐƵďƌĂŵĂŶŝĂŵZ͕ĞŶĞƌĂŐĂŵĂ͕ZĂŶŐĂŶĂƚŚĂŶ^^͘ŶĂƟŽŶĂůƐƵƌǀĞǇŽĨĂǀĂŝůĂďŝůŝƚǇŽĨŬĞǇĞƐƐĞŶƟĂů ŵĞĚŝĐŝŶĞƐ ĨŽƌ ĐŚŝůĚƌĞŶ ŝŶ ^ƌŝ >ĂŶŬĂ͘ ĞǇůŽŶ DĞĚŝĐĂů :ŽƵƌŶĂů͘ ϮϬϭϭ͖ϱϲ;ϯͿ͗ϭϬϭʹϭϬϳ͘ ĚŽŝ͗ ŚƩƉ͗ͬͬĚŽŝ͘ ŽƌŐͬϭϬ͘ϰϬϯϴͬĐŵũ͘ǀϱϲŝϯ͘ϯϱϵϳ ϭϬϱ͘ ŚĞŶ t͕ dĂŶŐ ^͕ ^ƵŶ :͕ ZŽƐƐͲĞŐŶĂŶ ͕ tĂŐŶĞƌ <͘ ǀĂŝůĂďŝůŝƚǇ ĂŶĚ ƵƐĞ ŽĨ ĞƐƐĞŶƟĂů ŵĞĚŝĐŝŶĞƐ ŝŶ ŚŝŶĂ͗ŵĂŶƵĨĂĐƚƵƌŝŶŐ͕ƐƵƉƉůǇ͕ĂŶĚƉƌĞƐĐƌŝďŝŶŐŝŶ^ŚĂŶĚŽŶŐĂŶĚ'ĂŶƐƵƉƌŽǀŝŶĐĞƐ͘BMC Health Serv Zes ϮϬϭϬ͖ϭϬ͗Ϯϭϭ͘

ϭϬϲ͘ hEZt͘DĞĚŝĐŝŶĞƉƌŽĐƵƌĞŵĞŶƚƉƌŝĐĞƐĂŶĚƉƌŽĐĞƐƐĞƐŝŶƚŚĞhŶŝƚĞĚEĂƟŽŶƐZĞůŝĞĨĂŶĚtŽƌŬƐŐĞŶĐǇ ĨŽƌ WĂůĞƐƟŶĞ ZĞĨƵŐĞĞƐ ŝŶ ƚŚĞ EĞĂƌ ĂƐƚ ;hEZtͿ͘ :ŽƌĚĂŶ͗ hEZt͕ ϮϬϭϭ͘ ǀĂŝůĂďůĞ Ăƚ ŚƩƉ͗ͬͬǁǁǁ͘ ƵŶƌǁĂ͘ŽƌŐͬƌĞƐŽƵƌĐĞƐͬƌĞƉŽƌƚƐͬŵĞĚŝĐŝŶĞͲƉƌŽĐƵƌĞŵĞŶƚͲƉƌŝĐĞƐͲĂŶĚͲƉƌŽĐĞƐƐĞƐͲƵŶƌǁĂ ϭϬϳ͘ DŝŶŝƐƚƌǇŽĨ,ĞĂůƚŚĂŶĚDŝŶŝƐƚƌǇŽĨ/ŶĚƵƐƚƌǇ͕&ĞĚĞƌĂůĞŵŽĐƌĂƟĐZĞƉƵďůŝĐŽĨƚŚŝŽƉŝĂ͘EĂƟŽŶĂůƐƚƌĂƚĞŐǇ ĂŶĚƉůĂŶŽĨĂĐƟŽŶĨŽƌƉŚĂƌŵĂĐĞƵƟĐĂůŵĂŶƵĨĂĐƚƵƌŝŶŐĚĞǀĞůŽƉŵĞŶƚŝŶƚŚŝŽƉŝĂ;ϮϬϭϱͲϮϬϮϱͿ͘ĞǀĞůŽƉŝŶŐ ƚŚĞƉŚĂƌŵĂĐĞƵƟĐĂůŝŶĚƵƐƚƌǇĂŶĚŝŵƉƌŽǀŝŶŐĂĐĐĞƐƐ͘:ƵůǇϮϬϭϱ͘ŚƩƉ͗ͬͬǁǁǁ͘ǁŚŽ͘ŝŶƚͬƉŚŝͬƉƵďůŝĐĂƟŽŶƐͬ ƚŚŝŽƉŝĂͺƐƚƌĂƚĞŐǇͺůŽĐĂůͺƉŽĚƵĐƟŽŶ͘ƉĚĨ ϭϬϴ͘ EŝģŶƐ >D͕ sĂŶ ĚĞ WŽĞů ͕ ĂŵĞƌŽŶ ͕ ǁĞŶ D͕ >ĂŝŶŐ Z͕ ƌŽƵǁĞƌ t&͘ WƌĂĐƟĐĂů ŵĞĂƐƵƌĞŵĞŶƚ ŽĨ ĂīŽƌĚĂďŝůŝƚǇ͗ĂŶĂƉƉůŝĐĂƟŽŶƚŽŵĞĚŝĐŝŶĞƐ͘BulleƟn of the World Health Organ ϮϬϭϮ͗ϵϬ͗ϮϭϵͲϮϮϳ͘ ϭϬϵ͘ tŽŶŐ:͕ZŝĐŚĞůĐǇŶ:͕ĂĐůĂǇDĞƚĂů͘,ŽǁĞīĞĐƟǀĞŚĂƐƚŚĞ'ĞŶĞƌŝĐƐĐƚďĞĞŶ͍WŚŝůŝƉƉŝŶĞ/ŶƐƟƚƵƚĞĨŽƌ

ĞǀĞůŽƉŵĞŶƚ^ƚƵĚŝĞƐ͘WŽůŝĐǇEŽƚĞƐϮϬϭϲ͗Ϭϲ͘

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ϭϲϯ ϭϭϭ͘ ĂŵĞƌŽŶ͕DĂŶƚĞůͲdĞĞƵǁŝƐƐĞ<͕>ĞƵŅĞŶƐ,'D͕>ĂŝŶŐZ>͘^ǁŝƚĐŚŝŶŐĨƌŽŵŽƌŝŐŝŶĂƚŽƌďƌĂŶĚŵĞĚŝĐŝŶĞƐ ƚŽŐĞŶĞƌŝĐĞƋƵŝǀĂůĞŶƚƐŝŶƐĞůĞĐƚĞĚĚĞǀĞůŽƉŝŶŐĐŽƵŶƚƌŝĞƐ͗ŚŽǁŵƵĐŚĐŽƵůĚďĞƐĂǀĞĚ͍Value in Health ϮϬϭϮ͖ϭϱ;ϱͿ͗ϲϲϰͲϲϳϯ͘ ϭϭϮ͘ ǁĞŶ D͘ ĞǀĞůŽƉŝŶŐ ĂŶĚ /ŵƉůĞŵĞŶƟŶŐ ŵĞĚŝĐŝŶĞ ƉƌŝĐŝŶŐ ƉŽůŝĐŝĞƐ ŝŶ ƌĞƐŽƵƌĐĞͲĐŽŶƐƚƌĂŝŶĞĚ ƉŚĂƌŵĂĐĞƵƟĐĂůƐĞƫŶŐƐ͘ƌŝĞĮŶŐŶŽƚĞĨƌŽŵƌĞŐŝŽŶĂůĐŽŶƐƵůƚĂƟŽŶƐ͘tŽƌůĚ,ĞĂůƚŚKƌŐĂŶŝǌĂƟŽŶ͕ϮϬϭϯ ;ƵŶƉƵďůŝƐŚĞĚͿ͘ ϭϭϯ͘ <ŝŶŐZ͕<ĂŶĂǀŽƐW͘ŶĐŽƵƌĂŐŝŶŐƚŚĞƵƐĞŽĨŐĞŶĞƌŝĐŵĞĚŝĐŝŶĞƐ͗ŝŵƉůŝĐĂƟŽŶƐĨŽƌƚƌĂŶƐŝƟŽŶĞĐŽŶŽŵŝĞƐ͘ CroaƟan Med J ϮϬϬϮ͖ϰϯ;ϰͿ͗ϰϲϮͲϰϲϵ͘ ϭϭϰ͘ <ĂƉůĂŶt͕tŝƌƚǌs͕EŐƵǇĞŶ͕ǁĞŶD͕sŽŐůĞƌ^͕>ĂŝŶŐZ͘WŽůŝĐǇŽƉƟŽŶƐĨŽƌƉƌŽŵŽƟŶŐƚŚĞƵƐĞŽĨŐĞŶĞƌŝĐ ŵĞĚŝĐŝŶĞƐŝŶůŽǁͲĂŶĚŵŝĚĚůĞͲŝŶĐŽŵĞĐŽƵŶƚƌŝĞƐ͘;ƵŶƉƵďůŝƐŚĞĚͿ ϭϭϱ͘ <ĂƉůĂŶt͕Zŝƚǌ>^͕sŝƚĞůůŽD͕tŝƌƚǌs:͘WŽůŝĐŝĞƐƚŽƉƌŽŵŽƚĞƵƐĞŽĨŐĞŶĞƌŝĐŵĞĚŝĐŝŶĞƐŝŶůŽǁĂŶĚŵŝĚĚůĞ ŝŶĐŽŵĞĐŽƵŶƚƌŝĞƐ͗ĂƌĞǀŝĞǁŽĨƉƵďůŝƐŚĞĚůŝƚĞƌĂƚƵƌĞ͕ϮϬϬϬͲϮϬϭϬ͘Health PolicyϮϬϭϮ͖ϭϬϲ;ϯͿ͗ϮϭϭͲϮϰ͘ĚŽŝ͗ ϭϬ͘ϭϬϭϲͬũ͘ŚĞĂůƚŚƉŽů͘ϮϬϭϮ͘Ϭϰ͘Ϭϭϱ ϭϭϲ͘ >ĂƉƚĞǀĂ D͕ <ĂůŝĂ zE͘ ŽŵƉĂƌŝƐŽŶ ŽĨ ƌĞŐƵůĂƚŽƌǇ ŐƵŝĚĞůŝŶĞƐ ĨŽƌ ŝŶƐƵůŝŶƐͬďŝŽƐŝŵŝůĂƌƐ͘ ^ĐŚŽŽů ŽĨ WŚĂƌŵĂĐĞƵƟĐĂů^ĐŝĞŶĐĞƐ͕hŶŝǀĞƌƐŝƚǇŽĨ'ĞŶĞǀĂƌĞƉŽƌƚĨŽƌƚŚĞ/^^^ƚƵĚǇ͘ϮϬϭϲ;ĨŽƌƚŚĐŽŵŝŶŐͿ ϭϭϳ͘ WĞƌƐŽŶŶĞůĐŽŵŵƵŶƵŝĐĂƟŽŶƐǁŝƚŚĂďŝŽƐŝŵŝůĂƌŵĂŶƵĨĂĐƚƵƌĞƌ͕ϮϬϭϲ͘ ϭϭϴ͘ DŝŶŐŚĞƫW͕ZŽĐĐŽW͕ŝůƵƌǌŽ&͕sĞĐĐŚŝŽ>͕>ŽĐĂƚĞůůŝ&͘dŚĞƌĞŐƵůĂƚŽƌǇĨƌĂŵĞǁŽƌŬŽĨďŝŽƐŝŵŝůĂƌƐŝŶƚŚĞ European Union. Drug Discov Today ϮϬϭϮ͖ϭϳ͗ϲϯʹϳϬ͘

ϭϭϵ͘ 'ƌĂǇ >͘ DĞĚŝĐŝŶĞ ƉƌŝĐŝŶŐ ŝŶƚĞƌǀĞŶƟŽŶƐͲƚŚĞ ^ŽƵƚŚ ĨƌŝĐĂŶ ĞǆƉĞƌŝĞŶĐĞ͘ Southern Med Zevieǁ ϮϬϬϵ͖Ϯ;ϮͿ͗ϭϱͲϭϵ͘

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