WASHINGTON, DC – A study by the Pan American Health Organization (PAHO) has revealed significant barriers in access to essential hypertension medications across Latin America and the Caribbean (LAC).
The study, published in the Journal of Pharmaceutical Policy and Practice, said the barriers include outdated essential medicines lists and diffuse procurement practices, adding that it underscored the need for more standardized antihypertensive medicines to help reduce the cardiovascular disease burden in the region.
Cardiovascular diseases are the leading cause of death in the Americas, accounting for over two million deaths annually.
Hypertension affects 35.4 per cent of adults aged 30-79, and remains inadequately managed, 37 per cent of individuals with hypertension in Latin America and the Caribbean are undiagnosed, while 15 per cent of those diagnosed do not receive treatment and 47 per cent of those treated do not have their blood pressure controlled.
These gaps contribute to elevated rates of stroke and heart disease and PAHO said it has been helping countries address this issue through the HEARTS initiative, which aims to enhance hypertension management and cardiovascular risk prevention through standardized treatment protocols and improved access to essential medications.
The study, covering 22 countries participating in the HEARTS initiative, found notable inconsistencies in the inclusion of recommended antihypertensive medicines on National Essential Medicines Lists (NEMLs).
PAHO said the limited availability of fixed-dose combinations (FDCs) antihypertensive products on such lists was particularly concerning. FDCs, included in the World Health Organization (WHO) List of Essential Medicines in 2019, have demonstrated to effectively control blood pressure, enhance patient adherence, and reduce side effects and adverse events compared to monotherapy.
Additionally, the study revealed significant variations in medicine registration, pricing, and procurement practices, which collectively hinder access and affordability.
“Antihypertensive medicines are inexpensive to produce and can save millions of lives,” said Pedro Orduñez, advisor on Chronic Diseases at PAHO and one of the authors of the study.
“Reducing the price and improving the quality is a key intervention to improve access and quality of care,” he added.
The lead author of the study, Christopher Lim, who is also the chief of PAHO’s Strategic Fund, said despite the high prevalence of hypertension, many people in the region lack access to the medications needed to control their blood pressure.
“Our findings highlight the need for decision-makers to update NEMLs to include these critical medicines.”
Among the key recommendations from the study include the need to update National Essential Medicines Lists alinging them with evidence-based guidelines and include essential FDCs to improve treatment adherence and control.
In addition there is also a need to Improve procurement practices through streamline procurement processes and leverage pooled procurement mechanisms, such as the PAHO Strategic Fund, to consolidate demand, negotiate better prices, availability, and ensure consistent supply of quality-assured medicines.
The study also recommends increase transparency, noting the need to address transparency issues in medicine pricing through standardized reporting and the development of platforms for price information sharing.
It also calls for enhance market access through the support of the registration and availability of essential medications across all countries to prevent market fragmentation and ensure equitable access.
“PAHO’s Strategic Fund can play a crucial role in helping countries overcome these challenges by facilitating pooled procurement of quality-assured medications,” Lim said, adding “this approach has proven successful in the management of other diseases and offers valuable insights for enhancing access to antihypertensive treatments”.
PAHO said the study’s results underscore the importance of continued collaboration among governments, healthcare systems, and stakeholders to address barriers in access to medication in order to improve cardiovascular health outcomes throughout the region.