Factors Influencing Access to Essential Medicines in Low- and Middle-Income Countries: A Quantitative Analysis of 72 Medicines

Abstract

Background: Access to essential medicines is an important challenge worldwide, with low- and middle-income countries accounting for the majority population without access to essential medicines. Using the diffusion of innovations framework, this research examines the effects of medicine-, country-, and company-level factors on access to essential medicines centrally authorized in the EU. Methods: This study contains a cross-sectional examination of 72 essential medicine authorizations in 8 LMICs. Logistic regressions were conducted to determine the impact of medicine- and company-level factors. Kendall's tau non-parametric correlation was used to determine the relationship of local medicine authorizations to country-level factors. Results: Access to essential medicines centrally authorized in the EU varied across LMICs. Medicine- and company-level factors were significant predictors of authorizations, while country-level factors correlated with different essential medicine authorizations in LMICs - results varied on a country-by-country basis and no factor alone could explain differences in access to medicines in LMICs. Conclusion: Differences in access to essential medicines in Europe vs LMICs, as well as between LMICs, is alarming and indicative of future research to better understand this problem. Future research should explore additional medicine-, country-, and company-level factors, and delays experienced in access to essential medicines to obtain a full understanding of diffusion of essential medicines in LMICs.