Health policy and systems research in access to medicines: A prioritized agenda for low- and middle-income countries

Maryam Bigdeli, Dena Javadi, Joelle Hoebert, Richard Laing, Kent Ranson, Daniel Arhinful, Samer Jabbour, Vera Lucia Luiza, Chean Men, Chuc Nguyen Thi Kim, Joseph Ntaganira, Claudine Ntsama Essomba, Arash Rashidian, Sakhtivel Selvaraj, Lamphone Syhakhang, Shehla Zaidi

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)


Objectives: To identify priority policy issues in access to medicines (ATM) relevant for low- and middle-income countries, to identify research questions that would help address these policy issues, and to prioritize these research questions in a health policy and systems research (HPSR) agenda. Methods: The study involved i) country- and regional-level priority-setting exercises performed in 17 countries across five regions, with a desk review of relevant grey and published literature combined with mapping and interviews of national and regional stakeholders; ii) interviews with global-level stakeholders; iii) a scoping of published literature; and iv) a consensus building exercise with global stakeholders which resulted in the formulation and ranking of HPSR questions in the field of ATM. Results: A list of 18 priority policy issues was established following analysis of country-, regional-, and global-level exercises. Eighteen research questions were formulated during the global stakeholders' meeting and ranked according to four ranking criteria (innovation, impact on health and health systems, equity, and lack of research). The top three research questions were: i) In risk protection schemes, which innovations and policies improve equitable access to and appropriate use of medicines, sustainability of the insurance system, and financial impact on the insured? ii) How can stakeholders use the information available in the system, e.g., price, availability, quality, utilization, registration, procurement, in a transparent way towards improving access and use of medicines? and iii) How do policies and other interventions into private markets, such as information, subsidies, price controls, donation, regulatory mechanisms, promotion practices, etc., impact on access to and appropriate use of medicines?Conclusions: Our HPSR agenda adopts a health systems perspective and will guide relevant, innovative research, likely to bear an impact on health, health systems and equity.

Original languageEnglish
Article number37
JournalHealth Research Policy and Systems
Issue number1
Publication statusPublished - 14 Oct 2013


  • Access to medicines
  • Health systems
  • Health systems research
  • Priority setting


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