[Ip-health] Benefits of global partnerships to facilitate access to medicines in developing countries: a multi-country analysis of patients and patient outcomes in GIPAP

[Joana Ramos]

Article URL http://www.globalizationandhealth.com/content/5/1/19

Benefits of global partnerships to facilitate access to medicines in
developing
countries: a multi-country analysis of patients and patient outcomes in
GIPAP
Globalization and Health 2009, 5:19, 31 December 2009


Panos Kanavos*1, Sotiris Vandoros1, Pat Garcia-Gonzalez2
1
1: LSE Health, The London School of Economics and Political Science,
London,
England ; 2: The Max Foundation, Seattle, USA


Abstract
Background: Access to medicines in developing countries continues to be a
significant problem due to lack of insurance and lack of affordability.
Chronic
Myeloid Leukemia (CML), a rare disease, can be treated effectively, but the
pharmaceutical treatment available (imatinib) is costly and unaffordable
by most
patients. GIPAP, is a programme set up between a manufacturer and an NGO to
provide free treatment to eligible CML patients in 80 countries worldwide.

Objectives: To discuss the socio-economic and demographic
characteristics of
patients participating in GIPAP; to research the impact GIPAP is having
on health
outcomes (survival) of assistance-eligible CML patients; and to discuss the
determinants of such outcomes and whether there are any variations
according to
socio-economic, demographic, or geographical criteria.

Methods: Data for 13,568 patients across 15 countries, available
quarterly, were
analysed over the 2005-2007 period. Ordered Probit panel data analysis
was used to
analyze the determinants of a patient=E2=80=99s progress in terms of
participation in the
programme. Four waves of patients entering quarterly in 2005 were used
to evaluate
patient survival over the sample period.

Results: All patients in the sample are eligible to receive treatment
provided they
report to a facility quarterly. 62.3% of patients were male and 37.7%
female. The
majority (84.4%) entered during the chronic phase of the disease and
their average
age was 38.4 years. Having controlled for age, location and occupation,
the analysis
showed that patients were significantly much more likely to move towards
a better
health state after receiving treatment irrespective of their disease
stage at the point of
entry to the program (OR=3D30.5, =CE=B1=3D1%); and that the larger the gap
between diagnosis
and approval for participation in the program, the more likely it is
that patients=E2=80=99
condition deteriorates (OR=3D0.995, =CE=B1=3D1%), due to absence of treatme=
nt.
Regressions to
account for the effect of large countries (India, China, Pakistan) did
not show any
important differences when compared to the remaining countries in the
sample.
Survival analysis shows that at least 66 percent of all patients that
entered the program
in 2005 were alive and active by the end of 2007.

Conclusions: GIPAP has a significant positive effect on patient access
to important
medicines for a life threatening condition such as CML. It impacts both
the progress
and phase of the disease and leads to a high survival rate. Overall, it
sets a good
example for access to treatment in developing countries, where such
programmes can
substitute or complement local efforts to provide care to eligible
patients. ...




----------------
Joana Ramos, MSW
Cancer Resources & Advocacy
Seattle WA USA
+1-206-229-2420
http://ramoslink.info/
www.bmtbasics.org