Cardiovascular diseases (CVD) represent the highest burden of disease globally. Medicines are a critical intervention used to prevent and treat CVD. This review describes access to medication for CVD from a health system perspective and strategies that have been used to promote access, including pro...viding medicines at lower cost, improving medication supply, ensuring medicine quality, promoting appropriate use, and managing intellectual property issues. Using key evidence in published and gray literature and systematic reviews, we summarize advances in access to cardiovascular medicines using the 5 health system dimensions of access: availability, affordability, accessibility, acceptability, and quality of medicines. There are multiple barriers to access of CVD medicines, particularly in low- and middle-income countries. Low availability of CVD medicines has been reported in public and private healthcare facilities. When patients lack insurance and pay out of pocket to purchase medicines, medicines can be unaffordable. Accessibility and acceptability are low for medicines used in secondary prevention; increasing use is positively related to country income. Fixed-dose combinations have shown a positive effect on adherence and intermediate outcome measures such as blood pressure and cholesterol. We have a new opportunity to improve access to CVD medicines by using strategies such as efficient procurement of low-cost, quality-assured generic medicines, development of fixed-dose combination medicines, and promotion of adherence through insurance schemes that waive copayment for long-term medications. Monitoring progress at all levels, institutional, regional, national, and international, is vital to identifying gaps in access and implementing adequate policies.
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The list of emergency medicine has been developed though various consultative meeting and workshops with concerned health professionals and institutions. The medicines in the list should be administered to emergency patients only treated in the health institutions, purchased from legal medicine reta...il outlets on the basis of prescription paper and legal receipt. The stock that should be handled and hoarding of such medicine is prohibited. In addition each medicine administered to emergency patient should be registered in emergency medicine administration registration book.
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Decree of the Minister of Health of the Republic of Indonesia No. 2500 / MENKES / SK / XII / 2011 on National Essential Medicines List 2011
Decree of the Minister of Health of the Republic of Indonesia on the Establishment of Hospitals and Satellite Test of Methadone Therapy Service and Program Guidelines for Methadone Maintenance Therapy