Uganda’s Essential Medicines and Health Supplies List (EMHSLU) for 2023 includes Oral Hypoglycemic Agents (OHAs) aimed at managing type 2 diabetes. Recent evaluations reveal that several medications could be optimized to enhance availability, accessibility, and affordability, ultimately improving health outcomes while reducing government expenditure.
Evaluation Methodology
A comprehensive literature review was conducted, focusing on metrics related to the availability, accessibility, and affordability of OHAs. The study also assessed the cost-effectiveness, safety, and efficacy of five OHA classes available in Uganda. Following the review, a budget impact analysis (BIA) was performed to identify potential cost savings by refining the EMHSLU through two scenarios: shifting within the existing list and incorporating non-listed drugs.
Key Findings
The analysis discovered that the 2023 EMHSLU additions are less available and accessible compared to the 2016 list. Scenario one demonstrated that replacing glimepiride 2 mg and gliclazide 80 mg with glibenclamide 5 mg could save up to USD 2.65 million annually. Scenario two indicated that substituting dapagliflozin 10 mg and glimepiride 4 mg with higher doses could result in savings of USD 230,000 and USD 600,000 per year, respectively. Additionally, sitagliptin emerged as a cost-effective option with an Incremental Cost Effectiveness Ratio of $6,132 per Quality-Adjusted Life Year.
Inferences:
- Optimizing OHA selections can lead to significant government cost savings.
- Higher-dose substitutions may enhance affordability without compromising efficacy.
- Incorporating cost-effective drugs like sitagliptin can improve overall health outcomes.
The study underscores the importance of regularly reviewing and updating national essential medicines lists to reflect current economic and health landscapes. By strategically selecting OHAs based on comprehensive criteria, Uganda can ensure sustainable management of type 2 diabetes while maintaining high standards of care.
Strategic adjustments to the EMHSLU not only promise substantial financial savings but also enhance the availability of effective diabetes treatments. Policymakers should consider these findings to optimize healthcare budgets and improve patient access to essential medications. Future research could explore the long-term health impacts of these substitutions to further validate their effectiveness and sustainability within Uganda’s healthcare system.
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