How do stock outs or shortages in public health facilities affect private healthcare providers and consumers? originally appeared on Quora: the place to gain and share knowledge, empowering people to learn from others and better understand the world.
Answer by Anne Fitzpatrick, Professor at The Ohio State University, on Quora:
Essential medicines are drugs that the World Health Organization has deemed crucial for a population to have reliable and regular access to. Many of these are life saving drugs. However, in the low and middle-income countries, “stock outs” of these medicines are very common. The stockout rates at public health facilities are estimated to be as high as 33%. There are even higher rates observed for specific classes of medicines, such as drugs for HIV-positive patients as well as for treating malaria. It is important to note that the precise number of stockout rates depend on specific countries and time periods.
For patients, the absence of drugs can mean prolonged illness, disrupted treatments for chronic conditions, increased rates of morbidity, and even deaths; all that could have been avoided.
When public supplies dwindle, patients are often forced into the private sector, where the costs are markedly higher. In Uganda, for instance, during stockouts the price of antimalarial drugs can surge by 35%. As demand spikes in private facilities due to public shortages, those who can least afford it face steep prices. Consequently, some patients opt to forgo treatment entirely. Furthermore, there is also the cost of time and hassle as patients go across multiple health facilities in hopes of getting treated. Overall, drug shortages work to decrease trust in the healthcare system.
Stockouts are also frustrating and demotivating for public sector health care providers in low-income settings, who are unable to appropriately treat patients.
Private healthcare providers, on the other hand, experience a different set of challenges and opportunities. An influx of patients might can strain resources and inflate prices due to increased demand. This not only affects the reputation of these providers but also raises ethical concerns about profiting from public sector shortcomings.
Public health facility stockouts send ripples through the healthcare landscape, compromising patient health, adding financial strain, and pressuring private providers. Overall, drug shortages work to decrease trust in the healthcare system. There are numerous initiatives to reduce stockouts by improving supply chain operations and access to high-quality medicines worldwide, such as the Global Fund and PEPFAR. But more work and research is needed to ensure reliable access to medicines worldwide.
It’s a stark reminder that when one part of the healthcare system falters, the entire network feels the tremors. Ensuring the availability of essential medicines in public facilities is not just about health equity; it’s about stabilizing the entire healthcare ecosystem for the well-being of all.
Did you know that drug shortages also happen in the US? Year 2023 saw the highest number of active drug shortages on average (measured quarterly) since 2015. Click here to learn more.
This question originally appeared on Quora – the place to gain and share knowledge, empowering people to learn from others and better understand the world.