Evaluating the Tunisian 'Access Program' for Innovative Therapies: Stakeholder Perspectives and Operational Recommendations
DOI:
https://doi.org/10.62438/tunismed.v104i08.6238Keywords:
Access to medicines, innovative therapies, geographic disparities, indigent patients, pharmaceutical donationsAbstract
Introduction: Access to innovative medicines is a major challenge in middle-income countries, where budgetary constraints and social inequalities hinder therapeutic equity. In response to the exclusion of indigent patients not covered by the National Health Insurance Fund (CNAM), the
Tunisian Ministry of Health launched the Access Program in 2015. This initiative is based on the donation of innovative drugs by pharmaceutical companies, in partnership with public hospitals. Its objective is to provide free access to high-cost treatments for severe conditions such as cancer
and autoimmune diseases.
Aim: To assess the program's functioning based on the experiences of its beneficiaries and operational stakeholders.
Methods: A descriptive cross-sectional survey was conducted between August and December 2024 in two hospitals (Mongi Slim La Marsa and Abderrahmen Mami Ariana).
A total of 50 patients, 22 prescribing clinicians, 4 hospital pharmacists, and 5 representatives from the pharmaceutical industry participated in the survey.
Results: Among the patients surveyed, 52% reported access-related difficulties, including stock shortages, prolonged delivery delays (with waiting times of 1 to 3 months reported by 40% of patients and estimated by 91% of prescribing clinicians). and geographic remoteness. Statistical analysis revealed a significant association between these barriers and overall patient satisfaction with the Access Program (p < 0.001): the more difficult
the access, the lower the level of satisfaction. In addition, healthcare professionals emphasized the lack of formalized protocols and limited stock visibility, while pharmaceutical companies highlighted the absence of post-distribution follow-up mechanisms.
Conclusion: The Access Program ....(abstract truncated at 250 words).
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