Exploring factors affecting access to non-communicable disease medicines in low- and middle-income countries: a systematic review

Challenges across all six dimensions of access significantly affect access to NCD medicines. These challenges were exacerbated during the COVID-19 pandemic. Access recommendations include (1) improved evidence-based forecasting to reduce stockouts through investments in data infrastructure, innovative LMIC-specific forecasting tools and pooled procurement; (2) increased use of quality-assured generic medicines through international non-proprietary name prescribing, regulation of originator brand promotion and generic substitution; (3) improved quality of NCD medicines through stringent regulatory requirements and national and supranational pharmacovigilance systems; and (4) expansion of NCD medicine financing through universal health coverage.