Publications by authors named "L Teulieres"

The successful treatment of Lyme disease (LD) is contingent on accurate diagnosis. However, current laboratory detection assays lack sensitivity in the early stages of the disease. Because delayed diagnosis of LD incurs high healthcare costs and great suffering, new highly sensitive tests are in need.

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The survey was conducted in Senegal in April 2001 on a representative sample of providers and clients. Results show that access to medicines in Senegal was limited for three main reasons: (1) the supply of drugs was inadequate, and even critical drugs were often missing in health centres, and were somewhat less in pharmacies; (2) the health infrastructures appeared insufficient to cover the needs of the whole population, creating high opportunity costs; (3) the cost of the drugs prescribed was higher than the minimum price, sometimes exceeding the capacity of poorer people, although high cost was seldom reported as the main reason for not acquiring prescribed drugs. Improving access to medicine is a priority to help reduce health inequalities in developing countries.

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This article presents the results of a global survey on drug accessibility conducted in Senegal in 2001. The original tool we developed to measure drug affordability for this study considered 5 marker diseases and their corresponding medical treatments and determined the theoretical amount that each population quintile can devote to the purchase of these treatments at market prices without damaging their economic status (affordability threshold). These results were then compared with those obtained as part of a field survey of 987 patients at 41 health centres and 51 private chemists (pharmacists).

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This article seeks to shed light on the reasons for the lack of correlation between the price of drugs in this very poor sub-Saharan country and the population's ability to pay for them. The analysis is based on: (i) a comparison between the wholesale (exclusive of VAT and other taxes) and government-fixed retail prices and the corresponding prices of the same drugs in their country of origin (France); (ii) a description of the price-setting mechanisms in Senegal in both the public and private sectors; and (iii) an evaluation of public-sector retail price in Senegal, by end users and prescribing professionals in both sectors. The study found that: (i) patient expenditure would be one-fifth as high if all the drugs in the sample were sold at their government-fixed public-sector retail prices; (ii) the most cost effective drugs are sold at fixed retail prices higher than those of drugs not reimbursed by the national health insurance in France because considered less cost-effective; (iii) the mechanism for setting public retail prices seems to be unrelated to public health objectives, does not consider specific population groups, target diseases, or the drugs' therapeutic value, and therefore cannot be considered an effective tool for implementing national drug policies.

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