Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Affordability of Essential Medicines: The Case of Fluoride Toothpaste in 78 Countries

Version 1 : Received: 15 April 2022 / Approved: 15 April 2022 / Online: 15 April 2022 (10:46:26 CEST)

How to cite: Gkekas, A.; Varenne, B.; Benzian, H.; Stauf, N.; Listl, S. Affordability of Essential Medicines: The Case of Fluoride Toothpaste in 78 Countries. Preprints 2022, 2022040146 (doi: 10.20944/preprints202204.0146.v1). Gkekas, A.; Varenne, B.; Benzian, H.; Stauf, N.; Listl, S. Affordability of Essential Medicines: The Case of Fluoride Toothpaste in 78 Countries. Preprints 2022, 2022040146 (doi: 10.20944/preprints202204.0146.v1).

Abstract

Background: Fluoride toothpaste (FT) has recently been included in the World Health Organization’s (WHO) Model List of Essential Medicines. Whereas it is essential for preventing dental caries, its current affordability around the globe remains unclear. This study aimed to analyse the affordability of FT in as many as possible countries worldwide. Methods: A standardized protocol was developed to collect country-specific information about the characteristics of the cheapest FT at a common point of purchase. 82 members of the WHO Global Oral Health Network of Chief Dental Officers (CDOs), directors of WHO Collaborative Centres and other oral health experts collected data using mobile phone technology. The Fluoride Toothpaste Affordability Ratio (FTAR) was calculated as the price associated with the recommended annual consumption of FT, relative to the daily wage of the lowest-paid unskilled government worker (FTAR >1 = unaffordable spending on fluoride toothpaste). The daily expenditure per capita of the poorest 15% of the income distrubition was used as the main proxy of the daily wage, using World Bank data. Alternatively, we used the daily minimum wage as a proxy of the daily wage. Stratified descriptive statistics were undertaken with respect to different World Bank Income Groups and WHO Regions. Results: There are significant discrepancies in the affordability of FT across 78 countries. FT was strongly affordable in high-income countries, relatively affordable in upper middle-income countries, and strongly unaffordable in lower middle-income and low-income countries. The affordability of FT across WHO Regions was dependent upon the economic mix of WHO Regions’ member states. Conclusion: FT is still unaffordable for many people, particularly in low-resource settings. Health policy members should develop better strategies to address and improve the universal affordability of FTs, for the incidence of dental caries to be reduced at a global level.

Keywords

Essential medicines; affordability; NCD prevention; oral healthcare; access

Subject

MEDICINE & PHARMACOLOGY, Dentistry

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