Dispensing of medicines for asthma and chronic obstructive pulmonary disease through the government health insurance in Syria: a retrospective analysis

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dc.contributor.authorRavinetto Raffaella
dc.contributor.authorAljadeeah Saleh
dc.contributor.authorTomas Ana
dc.date.accessioned2025-10-30T09:19:05Z
dc.date.available2025-10-30T09:19:05Z
dc.date.issued2025
dc.description.abstractAsthma and chronic obstructive pulmonary disease (COPD) are common noncommunicable diseases, exacerbated in conflict settings by the heightened environmental exposure to triggers, weakened health systems, and poor access to medicines and healthcare. However, accurate data on medicines dispensing in this context are generally scarce. We examined the patterns and rates of medicines dispensing for asthma and COPD among the beneficiaries of the Syrian governmental health insurance scheme between June 2018 and March 2021. We retrospectively analyzed the outpatient dispensing records for 125,371 adults. Medicines for asthma and COPD were identified using the Anatomical Therapeutic Chemical (ATC) classification system. Dispensing rates were calculated as the number of packages per 1,000 beneficiaries per month, stratified by age, sex, and route of administration. Out of our sample, 15.02% received at least one package of a medicine for asthma or COPD. Oral formulations were the most frequently dispensed (92.67% of patients), particularly oral salbutamol and xanthines. Inhaled medicines, including inhaled corticosteroids (ICS) and ICS long-acting β2-agonists (ICS-LABA) combinations, were markedly under-dispensed (17.08% of patients). Dispensing rates were higher in females and older adults. Seasonal variation showed peaks in autumn and winter, with a notable decline in April 2020, coinciding with the early COVID-19 period. The study highlights substantial gaps in dispensing of medicines for asthma and COPD, with particularly low rates for inhalers, likely reflecting barriers driven by the conflict, economic instability, and sanctions. Robust coordinated action is needed to improve their availability in Syria.
dc.identifier.citationSaleh Aljadeeah, Raffaella Ravinetto & Ana Tomas (2025) Dispensing of medicines for asthma and chronic obstructive pulmonary disease through the government health insurance in Syria: a retrospective analysis, Global Health Action, 18:1, 2556526, DOI: 10.1080/16549716.2025.2556526
dc.identifier.urihttps://doi.org/10.1080/16549716.2025.2556526
dc.identifier.urihttps://hdl.handle.net/10566/21337
dc.language.isoen
dc.publisherTaylor and Francis Ltd
dc.subjectdispensing of medicines
dc.subjectasthma
dc.subjectchronic obstructive pulmonary disease
dc.subjectgovernment health insurance
dc.subjectSyria
dc.titleDispensing of medicines for asthma and chronic obstructive pulmonary disease through the government health insurance in Syria: a retrospective analysis
dc.typeArticle

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