Drug procurement methods and challenges in Asian low and lower-middle-income countries: A systematic review

Background: Pharmaceutical procurement plays a pivotal role in healthcare within Asian low and lower-middle-income countries (LLMICs), ensuring accessibility to essential, cost-effective, and high-quality medicines. Tailored approaches are imperative due to specific challenges inherent in these countries. Objectives: This review examines several drug procurement systems in Asian countries with LLMICs while identifying and evaluating any potential challenges that might arise within the systems. Materials and Methods: This review using the preferred reporting items for systematic reviews and meta-analyses guidelines and three search engines (PubMed, Science Direct, and Research Gate) employing Boolean search terms. The search focuses on drug procurement, medicine procurement, drug purchasing, and drug availability, combined with the names of Asian countries. Eligible studies must describe procurement methods and associated problems from LLMICs in Asia. Quality assessment performed using the Critical Appraisal Skills Program, and data are systematically extracted and analyzed. Results: A total of 11 original articles meet the inclusion criteria. A majority of the studies used qualitative approaches, shown that qualitative methods’ strengths in health policy research. Procurement processes, methods, and challenges in each country are examined, offering a comprehensive view of pharmaceutical supply chains. The findings encompass issues such as pricing disparities, supply chain inefficiencies, administrative complexities, and variations in drug choices. Challenges in the drug procurement process are discussed in depth. Conclusion: Pharmaceutical procurement in LLMICs is complex, requiring tailored strategies, global collaboration, and technology for efficiency and transparency. Addressing these challenges is crucial for medication availability and improved public health.