INTRODUCTION
Use
References
Use by healthcare professionals and people with diabetes covers the responsiveness and adequacy of products for people’s needs; acceptability by both parties; and rational use.14,15,17 A study of these elements could not be included in this survey and constitute a field for future research. Availability, accessibility, affordability and proper use should be achieved while ensuring equity and quality at each level. Quality is defined here as compliance to international, regional and national standards.17,18 Equitable access refers to the imperative to ensure access according to needs.15 The main potential equity issues that were investigated in this study were differences in access between product categories, between people with different types of diabetes, and between people living in ruralb2 or urban settings.3
In this publication This publication is organised around the five sub-regions of Europe and the three elements of access described above. The first chapters provide a comparative analysis of access to diabetes medicines and medical devices in each of the five sub-regions:
• • • • •
North-West Europe Sout-West Europe Central and Eastern Europe South-East Europe Eastern Europe
These sections are complemented by a short country profile for each of the 47 countries surveyed. Finally, main findings and future perspectives are summarised in the conclusion.
b For the purpose of this study, as each country has its own definition of rurality, the latter was defined as remoteness from healthcare services. Respondents reporting living more than 5 km away from a practising doctor or pharmacist were defined as rural respondents.
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UN Human Rights Council, 2013a UN Human Rights Council, 2013b UN Human Rights Council, 2013c European Commission, 2013b EurActiv, 2013 Hjertqvist, 2013 The Greens-European Free Alliance, 2013 EATG et al., 2013 Karanikolos et al., 2013 WHO-EURO, 2013 Maurice, 2013 European Commission, 2011 WHO, 2013c Frost & Reich, 2008 Obrist et al., 2007 Tanahashi, 1987 WHO, 2004 WTO, 2013 Beran, McCabe, & Yudkin, 2008 IDF, 2009 IDF, 2012 IDF, ISPAD, 2011 Adina Sanpetreanu (Romania), person communication, 2013 Claudia Huber (Switzerland), person communication, 2013 Healthcare professional specialised in diabetes care (United Kingdom), person communication, 2013 Beran & Higuchi, 2012 Beran, Yudkin, & Courten, 2006 WHO, HAI, 2012 Deeb, Tan, & Alberti, 1994 IDF, 1997 IDF, 2002 IDF, 2006 World Health Organization (WHO) in EURADIA, FEND, IDF, & PCDE., 2011 Diabetes UK (2013b) “Types of diabetes”, 2013 Beran, McCabe, & Yudkin, 2008 EURADIA, FEND, IDF, & PCDE, 2011 Jordan, Roderick, Martin, & Barnett, 2004