{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:49:48Z","timestamp":1791287388834,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Epilepsy is a major neurological disorder that requires long\u2010term medical treatment. Once epilepsy is diagnosed, people with epilepsy face many difficulties in accessing treatment (treatment gap). Our objective was to assess the situation regarding the availability, price, affordability, and quality of anti\u2010seizure medication (ASM), which are major determinants of access to treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A cross\u2010sectional study was performed in provincial\/district hospitals and private pharmacies in urban and rural areas in Cambodia. Data on ASM availability and price were obtained through drug suppliers. Affordability was estimated as the number of day wages the lowest\u2010paid government employee must work to purchase a monthly treatment. Samples of ASM were collected, and the quality of ASM was assessed through Medicine Quality Assessment Reporting Guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 138 outlets visited, only 72 outlets (52.2% [95% CI 43.5\u201060.7]) had at least one ASM available. Phenobarbital 100\u00a0mg was the most available (35.5%), followed by carbamazepine 200\u00a0mg (21.7%), phenobarbital 50\u00a0mg (11.6%), sodium valproate 500\u00a0mg (9.4%), and phenytoin 100\u00a0mg (9.4%). In provincial\/district hospitals, ASM was provided free of charge. In private pharmacies, affordability for phenobarbital 50\u00a0mg and 100\u00a0mg was the best, with 0.6 and 0.5\u00a0days, respectively, compared to phenytoin 100\u00a0mg (1.8\u00a0days), and other ASM. No counterfeit ASM was found in this study. Phenytoin sample presented the worst quality (33.0%) compared to carbamazepine (27.8%), and other ASM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>A lack of access to affordable and effective ASM due to low availability and poor quality of ASM was identified. Our research highlights the need for future policy efforts to ensure the quality of ASM and improve their availability. This can be achieved by involving the calculation of their annual needs for these drugs and increasing the national production of ASM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12514","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T21:55:38Z","timestamp":1623189338000},"page":"548-558","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Availability, affordability, and quality of essential anti\u2010seizure medication in Cambodia"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5715-2051","authenticated-orcid":false,"given":"Noudy","family":"Sengxeu","sequence":"first","affiliation":[{"name":"INSERM Univ. Limoges, CHU Limoges IRD U1094 Tropical Neuroepidemiology Institute of Epidemiology and Tropical Neurology GEIST Limoges France"},{"name":"Faculty of Pharmacy University of Health Sciences Vientiane Lao PDR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanraksmey","family":"Aon","sequence":"additional","affiliation":[{"name":"Cambodian Society of Neurology Calmette Hospital Phnom Penh Cambodia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanh","family":"Dufat","sequence":"additional","affiliation":[{"name":"Natural Products, Analysis and Synthesis CiTCoM (Cibles Th\u00e9rapeutiques et Conception de M\u00e9dicaments)\u2010UMR 8038 CNRS\/Universit\u00e9 de Paris Faculty of Health\u2010Pharmacie Universit\u00e9 de Paris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Boumediene","sequence":"additional","affiliation":[{"name":"INSERM Univ. Limoges, CHU Limoges IRD U1094 Tropical Neuroepidemiology Institute of Epidemiology and Tropical Neurology GEIST Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samleng","family":"Chan","sequence":"additional","affiliation":[{"name":"Cambodian Society of Neurology Calmette Hospital Phnom Penh Cambodia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Ros","sequence":"additional","affiliation":[{"name":"Cambodian Society of Neurology Calmette Hospital Phnom Penh Cambodia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre\u2010Marie","family":"Preux","sequence":"additional","affiliation":[{"name":"INSERM Univ. Limoges, CHU Limoges IRD U1094 Tropical Neuroepidemiology Institute of Epidemiology and Tropical Neurology GEIST Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Voa","family":"Ratsimbazafy","sequence":"additional","affiliation":[{"name":"INSERM Univ. Limoges, CHU Limoges IRD U1094 Tropical Neuroepidemiology Institute of Epidemiology and Tropical Neurology GEIST Limoges France"},{"name":"Department of Pharmacy CHU Limoges Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5543-3741","authenticated-orcid":false,"given":"Jeremy","family":"Jost","sequence":"additional","affiliation":[{"name":"INSERM Univ. Limoges, CHU Limoges IRD U1094 Tropical Neuroepidemiology Institute of Epidemiology and Tropical Neurology GEIST Limoges France"},{"name":"Department of Pharmacy CHU Limoges Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000333"},{"key":"e_1_2_8_3_1","unstructured":"BoardE.Global burden of epilepsy and the need for coordinated action at the country level to address its health social and public knowledge implications: draft resolution proposed by Maldives People's Republic of China and Russian Federation. World Health Organization 2015. Available on:https:\/\/apps.who.int\/iris\/handle\/10665\/251859. Accessed October 2019.2015."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2005.00404.x"},{"key":"e_1_2_8_5_1","first-page":"227","article-title":"Efficacy of international approaches to medicine price regulation and control: a scoping review","volume":"7","author":"Bashaar M","year":"2017","journal-title":"J Appl Pharm Sci"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.09.064147"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2174\/1381612823666170809103202"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1331\/154434503322642642"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12432"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40064-016-3409-5"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2008.03.006"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14445"},{"key":"e_1_2_8_13_1","unstructured":"SokhaP.Decentralization and poverty reduction in Cambodia: Experiences and challenges. In: Decentralization: Poverty Reduction Empowerment and Participation Division for Public Administration and Development Management United Nations New York;2005. Available on:https:\/\/publicadministration.un.org\/publications\/content\/PDFs\/E\u2010Library%20Archives\/2005%20Decentralization_Poverty%20Reduction %20Empowerment%20and%20Participation.pdf#page=162. Accessed March 2019:162\u2010170."},{"key":"e_1_2_8_14_1","unstructured":"Department of Drugs and Food in Cambodia.Pharmaceutical sector strategic plan 2013\u20102018;2012. Available on:http:\/\/www.haiasiapacific.org\/wp\u2010content\/uploads\/2015\/02\/CambodiaPSSP2013\u20102018FinalDraftOct2012.pdf. Accessed April 2020."},{"key":"e_1_2_8_15_1","unstructured":"National Institute of Statistics Cambodia.Cambodia demographic and health survey 2010;2011. Available on:https:\/\/dhsprogram.com\/pubs\/pdf\/Fr249\/Fr249.pdf. Accessed December 2019."},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0046296"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2011.03102.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000345118"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-018-3617-x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040082"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.2003.01194.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2010.02494.x"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.106834"},{"key":"e_1_2_8_24_1","first-page":"741","article-title":"Quality of pharmaceutical items available from drugstores in Phnom Penh, Cambodia","volume":"35","author":"Yang D","year":"2004","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"e_1_2_8_25_1","unstructured":"National Institute of Statistics of Cambodia.Cambodia inter\u2010censal population survey 2013\u2010final report;2013. Available on:https:\/\/www.stat.go.jp\/info\/meetings\/cambodia\/pdf\/ci_fn02.pdf. Accessed November 2019."},{"key":"e_1_2_8_26_1","unstructured":"World health Organization.The Kingdom of Cambodia health system review. Health Syst Transit;2015. Available on:http:\/\/iris.wpro.who.int\/handle\/10665.1\/11356. Accessed March 2020: 5."},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.181255"},{"key":"e_1_2_8_28_1","unstructured":"World Health Organization.Price availability and affordability: an international comparison of chronic disease medicines;2006. Available on:https:\/\/apps.who.int\/iris\/handle\/10665\/116493. Accessed March 2020."},{"key":"e_1_2_8_29_1","unstructured":"World Health Organization\/Health Action International.Measuring medicine prices availability affordability and price components;2008. Available on:https:\/\/www.who.int\/medicines\/areas\/access\/OMS_Medicine_prices.pdf. Accessed on March 2020."},{"key":"e_1_2_8_30_1","unstructured":"DalisP.Links between employment and poverty in Cambodia: Cambodia's leading independent development policy research institute (CDRI);2014. Available on:https:\/\/cdri.org.kh\/wp\u2010content\/uploads\/wp92e.pdf. Accessed on November 2019."},{"key":"e_1_2_8_31_1","unstructured":"World Health Organization.ATC\/DDD Index;2019. Available on:https:\/\/www.whocc.no\/atc_ddd_index\/. Accessed on December 2019."},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/1010539513500336"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291713001943"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v6i1.604"},{"key":"e_1_2_8_35_1","first-page":"1","article-title":"Special report\u2010mental health and human rights in Cambodia","volume":"35","author":"Daniel M","year":"2017","journal-title":"Fordham Int Law J"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.12.113183"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2006.00425.x"},{"key":"e_1_2_8_38_1","first-page":"S252","article-title":"Facilities and services for people with epilepsy\u2010A survey from the Northeast Thailand","volume":"100","author":"Tiamkao S","year":"2017","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_8_39_1","first-page":"271","article-title":"Is the Thailand epilepsy service adequate to help patients?","volume":"18","author":"Tiamkao S","year":"2013","journal-title":"Neurol Asia"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.149376"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2007.02.018"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2005.01805.x"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.4103\/0253-7613.36541"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.4103\/0250-474X.151550"},{"key":"e_1_2_8_45_1","first-page":"e3220","article-title":"La circulation non contr\u00f4l\u00e9e des m\u00e9dicaments en Asie du Sud\u2010Est et au Cambodge","volume":"24","author":"Bourdier F","year":"2014","journal-title":"L'espace Politique"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.10.084327"},{"key":"e_1_2_8_47_1","unstructured":"World Health Organization.Cambodia\u2010WHO country cooperation strategy 2016\u20102020;2016. Available on:https:\/\/apps.who.int\/iris\/handle\/10665\/246102. Accessed on April 2019."},{"key":"e_1_2_8_48_1","unstructured":"Netherlands Embassy in Bangkok.Life Sciences & Healthcare in Cambodia;2018. Available on:https:\/\/www.google.com\/url?sa=t&rct=j&q=&esrc=s&source=web&cd=17&cad=rja&uact=8&ved=2ahUKEwi\u2010gaOc\u20105PlAhUJTBoKHZe2DZ8QFjAQegQIChAJ&url=https%3A%2F%2Fwww.netherlandsworldwide.nl%2Fbinaries%2Fen\u2010nederlandwereldwijd%2Fdocuments%2Fpublications%2F2018%2F10%2F04%2Fhealthcare\u2010cambodia%2FHealthcare.pdf&usg=AOvVaw3D7dnFNFC7aiebSbryeHsL. Accessed on October 2019."},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0212125"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-817"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2009.53"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0074817"},{"key":"e_1_2_8_53_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/978-3-0348-7913-2_2","volume-title":"Access and Availability of Pharmaceuticals in International Health. Managing Pharmaceuticals in International Health","author":"Wiedenmayer K","year":"2004"}],"container-title":["Epilepsia Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.12514","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi4.12514","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.12514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:44:20Z","timestamp":1693356260000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi4.12514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,23]]},"references-count":52,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1002\/epi4.12514"],"URL":"https:\/\/doi.org\/10.1002\/epi4.12514","archive":["Portico"],"relation":{},"ISSN":["2470-9239","2470-9239"],"issn-type":[{"value":"2470-9239","type":"print"},{"value":"2470-9239","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,23]]},"assertion":[{"value":"2020-12-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}