{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:30:42Z","timestamp":1787041842600,"version":"build-2736575974"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Psychopharmacology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Mental disorders affect approximately 20% of the global population and remain a leading cause of disability and premature mortality. Despite pharmacotherapy being central to treatment, access to psychotropic medicines is highly unequal, particularly in low- and middle-income countries. In South America, comprehensive national evaluations integrating availability, price, affordability, and geographic accessibility are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess the availability, cost, affordability, and geographic accessibility of psychotropic medicines across public and private sectors in all regions of Peru.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A secondary cross-sectional analytical study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We use open-access data from the Peruvian Observatory of Pharmaceutical Products between May 20 and 25, 2025. A total of 54 psychotropic medicines were included based on the WHO and national essential medicine lists and expert consensus. Outcomes included median unit cost (interquartile range), availability (% of facilities), affordability (days of minimum wage for a 30-day treatment), and regional accessibility. Public\u2013private cost differences were assessed using Wilcoxon rank-sum tests and Cliff\u2019s Delta.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Only 22.2% of psychotropics were classified as essential by both WHO and national criteria. Median costs were substantially higher in the private sector, with price differences ranging from 2- to 140-fold (e.g., risperidone 2\u2009mg: $1.41 private vs $0.01 public; Cliff\u2019s Delta\u2009=\u20090.99). While essential medicines were generally affordable in the public sector (&lt;1 day of minimum wage), newer and long-acting formulations required up to 276\u2009days of labor. Public-sector availability was limited, and geographic accessibility showed marked centralization: several Amazonian and highland regions lacked access to key psychotropics, whereas private-sector availability was near-universal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Psychotropic medication access in Peru is characterized by profound economic and geographic inequities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20451253261440374","type":"journal-article","created":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T07:36:48Z","timestamp":1786865808000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic apartheid: a cross-sectional assessment of estimated cost, accessibility, affordability, and availability among psychotropic medications across 25 regions"],"prefix":"10.1177","volume":"16","author":[{"given":"Javier A.","family":"Flores-Cohaila","sequence":"first","affiliation":[{"name":"Grupo NEMECS: Neurociencias, Metabolismo, Efectividad Cl\u00ednica y Sanitaria, Universidad Cient\u00edfica del Sur, Carrera de Medicina Humana, Lima, Per\u00fa"},{"name":"Departamento de Psiquiatr\u00eda, Hospital V\u00edctor Larco Herrera, Magdalena del Mar, Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Arturo","family":"V\u00edlchez 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