Health
Study Finds Stark Global Inequalities in Cost of Essential Medicines
European countries are spending more on essential medicines than any other region, but wealthier nations ultimately benefit from greater affordability once purchasing power is taken into account, a new international study has found.
The research, published in the JAMA Health Forum, analyzed the cost and availability of 549 essential medicines across 72 markets worldwide. These drugs, drawn from the World Health Organization’s (WHO) list of essential medicines, range from painkillers and antibiotics to anesthetics, chemotherapy drugs, and treatments for mental health conditions.
The study revealed that in 2022, European nations collectively spent around €1.74 billion, averaging €167 per person. In comparison, the Americas spent approximately €868 million overall, while Southeast Asia reported just €6 per capita. Availability of medicines also varied widely, with Germany stocking 438 of the listed medicines, compared with just 225 in Kuwait. Across 33 European countries included, the average was 367 medicines available.
While richer nations typically face higher list prices for drugs, they are cushioned by stronger purchasing power, national insurance systems, and state-led price negotiations. Once these factors are taken into account, many wealthier countries enjoy some of the lowest effective medicine costs globally.
By contrast, lower-income nations, despite often showing lower list prices, face a disproportionate burden. For people in parts of Africa and Southeast Asia, a month’s treatment can cost weeks of wages, forcing families to make impossible choices between healthcare and other essentials.
The study highlighted significant variations across regions. In Lebanon, for instance, drug prices were roughly one-fifth of those in Germany when adjusted for purchasing power, while in Argentina, they were nearly six times higher. In Pakistan, the cost of medicines equaled German levels once purchasing power was considered, while in the United States, prices reached three times higher than Germany’s.
The financial burden was most acute for treatments such as chemotherapy and chronic disease medications. A minimum-wage worker in India would need about 10 days’ wages to afford a month’s supply of tenofovir disoproxil, a drug for hepatitis B and HIV/AIDS. For paclitaxel, a chemotherapy drug, workers in poorer countries could spend nearly six weeks of wages on a single month’s treatment.
Mental health and cardiovascular drugs emerged as some of the costliest categories, while hepatitis treatments were among the least expensive. Researchers stressed that these disparities highlight a pressing issue of global health equity.
“Some poorer countries face a higher burden of medication costs, even if the price for the same medicine is lower compared to richer countries,” the study concluded, urging policymakers to consider both price and affordability in shaping access to essential treatments.
Health
World Cup Emotion Can Strain the Heart, Cardiologists Warn Fans at Risk
As the World Cup begins, medical experts are cautioning football fans with underlying heart conditions that the emotional intensity of matches can place unexpected strain on the cardiovascular system.
Cardiologists say that the excitement, tension, and anxiety generated during high-stakes games can trigger physical reactions similar to intense exercise, raising heart rate, blood pressure, and stress hormones.
“Intense emotions, whether positive or negative, can act as ‘precipitating risk factors’ for cardiovascular events such as heart attack,” said Paola Santalucia, a cardiologist and board member of the European Heart Network.
She explained that moments of extreme excitement, such as a decisive penalty shootout or a last-minute goal, may pose risks for people already living with heart disease. Those with additional risk factors, including hypertension, obesity, or smoking habits, are also advised to be cautious during emotionally charged matches.
Research using wearable devices has shown that during major football events, some fans experience heart rates climbing as high as 150 beats per minute. That level is comparable to sprinting and reflects how strongly the body reacts to emotional stress.
A study examining supporters during the 2025 German Cup final found that even watching from home can significantly affect physiological responses. “They still had an increase in heart rate that compares to walking, even though they didn’t walk,” said Christian Deutscher, professor of sports economics at Bielefeld University and co-author of the study.
He noted that the most intense reactions often occur not during goals themselves, but during moments of uncertainty such as VAR checks, penalty shootouts, or shots striking the post. These unpredictable situations, he said, are what drive the strongest emotional and physical responses among fans.
Deutscher also pointed out that stadium spectators may experience even greater strain due to environmental factors such as heat and alcohol consumption.
However, experts emphasize that football itself is not inherently dangerous. Instead, it is the body’s natural response to excitement that can create temporary stress.
“The adrenergic stimulation is at its max: extreme high blood pressure, high heart rate, and adrenaline, cortisol, skyrocketing,” said Dan Atar, professor of cardiology at Oslo University Hospital. In rare cases, he added, this surge can contribute to the rupture of arterial plaque in vulnerable individuals, potentially leading to a heart attack.
Atar stressed that such events can occur in everyday situations as well, including physical exertion like shoveling snow. “It is in no way dangerous to watch a football game,” he said. “All this is physiologic. It’s not dangerous to be excited.”
Still, he acknowledged that combining emotional stress with alcohol, heat, and pre-existing conditions can increase risk for some viewers.
Doctors advise those at higher risk to continue prescribed medications, limit alcohol intake, avoid smoking, and watch for warning signs such as chest pain or irregular heartbeat.
“The key message is not to avoid enjoying the match, but to do so with moderation and awareness,” Santalucia said.
Health
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Health
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