Fig. 1

Theoretical model for medicines as health needs. The theoretical model comprises stakeholders, policies and practices that modulate the perception of medicines as a health need from two perspectives - health and market - at three levels: international, national and local levels. The different perceptions created of medicines as a health need (according to Brashaw’s categories) do not always coincide, and as a result of this “conflict” the patients do not get access to the medicines they perceive as a need. The health system scheme ('software' and 'hardware') was adapted from Sheikh et al. (2011). Pharmaceutical policy is represented as a square behind the stakeholders and policies considered at the national level, since pharmaceutical policies could adopt different forms according to the context: (a) a unique document considering all the aspects defining them; or (b) a policy that guides the development of the other policies. Source: Vargas-Peláez, et al., 2017 [1] with permission of the Journal Social Science and Medicine