Public–Private Partnership Models for Improving Access to Affordable Medications for the Treatment of Non-Communicable Diseases

Non-communicable diseases (NCDs) represent a major global health burden, yet access to affordable medications remains limited, particularly in low- and middle-income countries (LMICs). Public–Private Partnership (PPP) models have emerged as a potential strategy to enhance medicine availability and affordability, but evidence on their effectiveness remains limited. This study aimed to evaluate the impact of PPP models on access to essential medications for the treatment of NCDs, focusing on medicine availability, stock-outs, pricing, and patient affordability. A quantitative cross-sectional study was conducted using data from 240 health facilities, including 120 PPP-supported and 120 non-PPP facilities. Data on medicine availability, stock-out frequency, median unit prices, and affordability (measured as days’ wages required for standard treatment) were collected from facility records and national databases. Descriptive statistics, comparative analyses, and multivariable linear regression were performed to assess the association between PPP participation and access outcomes. PPP-supported facilities demonstrated significantly higher medicine availability (88.6% vs. 71.2%, p < 0.001) and fewer stock-outs (1.3 vs. 3.9 per year, p < 0.001) compared with non-PPP facilities. Median unit prices were lower in PPP facilities (USD 0.48 vs. 0.73, p = 0.002), resulting in improved affordability (1.6 vs. 2.9 days’ wages per treatment, p < 0.001). Among PPP models, pooled procurement and long-term contracts were associated with the greatest improvements in availability, price reduction, and affordability. Multivariable regression confirmed that PPP participation, long-term contracts, and pooled procurement were independently associated with improved affordability, even after controlling for facility characteristics and geographic location. In conclusion, Public–Private Partnerships significantly improved access to affordable NCD medications by enhancing availability, reducing stock-outs, and lowering prices. The effectiveness of PPPs was contingent on model type, contract stability, and governance mechanisms. Policymakers should consider PPPs as a strategic tool for sustainable medicine access, while ensuring equity, transparency, and strong public-sector oversight.