Measuring access to medicines: a survey of prices, availability and affordability in Shaanxi province of China.
Measuring access to medicines: a survey of prices, availability and affordability in Shaanxi province of China.
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衡量药品获取情况：中国陕西省价格、可获得性和可负担性调查
DOI：
10.1371/journal.pone.0070836
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Fang Y
中科院分区：
文献类型：
--
作者：
Jiang M;Yang S;Yan K;Liu J;Zhao J;Fang Y
测算陕西省2009年新医改实施后部分药品的价格和可获得性。2010年9月至10月，使用世界卫生组织和国际卫生行动组织制定的标准化方法，从陕西省、中国西部六个地区的50个公共和36个私营药店收集了47种药品的价格和可获得性数据。将药品价格与国际参考价进行比较，得出中位数价格比。可负担性被衡量为最低工资的非熟练政府工作人员购买普通疾病标准治疗所需的天数。在公共部门，原创品牌和最低价格仿制药的平均可获得性分别为8.9%和26.5%，在私营部门分别为18.1%和43.6%。公共部门采购仿制药和原创品牌的价格中值比率分别为0.75和8.49，而患者支付的价格分别为0.97和10.16。私营部门最低价格的仿制药和原创品牌的最终患者价格分别约为其国际零售价的1.53倍和8.36倍。公共部门供应商对仿制药的加价为30.4%，对原创品牌的加价为19.6%。在私营部门，原创品牌的价格平均比普通品牌高出390.7%。私营部门的仿制药价格比公共部门高出17.3%。工资最低的政府工作人员从私营部门购买最低价格仿制药的卡托普利需要0.1天的工资，而从氯沙坦购买的工资为6.6天。对于原创品牌，沙丁胺醇吸入器的成本上升到1.2天的工资，奥美拉唑的成本上升到15.6天的工资。应提高中国药品的价格、可获得性和可负担性，确保公平获得基本医疗服务，特别是贫困人口。这需要多方面的干预，以及审查和调整政策、条例和教育干预的重点。
To measure the prices and availability of selected medicines in Shaanxi Province after the implementation of new healthcare reform in 2009. Data on the prices and availability of 47 medicines were collected from 50 public and 36 private sector medicine outlets in six regions of Shaanxi Province, Western China using a standardized methodology developed by the World Health Organization and Health Action International from September to October 2010. Medicine prices were compared with international reference prices to obtain a median price ratio. Affordability was measured as the number of days’ wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. The mean availabilities of originator brands and lowest-priced generics were 8.9% and 26.5% in the public sector, and 18.1% and 43.6% in the private sector, respectively. The public sector procured generics and originator brands at median price ratios of 0.75 and 8.49, respectively, while patients paid 0.97 and 10.16. Final patient prices for lowest-priced generics and originator brands in the private sector were about 1.53 and 8.36 times their international retail prices, respectively. Public sector vendors applied high markups of 30.4% to generics, and 19.6% to originator brands. In the private sector, originator brands cost 390.7% more, on average, than their generic equivalents. Generic medicines were priced 17.3% higher in the private sector than the public sector. The lowest-paid government worker would need 0.1 day’s wages to purchase captopril for lowest-priced generics from private sector, while 6.6 days’ wages for losartan. For originator brands, the costs rise to 1.2 days’ wages for salbutamol inhaler and 15.6 days’ wages for omeprazole. The prices, availability and affordability of medicines in China should be improved to ensure equitable access to basic medical treatments, especially for the poor. This requires multi-faceted interventions, as well as the review and refocusing of policies, regulations and educational interventions.
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