我国基本药物目录遴选与评价方法的问题与反思

Reflection on the Selection and Evaluation of Essential Drug List

目的:通过回顾世界卫生组织(WHO)基本药物示范目录遴选程序与方法的沿革,分析当前我国基本药物目录遴选与评价方法面临的问题和挑战,为进一步推动我国基本药物目录循证遴选和评价提出建议。方法:比较我国历年及2009年《国家基本药物目录》与《WHO基本药物目录》的药物遴选与方法,找出我国基本药物目录中的问题与局限,提出针对性解决思路。结果:我国基本药物目录遴选与评价方法存在以下突出问题:我国基本药物目录品种变化巨大,部分收录药品缺乏科学证据及存在安全性隐患(尤其是中药注射剂);同类药品品种过多,缺乏同类药品综合比较科学评价方法;缺乏基本药物循证遴选与评价指南和技术标准。结论:针对我国基本药物目录遴选与评价方法中的问题,开展基本药物循证评价方法学研究,建立我国基本药物目录遴选指南和配套的方法学技术指南与标准及遴选证据库;建立我国基本药物循证评价与遴选的专业人才队伍及机构,以推动我国基本药物目录的循证遴选,提高遴选决策科学性。

OBJECTIVE：To review the selection process and methods of WHO Essential Drug List and to analyze the problem and challenge of the selection and evaluation of National Essential Drug List in order to provide suggestion for the selection and evaluation of essential drug list in China. METHODS：The selection process of previous National Essential Drug Lists were compared with that of National Essential Drug Lists（2009 edition）and WHO Essential Drug List. The problem and limit of National Essential Drug List were found out to put forward countermeasure. RESULTS：The prominent problem of the selection and evaluation of National Essential Drug List were as follows：the categories of drugs were changed significantly and including of some drugs was not supported by scientific evidence. There was no indirection and standard for the evidencebased selection and evaluation of essential drug. CONCLUSION：Aiming at the problem of the selection and evaluation of National Essential Drug List,evidencebased evaluation research is conducted to establish indirection and standard for the selection of essential drug list and database. Professionals and institutions for evidencebased evaluation and selection of essential drug list should be established to promote evidencebased evaluation and selection of National Essential Drug List and make more scientific decision.