2010-2012年陕西省常见慢性病用药的可获得性及可负担性调查分析

Investigation and Analysis of Availability and Affordability of Common Medicines for Chronic Diseases in Shaanxi Province from 2010 to 2012

目的:了解实施国家基本药物制度以来常见慢性病用药的可获得性及可负担性情况,为后续制订和完善相关政策提供数据支撑。方法:采用世界卫生组织/国际健康行动机构的标准化调查方法,分别于2010年和2012年对陕西省6个城市的公立医院和零售药店中的26种慢性病用药的可获得性及可负担性进行调查和评价。结果:陕西省常见慢性病用药的可获得性情况不容乐观,与2010年相比,2012年部分慢性病用药的原研药(OBs)可获得性升高,但所有慢性病用药的最低价格仿制药(LPGs)可获得性均降低;与2010年相比,2012年慢性病用药的可负担性明显提高,虽然使用OBs治疗慢性病可负担性仍较差,但使用LPGs治疗除心血管疾病以外的慢性病可负担性良好。与其他发展中国家相比,陕西省慢性病用药的可获得性相对较低,但可负担性相对较好。结论:建议公立医院提高慢性病用药的采购效率,保障药物的可获得性;政府部门加大政策扶持力度,鼓励慢性病仿制药的生产供应;进行慢性病用药药品价格成分调查,提高药品定价的科学性;改善慢性病用药结构和报销水平,进一步提升慢性病用药的可负担性。

OBJECTIVE： To investigate the availability and affordability of common medicines for chronic disease since the implementation of National Essential Medicine System, and to provide data evidence for the formulation and improvement of related policies. METHODS： Using a standardized methodology （second edition） developed by WHO and Health Action International （HAl）, the availability and affordability of 26 kinds of medicines for chronic diseases collected in public hospitals and retail pharmacies in 6 cities of Shaanxi province in 2010 and 2012 were investigated and evaluated, respectively. RESULTS： The availability of common medicines for chronic disease was out of satisfaction in two years. The availability of some originator brands （OBs） in 2012 was slightly higher than in 2010. The availability of all the lowest priced generics （LPGs） in 2012 was lower than that in 2010. Meanwhile, the affordability of them was obviously improved in 2012. The affordability of OBs was poor, whereas LPGs showed good affordability to chronic disease except for cardiovascular disease. Compared with other developing countries, medi- cines for chronic disease showed poor availability but good affordability in Shaanxi province. CONCLUSIONS： It is suggested to improve procurement efficiency in public hospitals so as to ensure the availability of the needed medicines. The government should adjust some related policies to encourage the production and supply of generics; investigate the medicine price components to ensure rational prices; adjusting the structure and the level of chronic drug reimbursement in order to further improve the affordability of medicines for chronic diseases.