2010-2014年陕西省公立医院和零售药店药品可获得性动态评估研究

Comparative Study on the Availability of Drugs in Public Hospitals and Retail Pharmacies in Shaanxi Province

目的:了解基本药物制度实施以来陕西省药品可获得性变化情况,为国家基本药物制度的顺利推行提供实证支持。方法:采用世界卫生组织/健康行动国际组织(WHO/HAI)的标准化调查方法,分别于2010年、2012年和2014年,对陕西省6个地市的公立医院和零售药店中的44种常用药品的可获得性进行调查和评价。结果:无论是公立医院还是零售药店,2010年、2012年和2014年药品的平均可获得性均低于50%;零售药店的药品平均可获得性均高于公立医院;基本药物中原研药(OBs)和非基本药物中最低价格仿制药(LPGs)的平均可获得性变化不大;对于所有药品和基本药物来说,OBs均低于LPGs的平均可获得性;而对于所有非基本药物,OBs均大于基本药物的平均可获得性。结论:5年来,公立医院药品的可获得性不断提高,零售药店药品的可获得性不断降低。建议相关部门加强药品供应监管,促进药品可获得性的提高。同时,建议根据我国国情,建立一套基于WHO/HAI标准化法改良过的调查手册,用以指导我国药品可获得性的调查,从而真实地反映我国药品可及性的现状。

Objective： To compare the availability of drugs in public hospitals and retail pharmacies in Shaanxi Province since the implementation of essential medicines policy, so as to provide references and suggestions for the implementation of essential medicines policy. Methods： Totally 44 kinds of drugs in public hospitals and retail pharmacies in 2010, 2012 and 2014 were investigated using a standard methodology（second edition） developed by World Health Organization（WHO） and Health Action International（HAI）. Results： The average availability of investigated medicines was less than 50% both in public hospitals and in retail pharmacies during those three years and the average drug availability in retail pharmacy was higher than that in public hospitals. Moreover, there was not much change in the average availability of OBs in essential medicines and LPGs in non-essential medicines over the three years. The average availability of OBs was lower than that of LPGs for all medicines or counterpart essential medicines while the average availability of OBs was higher than that of LPGs for nonessential medicines. Conclusion： The data showed that the average availability in public hospital exhibited an overall upward trend while the average availability in retail pharmacy was going down. It is necessary to strengthen the regulation of drug supply to promote the availability of drugs. Additionally, an improved workbook according to the standardized methodology of WHO/HAI handbook is needed to guide the investigation of drug availability in our country, so as to fairly reflect the drug accessibility in our country.