北京市基本药物可及性评价研究

Analysis of accessibility of essential medicine in Beijing

目的：从可获得性、价格水平和可负担性的角度评价北京市基本药物的可及性。方法：根据北京市2013年糖尿病领域社保抽样处方数据，并结合4家基层医疗卫生机构处方数据和实地调研，通过基本药物配备率、中位价格比（Median pricerate，MPR）、致贫率等指标进行可及性评价。结果：21种样本药品中，尼群地平、硫酸镁、硝普钠、哌唑嗪、酚妥拉明和格列本脲6种药品的配备率不足15％；9个样本药品的MPR值为1．3～27．4；高血压、高血脂和糖尿病在城镇的致贫率为0．44％～0．70％，在农村的致贫率为1．17％～1．88％。结论：北京市部分基本药物配备率极低，基本药物价格水平偏高，基本药物的致贫人口数不容小视。建议：加强对基本药物可及性的监测，并出台相应配套政策。

Objectives： To evaluate essential medicines accessibility from the availability, drug price level and affordability perspective in Beijing. Methods： Data was collected from a sample of a Beijing social security database on diabetes in 2013 and a field research on 4 primary heahhcare institutions. The essential medicine equipping rate, medium price ratio （MPR） and poverty-inducing effect were selected as accessibility indicators. Results： Among 21 sample drugs, the nitrendipine, magnesium sulfate, sodium nitroprusside, prazosin, phentolamine and glyburide e- quipping rates are less than 15%. The 9 sample drugs MPR varied from 1.3 to 27.4. The hypertension, hyper- lipemia and diabete poverty-inducing rate varied from 0.44% to 0.70% in urban areas, and varied from 1.17% to 1.88% in rural areas. Conclusion： Some essential medicines in Beijing are equipped with a very low rate, but have a high price level, and the poverty-inducing population is large. We recommend strengthening the monitoring of es- sential medicines accessibility and introducing appropriate supporting policies.