我国药品短缺问题研究进展评述

A Review of Research on Drug Shortages in China

目的:总结我国药品短缺问题的研究现状,为该领域后续研究及解决药品短缺问题提供参考。方法:检索中国知网、万方、维普数据库,收集我国药品短缺问题的相关研究文献,检索时限为1989年1月至2015年4月。根据纳入与排除标准独立筛选文献、提取资料,分别从研究背景、现状、原因分析、影响因素以及实施策略等方面进行统计分析。结果:我国出现药品短缺的品种合计达148种,其中化学药126种,中成药22种,化学药品短缺品种多于中成药;短缺的化学药多集中在生物制品、心血管系统用药、血液系统用药、抗微生物药、抗寄生虫药等;短缺的中成药多集中在内科用药;我国药品短缺的原因复杂,如政府层面的定价政策不合理、配套措施不健全、招标体系不完善、相关部门监管不严格等,还包括医院方面"以药养医"的体制问题以及患者用药知识缺乏等;现有文献关于药品短缺问题的解决策略主要有设置专门的部门管理药品短缺,建立短缺药品管理指南和药品短缺信息沟通网络平台,制定合理的药品价格以及招标政策,加强药品的注册管理,以及实施短缺药品的常态化储备等。结论:当前我国药品短缺的品种多,覆盖的疾病种类广;有关药品短缺的原因分析不够深入,药品短缺的策略研究不够细致,付诸实施的有效措施较少;有关药品短缺对于医疗结果影响的研究鲜有报道。因此,还需不断进行药品短缺问题的跟踪评估和干预策略研究,为解决我国药品短缺问题提供切实可行的路径和策略。

Objective： To summarize the research status of drug shortages and to provide references for. Methods： The databases such as CNKI, Wan Fang Data and VIP were electronically searched to collect studies related to drug shortages and related issues such as the varieties, the reasons, strategies and so on. The retrieval was from January, 1989 to April, 2015. The literature was screened independently according to the inclusion and exclusion criteria, then data were extracted and finally the related studies were analyzed. Results： The varieties of drugs in-short in China added up to 148, including 126 kinds of chemical drugs and 22 kinds of traditional Chinese medicines. The chemical medicines in-short were mostly biological products, cardiovascular drugs, hematological system drugs, antimicrobial agents, antiphrastic drugs and so on. While the shortages of traditional Chinese medicines were mostly internal medicines. Moreover, reasons for the drug shortages in China were complicated, such as the unreasonable pricing policy, the unsound supporting measurements and bidding systems, loose supervision in related departments and some institutional issues in hospital systems and lack of medical knowledge in patients. The strategies to deal with drug shortage included establishing special department and platform to manage drug shortages, formulating guidelines to handle the problems, setting reasonable drug price and bidding policy, strengthening drugs registration, normalizing reservation of drugs in shortage and so on. Conclusion： Up to now, the status of drug shortages in China was not so optimistic. Drug shortages in China were varied, and the analysis of the reasons was not profound enough. Furthermore, the strategies for solving related problems were superficial and not in detail. What＇s more, there were few strategies to improve this situation and few concerns about the impact of drug shortages. More studies about drug shortages were needed to provide support and advice.