WHO和典型国家基本药物目录的框架结构设计对我国的启示

Framework design of WHO and typical national essential medicine lists and its implications for China

目的梳理国内外基本药物目录框架常见的呈现形式和构成要素,以期为我国基本药物目录框架优化提供参考。方法对比WHO和中国、南非、印度、马来西亚等典型国家的最新版基本药物目录,分析其目录框架呈现形式和构成要素的共性与差异。结果与结论WHO和典型国家常见的目录呈现形式包括分册、分类和符号注释,不同形式的管理思路、发挥作用和实施难度有所不同;常见的框架构成要素包括目标人群、医疗机构级别、药品使用条件、核心与补充目录、采购优先等级。对比发现,我国基药目录所涵盖的信息较为单薄,框架设计尚未充分发挥出基药目录指导临床合理用药和优化医疗卫生资源配置的理想作用,仍有一定的完善空间。建议我国明确目录不同呈现形式的特点和作用,基于国情和发展需求合理设定目录框架;在目录中补充药品临床使用、经济性、政策属性等多维度的药品信息,保障基本药物合理使用;在基药目录框架中增加“医疗机构级别”要素,细化基本药物配备使用的管理要求,优化医疗卫生资源配置。

OBJECTIVE To sort out the common presentation forms and components of the framework of domestic and foreign essential medicine lists(EMLs),in order to provide reference for optimizing the framework of the Chinese EML.METHODS The latest edition of the EMLs of WHO,China,South Africa,India,Malaysia and other typical countries were compared,and the similarities and differences of the presentation form and constituent elements of the list framework were analyzed.RESULTS&CONCLUSIONS The common presentation forms of WHO and typical countries’EMLs included version,classifications and symbols,of which management ideas,functions,and implementation difficulties varied;common framework elements included target population,hospital levels,drug use conditions,core and supplementary lists and procurement priority.Through comparison,it was found that the information covered by the Chinese EML was relatively thin,and the framework design had not yet fully played the ideal role in guiding clinical rational drug use and optimizing the allocation of health resources,and there was still some room for improvement.It is recommended that China clarify the characteristics and roles of different presentation forms of the EML,and reasonably set the EML framework based on national conditions and development needs;the multi-dimensional drug information should be supplemented,such as clinical use,economy,and policy attributes of drugs in the EML,to ensure the rational use of essential drugs;it is also necessary to add“the level of hospitals”in the framework of the EML,refine the management requirements for the allocation and use of essential medicine,and optimize the resource allocation of hospitals.