国家药品集中采购前后陕西省原研与仿制降压药可负担性的横断面调查

A Cross-sectional Survey on Affordability of Original and Generic Antihypertensive Drugs Before and After National Centralized Procurement in Shaanxi Province

目的了解国家药品集中采购实施前后,陕西省高血压用药的可负担性。方法以最低日工资标准和年人均可支配收入为指标,对2018年和2021年陕西省集中采购中标的10种仿制降压药和与其相同成分的原研降压药的可负担性进行横断面调查。结果国家药品集中采购政策实施以来,陕西省10种原研和仿制降压药可负担性均有所改善。10种原研药和仿制药月药品支出分别由2018年最低日工资标准的1.86~4.54倍和0.09~2.19倍下降至2021年的0.61~3.21倍和0.03~0.94倍。陕西省城镇居民对于降压药的可负担性优于农村居民,仿制降压药的可负担性优于原研药。未参加医疗保险陕西省农村居民原研降压药年药品支出占其年人均可支配收入的比重由2018年的10.29%~25.10%下降至2021年的3.12%~16.34%;仿制药其比例由2018年的0.49%~12.11%下降至2021年的0.15%~4.78%;参加医疗保险农村居民原研降压药其比例由2018年的5.63%~10.81%下降到2021年的2.63%~7.26%,仿制药其比例由2018年的0.49%~6.27%下降到2021年的0.15%~3.22%。结论国家药品集中采购政策的实施,对陕西省原研和仿制降压药可负担性产生了积极影响,尤其是农村居民的可获得性明显改善。应不断优化药品集采工作,提高医疗保障水平,改善人民群众(尤其是低收入人群)对药品的负担能力。

Objective To evaluate the affordability of antihypertensive drugs in Shaanxi province before and after the policies of the national centralized procurement.Methods A cross-sectional survey was conducted on the affordability of 10 bid-winning generic antihypertensive drugs in the national centralized procurement and originator brands that have same active ingredient with these generics supplied in Shaanxi province in 2018 and 2021,using the minimum daily wage standard and annual per capita disposable income as indicators.Results As shown in the results,since the implementation of the national centralized procurement policy,the affordability of 10 original brands as well as generic antihypertensive drugs in Shaanxi Province has improved significantly.The ratio of monthly drug expenditures of 10 original and generic drugs to the minimum daily wage standard decreased from 1.86-4.54 times and 0.09-2.19 times in 2018 to 0.61-3.21 times and 0.03-0.94 times in 2021,respectively.The affordability of antihypertensive drugs for urban residents in Shaanxi province is better than that for rural residents,and the affordability of generic drugs is better than that of original drugs.For uninsured rural residents in Shaanxi province,the proportion of original yearly drugs expenditure to annual per capita disposable income decreased from 10.29%-25.10%in 2018 to 3.12%-16.34%in 2021;and that of annual generic drugs expenditure decreased from 0.49%-12.11%in 2018 to 0.15%-4.78%in 2021.For insured rural residents,the proportion of annual original drugs expenditure decreased from 5.63%-10.81%in 2018 to 2.63%-7.26%in 2021;and that of annual generic drugs expenditure decreased from 0.49%-6.27%in 2018 to 0.15%-3.22%in 2021.Conclusion The implementation of national centralized drug procurement has positively impacted on the affordability of original and generic antihypertensive drugs in Shaanxi Province,and in particular,the affordability for rural residents has improved significantly.We should continuously optimize the drug procurement,increase medical security,and improve the affordability of drugs for people,especially low-income groups.