基本药物目录中的抗菌药物在南京地区医疗机构中的可及性调查研究
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篇名: 基本药物目录中的抗菌药物在南京地区医疗机构中的可及性调查研究
TITLE: Investigation and Study on the Accessibility of Antibiotics in Essential Medicine List in Medical Institutions of Nanjing Area
摘要: 目的:了解基本药物目录中的抗菌药物在南京地区医疗机构的可及性,为后续制订和完善相关药品政策提供依据。方法:以原研和仿制两种来源的药物为调查对象,采用世界卫生组织(WHO)/国际健康行动组织(HAI)共同制定的标准调查方法,选取基本药物目录(2018年版)和国际药品价格指南(2015年版)共同收录的35种抗菌药物,于2019年1-6月通过线上问卷的方式分别从可获得性(可提供该药品的机构占比)、药价水平[以中位价格比(MPR)计算]和可负担性(药品支出与非技术政府工人每日最低工资的比值)等3个维度对南京市13家二级及以上医疗机构进行调查,并提出药物政策制订建议。结果:原研药可获得性的中位数为0,区间范围为0~100%;仿制药的可获得性的中位数为30.80%,区间范围为0~100%。原研药价的MPR为5.54,区间范围为1.96~18.83;仿制药价的MPR为1.76,区间范围为0.16~7.66。原研药可负担性的中位数为8.68,区间范围为1.19~41.79;仿制药可负担性的中位数为0.52,区间范围为0.03~16.80。结论:与原研药相比,仿制药的可获得性更高;原研药的价格普遍很高,仿制药的价格大多较低;原研药总体可负担性较差,仿制药总体可负担性较好。基本药物的整体可及性尚有进一步提升的空间,当前保证原研药的可及性有助于满足临床治疗的需求。建议根据临床用药需求更新、调整基本药物目录,普及基本药物知识,并适度调整原研药价格,减轻患者用药负担。制订药物政策时需充分考虑地域因素和不同性质医疗机构的个性化使用需求。
ABSTRACT: OBJECTIVE:To investigate the accessibility of antibiotics in essential medicine list in medical institutions of Nanjing area ,and to provide reference for formulating and improving related drug policy. METHODS :Taking the original and imitated drugs as the objects of investigation ,the standard investigation method jointly formulated by WHO/HAI was adopted to select 35 kinds of antibiotics which were included in Essential Medicine List (2018 edition)and International Drug Price Indicator Guide(2015 edition),and to investigate 3 dimenions such as the availability (proportion of institutions that could provide this drug),price(calculated by MPR )and affordability (the ratio of drug expenditure to the daily minimum wage of non-technical government workers )of them in 13 second-class or above medical institutions in Nanjing area by online questionnaires during Jan.-Jun. 2019,so as to put forward the suggestions for drug policy formulation. RESULTS :The median availability of original drugs was 0,with a range of 0 to 100%;the median availability of generic drugs was 30.80%,with a range of 0 to 100%. The median MPR of original drugs was 5.54,with a range of 1.96 to 18.83;the median MPR of generic drugs was 1.76,with a range of 0.16 to 7.66. Median affordability of original drugs was 8.68,with a range of 1.19 to 41.79;the median affordability of generic drugs was 0.52, with a range of 0.03 to 16.80. CONCLUSIONS:Generic drugs are more available than the originals. The price of original drugs is generally very high , while the price of generic drugs is mostly cheaper. The affordability of original drugs is really poor , and the 规。E-mail:shaorong118@163.com affordability of generic drugs is totally good. There are stillrooms for further improvement in the overall accessibility of essential medicines. At present ,ensuring the accessibility of original drugs may be more helpful to meet the needs of treatment. It is suggested to update and adjust the essential medicine list based on the clinical medication requirement ,popularize the knowledge about essential medicines ,properly adjust the price of original drugs and ease the treatment burden of patient. It is supposed to take into full consideration about the regional factors and the needs of different medical institutions when making drug policy.
期刊: 2020年第31卷第11期
作者: 张亮,周秋云,张雪萌,俞颖,王杉杉,邵蓉
AUTHORS: ZHANG Liang,ZHOU Qiuyun ,ZHANG Xuemeng ,YU Ying,WANG Shanshan ,SHAO Rong
关键字: 基本药物;抗菌药物;可及性;医疗机构;南京
KEYWORDS: Essential medicine ;Antibiotics;Accessibility;Medical institution ;Nanjing
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