Stenson B, Tomson G, Syhakhang L
Karolinska Institutet, Stockholm, Sweden.
Health Policy Plan. 1997 Dec;12(4):329-40. doi: 10.1093/heapol/12.4.329.
An explosive development of private pharmacies in the Lao People's Democratic Republic (Lao P.D.R.) has led to 80% of pharmaceuticals being provided by the private sector. In order to achieve the goal of access to good quality health care for all citizens, the Lao government is making an effort to regulate the private pharmaceutical sector using the emerging legal system of laws, decrees, and regulations. The aim of this paper is to describe and analyze the system of drug regulation in Lao P.D.R. in relation to the public social goals. Relevant official documents at the central, provincial and district levels have been reviewed, interviews were held with 30 key informants and 15 pharmacies were surveyed. The public social goals have been expressed in terms of equity and quality of care. However, total drug expenditure may be as low as US$1 per person per year which is far below any minimum standard and does not make it possible to achieve reasonable access to drugs for all. The regulatory system has so far been focused on entry into the pharmaceutical retail market and dealing with basic issues of product quality and conditions of sale. An enforcement system including sanctions is being developed; other policy instruments such as information and economic means are hardly being used at all. The government presently faces a trade-off between quality of pharmaceutical services and geographical equity of access. The study shows that regulation is strongly influenced by the general socioeconomic context.
老挝人民民主共和国（老挝）私营药店的迅猛发展使得私营部门提供了80%的药品。为实现全体公民都能获得优质医疗保健服务的目标，老挝政府正努力利用新出现的法律法规体系对私营药品部门进行监管。本文旨在描述和分析老挝药品监管体系与公共社会目标的关系。对中央、省和地区各级的相关官方文件进行了审查，与30名关键信息提供者进行了访谈，并对15家药店进行了调查。公共社会目标体现在公平和医疗服务质量方面。然而，药品总支出可能低至每人每年1美元，这远远低于任何最低标准，也无法让所有人都能合理获得药品。到目前为止，监管体系一直侧重于药品零售市场准入以及处理产品质量和销售条件等基本问题。一个包括制裁措施的执法体系正在建立；而信息和经济手段等其他政策工具几乎完全未被使用。政府目前面临着药品服务质量与地理可及性公平之间的权衡。研究表明，监管受到总体社会经济背景的强烈影响。
