Department of Pharmacy Administration, School of Pharmacy, Health Science Centre, Xi'an Jiaotong University, Xi'an, China.
PLoS One. 2013 Aug 1;8(8):e70836. doi: 10.1371/journal.pone.0070836. Print 2013.
To measure the prices and availability of selected medicines in Shaanxi Province after the implementation of new healthcare reform in 2009.
Data on the prices and availability of 47 medicines were collected from 50 public and 36 private sector medicine outlets in six regions of Shaanxi Province, Western China using a standardized methodology developed by the World Health Organization and Health Action International from September to October 2010. Medicine prices were compared with international reference prices to obtain a median price ratio. Affordability was measured as the number of days' wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions.
The mean availabilities of originator brands and lowest-priced generics were 8.9% and 26.5% in the public sector, and 18.1% and 43.6% in the private sector, respectively. The public sector procured generics and originator brands at median price ratios of 0.75 and 8.49, respectively, while patients paid 0.97 and 10.16. Final patient prices for lowest-priced generics and originator brands in the private sector were about 1.53 and 8.36 times their international retail prices, respectively. Public sector vendors applied high markups of 30.4% to generics, and 19.6% to originator brands. In the private sector, originator brands cost 390.7% more, on average, than their generic equivalents. Generic medicines were priced 17.3% higher in the private sector than the public sector. The lowest-paid government worker would need 0.1 day's wages to purchase captopril for lowest-priced generics from private sector, while 6.6 days' wages for losartan. For originator brands, the costs rise to 1.2 days' wages for salbutamol inhaler and 15.6 days' wages for omeprazole.
The prices, availability and affordability of medicines in China should be improved to ensure equitable access to basic medical treatments, especially for the poor. This requires multi-faceted interventions, as well as the review and refocusing of policies, regulations and educational interventions.
评估 2009 年新医改实施后陕西省部分药品的价格和可及性。
2010 年 9 月至 10 月，采用世界卫生组织和健康行动国际组织制定的标准化方法，从陕西省 6 个地区的 50 家公立和 36 家私营药店收集了 47 种药品的价格和可及性数据。药品价格与国际参考价格进行比较，得出中值价格比。可负担性以最低工资非熟练政府工人购买常见疾病标准治疗所需的工资天数来衡量。
在公立部门，原研药和最低价格仿制药的平均可得性分别为 8.9%和 26.5%，在私营部门，分别为 18.1%和 43.6%。公立部门采购仿制药和原研药的中值价格比分别为 0.75 和 8.49，而患者支付的价格比分别为 0.97 和 10.16。私营部门最低价格仿制药和原研药的最终患者价格分别为国际零售价格的 1.53 倍和 8.36 倍左右。公立部门供应商对仿制药的加价率高达 30.4%，对原研药的加价率为 19.6%。在私营部门，原研药的平均价格比其仿制药高出 390.7%。仿制药在私营部门的价格比公立部门高出 17.3%。最低工资政府工人从私营部门购买最低价格的卡托普利仿制药只需 0.1 天的工资，而购买氯沙坦则需要 6.6 天的工资。对于原研药，沙丁胺醇吸入器的成本上升到 1.2 天的工资，奥美拉唑的成本上升到 15.6 天的工资。
中国应改善药品的价格、可及性和可负担性，以确保基本医疗服务的公平可及，尤其是为贫困人口。这需要多方面的干预，以及审查和重新调整政策、法规和教育干预。
