The University of Notre Dame, Fremantle, WA, Australia.
Department of Pharmacy, School of Applied Sciences, University of Huddersfield, HD1 3DH, Huddersfield, United Kingdom; School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Mail Bag 92019, Auckland, New Zealand.
Health Policy. 2018 Mar;122(3):243-249. doi: 10.1016/j.healthpol.2017.12.004. Epub 2017 Dec 20.
Medicines Access Programs (MAP) offer access to publicly unfunded medicines at the discretion of pharmaceutical companies. Limited literature is available on their extent and scope in Australia and New Zealand. This study aims to identify MAPs for cancer medicines that were operational in 2014-15 in Australia and New Zealand and describe their characteristics. A preliminary list of MAPs was sent to hospital pharmacists in Australia and New Zealand to validate and collect further information. Pharmaceutical companies were contacted directly to provide information regarding MAPs offered. Key stakeholders were interviewed to identify issues with MAPs. Fifty-one MAPs were identified covering a range of indications. The majority of MAPs were provided free of charge to the patient for medicines that were registered or in the process of being registered but were not funded. Variability in the number of MAPs across institutions and characteristics was observed. Australia offered more MAPs than New Zealand. Only two of 17 pharmaceutical companies contacted agreed to provide information on their MAPs. Eight stakeholder interviews were conducted. This identified that while MAPs are widely operational there is lack of clinical monitoring, inequity to access, operational issues and lack of transparency. Our results suggest a need for a standardised and mandated policy to mitigate issues with MAPs.
医药准入方案（MAP）由制药公司自行决定，为患者提供公共资金未覆盖的药品。目前，有关澳大利亚和新西兰 MAP 的范围和规模的文献有限。本研究旨在确定 2014-15 年在澳大利亚和新西兰运行的癌症药物 MAP，并描述其特征。向澳大利亚和新西兰的医院药剂师发送了一份初步的 MAP 清单，以验证和收集更多信息。还直接联系制药公司，以获取有关提供的 MAP 信息。对主要利益相关者进行了访谈，以确定 MAP 存在的问题。共确定了 51 种 MAP，涵盖了多种适应症。大多数 MAP 为未注册或正在注册但未获得资金的药品向患者免费提供。不同机构的 MAP 数量和特征存在差异。澳大利亚提供的 MAP 多于新西兰。在联系的 17 家制药公司中，只有两家同意提供其 MAP 信息。进行了 8 次利益相关者访谈。这表明，尽管 MAP 广泛运行，但存在缺乏临床监测、获取机会不平等、运营问题和缺乏透明度等问题。我们的研究结果表明，需要制定标准化和强制性政策来缓解 MAP 存在的问题。
