Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.
Trop Med Int Health. 2019 Jan;24(1):43-52. doi: 10.1111/tmi.13167. Epub 2018 Nov 13.
To evaluate price, availability and affordability of insulin products in Shaanxi Province, western China.
We used a simplified and adapted WHO/Health Action International method to obtain the availability and prices of insulin products and five oral anti-diabetic medicines as comparators in public general hospitals and private retail outlets. In addition, we investigated the price components of eight selected insulin products by tracing the supply chain.
All three kinds of insulin products, prandial, basal and premixed insulin, are 100% available in public hospitals, and have fairly high availability in the private sector (62.5-68.8%). The prices of most insulin products were higher than international reference prices in both sectors (ranging from 0.95 times to 2.33 times). All insulin products were unaffordable as they would cost 3.5-17.1 days' wage of the lowest-paid government workers in Shaanxi. The manufacturer's markup (selling price), which comprised more than 60% of the final price of all insulin products surveyed, was the largest price component.
Although availability of insulin products was high in public general hospitals and private retail pharmacies, their high price made them unaffordable to diabetes patients, especially low-income patients. The government should increase insurance compensation for those who need these life-saving medicines or decrease the cost of insulin products through negotiation with suppliers.
评估中国西部陕西省的胰岛素产品的价格、可及性和可负担性。
我们采用简化和改编的世界卫生组织/国际健康行动组织方法，在公立综合医院和私人零售药店获取胰岛素产品和五种口服抗糖尿病药物的可及性和价格，并对 8 种选定的胰岛素产品的价格构成进行了供应链追溯调查。
三种胰岛素产品，即餐时胰岛素、基础胰岛素和预混胰岛素，在公立医院均 100%可及，在私营部门的可及性也相当高（62.5-68.8%）。两种部门的大多数胰岛素产品的价格都高于国际参考价格（0.95 倍至 2.33 倍不等）。所有胰岛素产品都不可负担，因为它们的费用将占陕西省最低工资政府工作人员工资的 3.5-17.1 天。制造商的加价（售价），占所有调查的胰岛素产品最终价格的 60%以上，是最大的价格构成部分。
尽管胰岛素产品在公立综合医院和私人零售药店的可及性较高，但价格较高使得糖尿病患者，特别是低收入患者无法负担得起这些救命药。政府应通过与供应商谈判来增加对这些急需药品的保险补偿，或降低胰岛素产品的成本。
