Metcalfe Scott, Beyene Kebede, Urlich Jude, Jones Rhys, Proffitt Catherine, Harrison Jeff, Andrews Ātene
Chief Advisor Population Medicine/Deputy Medical Director (on external secondment).
Research Fellow in Pharmacoepidemiology and Health Outcomes.
N Z Med J. 2018 Nov 9;131(1485):27-47.
Analysis of dispensings of prescription medicines in New Zealand in 2006/07 reported large inequities between Māori and non-Māori. This present study has now updated the earlier work by describing variations in disease burden-adjusted medicines access by ethnicity in 2012/13, and changes over time.
The update has linked prescription medicine data with burden of disease estimates by ethnicity for 2012/13 and comparing with 2006/07. This has re-examined the shortfall in prescriptions for Māori vs non-Māori adjusting for age, population and burden of disease (ie, health loss, in disability-adjusted life years (DALYs)).
After adjusting for age, population and burden of disease, large inequalities still existed for Māori compared with non-Māori, with generally no improvement over the six years. In 2012/13, Māori had 41% lower dispensings overall than non-Māori; this was nominally worse compared with the 37% relative gap in 2006/07, but the trend was not statistically significant. Many complexities and limitations hamper valid interpretation, but large inequities in access and persistence, across many therapeutic groups, remain. The full University of Auckland report details these inequities.
Large inequities in medicines access for Māori continue. Inequities in access are unacceptable, their causes likely complex and entrenched; we believe they need deeper understanding of systems and barriers, pragmatic ways to monitor outcomes, and an all-of-sector approach and beyond. PHARMAC has committed to strategic action to eliminate inequities in access to medicines by 2025, recognising it needs partners to drive the necessary change. Kei a tātou tonu katoa te wero kia mahikaha, kia mahi tino mōhio, me te mahitahi (The challenge continues for us to work harder, work smarter, and work together); everyone in the health sector has a role.
对2006/07年度新西兰处方药配给情况的分析报告显示,毛利人和非毛利人之间存在巨大的不平等。本研究通过描述2012/13年度按种族划分的疾病负担调整后的药品可及性差异以及随时间的变化,更新了早期的研究工作。
此次更新将2012/13年度的处方药数据与按种族划分的疾病负担估计数相联系,并与2006/07年度进行比较。这重新审视了毛利人与非毛利人在考虑年龄、人口和疾病负担(即残疾调整生命年(DALYs)中的健康损失)情况下的处方缺口。
在调整年龄、人口和疾病负担后,与非毛利人相比,毛利人仍然存在巨大的不平等,在这六年中总体上没有改善。2012/13年度,毛利人的总体配给量比非毛利人低41%;与2006/07年度37%的相对差距相比,名义上更差,但该趋势无统计学意义。许多复杂情况和限制因素妨碍了有效解读,但在许多治疗组中,药品可及性和持续性方面的巨大不平等仍然存在。奥克兰大学的完整报告详细阐述了这些不平等情况。
毛利人在药品可及性方面仍然存在巨大不平等。可及性方面的不平等是不可接受的,其原因可能复杂且根深蒂固;我们认为需要更深入地了解系统和障碍,采取务实的方法监测结果,并采取全部门及更广泛的方法。药物管理局已承诺采取战略行动,到2025年消除药品可及性方面的不平等,认识到需要合作伙伴推动必要的变革。“让我们继续面临挑战,更加努力、更加明智地工作,并共同努力”;卫生部门的每个人都发挥着作用。