Department of Health Policy, School of Health Policy and Management, Nanjing Medical University, Nanjing, China.
Department of Clinical Pharmacy, School of Pharmacy, Nanjing Medical University, Nanjing, China.
Trop Med Int Health. 2021 May;26(5):518-529. doi: 10.1111/tmi.13559. Epub 2021 Mar 4.
As economic globalisation develops in-depth, infectious diseases that occur in a country or region no longer remains a regional issue. Antibiotics and antiviral medicines are essential medicines for the therapy of infectious diseases. This study aims to evaluate their availability, cost and affordability of AaAMs against infectious diseases in 41 public hospitals from 2013 to 2019 in Nanjing, China.
Data on the availability and price of 17 antibiotics and 6 antiviral medicines in 41 public hospitals were obtained from the Jiangsu Institute of Medicine Information. We adopted the WHO/Health Action International method to measure the availability, cost and affordability of these medicines.
The availability of selected medicines against infectious diseases was relatively low; the median availability of originator brands was near-zero and that of lowest-priced generics during the survey period less than 50%. The total availability of medicines was poor in primary hospitals as compared to secondary and tertiary hospitals. The median daily-defined dose cost of originator brands was expensive (range from 66.11 RMB to 107.83 RMB), whereas that of lowest price generics was fairly acceptable at < 8 RMB. The affordability of most surveyed medicines was reasonable, which showed significant improvement over time, but the daily cost of a few medicines for originator brands exceeded the average daily wage.
In general, the affordability of medicines surveyed was acceptable, while the availability was too low. There should be a great concern for improving the reserve system of anti-infective medicines in healthcare institutions. Policy should focus on improving the availability of generic drugs in hospitals and encouraging preferentially prescribed.
随着经济全球化的深入发展,一国或一地区发生的传染病不再是一个区域性问题。抗生素和抗病毒药物是治疗传染病的基本药物。本研究旨在评估 2013 年至 2019 年期间中国南京 41 家公立医院对抗感染疾病的抗生素和抗病毒药物的可获得性、价格和可负担性。
从江苏省医学信息研究所获取了 41 家公立医院 17 种抗生素和 6 种抗病毒药物的可获得性和价格数据。我们采用世界卫生组织/卫生行动国际方法来衡量这些药物的可获得性、成本和可负担性。
针对传染病的选定药物的可获得性相对较低;在调查期间,原研品牌的中位数可用性接近零,而最低价格仿制药的可用性不足 50%。与二级和三级医院相比,初级医院的药物总体可获得性较差。原研品牌的日治疗剂量费用中位数较高(范围为 66.11 元至 107.83 元),而最低价格仿制药的费用则较为合理,<8 元。大多数调查药物的可负担性是合理的,且随着时间的推移有显著改善,但少数原研品牌药物的日费用超过了平均日工资。
总体而言,所调查药物的可负担性是可以接受的,而可获得性太低。应高度关注改善医疗机构抗感染药物储备系统。政策应侧重于提高医院仿制药的可获得性,并鼓励优先处方。