Zhao Mingyue, Gillani Ali Hassan, Ji Duan, Feng Zhitong, Fang Yu, Yang Caijun
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.
Front Pharmacol. 2021 Feb 5;12:621307. doi: 10.3389/fphar.2021.621307. eCollection 2021.
The primary objective of the study was to assess the impact of the Low-Price Medicine Policy (LPMP) on the supply of low-price medicines (LPMs) in China. The secondary objective of the study was to describe the supply situation of LPMs from 2005 to 2018. The LPMP was launched in the third quarter of 2014 (2014Q3). An interrupted time series analysis was used to evaluate the impact of LPMP on the supply of LPMs in China. Ordinary least squares and Poisson regression models were utilized to estimate the effect of LPMP on LPMs' supply growth rate and the number of supplied LPMs. All the LPMs were divided into two subgroups: intermittent supply and continuous supply. The trend and level changes of the quarterly average growth rate and number of quarterly supplies for different LPM groups were analyzed from 2005 to 2018. For the quarterly average growth rate, before the intervention, a significant increasing trend was observed in the total group and the continuous supply subgroup; after the introduction of LPMP, the increasing trend was ceased and a significant decrease in the trend and level was noted for both the total group (trend coefficient: -0.0132, < 0.01; level coefficient: = -0.1510, < 0.05) and the continuous supply subgroup (trend coefficient: = -0.0133, < 0.01; level coefficient: = -0.1520, < 0.05); whereas it had no significant effect for intermittent supply subgroup. For the number of quarterly supplies, after the intervention of LPMP, decline of the supply number was observed (trend coefficient: = -0.0027, < 0.001; level coefficient: = -0.0584, < 0.001); whereas the LPMP was associated with an upward trend and level (trend coefficient: = 0.0715, < 0.001; level coefficient: = 0.174) for the intermittent supply subgroup. For most of the LPMs, LPMP did not meet the goal of stimulating LPM production. However, for severely shortage medicines (the intermittent supply subgroup), the effect of LPMP was positive. Comprehensive policies rather than just deregulating medicine price should be introduced to alleviate the situation of medicine shortage in China.
该研究的主要目的是评估低价药品政策(LPMP)对中国低价药品(LPM)供应的影响。该研究的次要目的是描述2005年至2018年期间低价药品的供应情况。低价药品政策于2014年第三季度(2014Q3)推出。采用中断时间序列分析来评估低价药品政策对中国低价药品供应的影响。利用普通最小二乘法和泊松回归模型来估计低价药品政策对低价药品供应增长率和供应的低价药品数量的影响。所有低价药品被分为两个亚组:间歇性供应和持续性供应。分析了2005年至2018年不同低价药品组季度平均增长率和季度供应数量的趋势和水平变化。对于季度平均增长率,在干预前,总组和持续性供应亚组均观察到显著的上升趋势;在引入低价药品政策后,上升趋势停止,总组(趋势系数:-0.0132,P<0.01;水平系数:=-0.1510,P<0.05)和持续性供应亚组(趋势系数:=-0.0133,P<0.01;水平系数:=-0.1520,P<0.05)的趋势和水平均显著下降;而对间歇性供应亚组没有显著影响。对于季度供应数量,在低价药品政策干预后,观察到供应数量下降(趋势系数:=-0.0027,P<0.001;水平系数:=-0.0584,P<0.001);而对于间歇性供应亚组,低价药品政策与上升趋势和水平相关(趋势系数:=0.0715,P<0.001;水平系数:=0.174)。对于大多数低价药品,低价药品政策未达到刺激低价药品生产的目标。然而,对于严重短缺药品(间歇性供应亚组),低价药品政策的效果是积极的。应出台综合政策而非仅仅放开药品价格来缓解中国药品短缺的状况。