基本药物的可及性、价格和可负担性：越南河静省的横断面调查。
Availability, prices and affordability of essential medicines: A cross-sectional survey in Hanam province, Vietnam.
机构信息
Department of Pharmaceutical Management and PharmacoEconomics, Hanoi University of Pharmacy, Hanoi city, Vietnam.
Pharmacy Department, 108 Military Center Hospital, Hanoi city, Vietnam.
出版信息
PLoS One. 2021 Nov 18;16(11):e0260142. doi: 10.1371/journal.pone.0260142. eCollection 2021.
OBJECTIVE
To measure medicines' prices, availability, and affordability in Hanam, Vietnam.
METHODS
The standardized methodology developed by the World Health Organization (WHO) and Health Action International was used to survey 30 essential medicines (EMs) in 30 public health facilities and 35 private medicine outlets in 2020. The availability of medicine was computed as the percentage of health facilities in which this medicine was found on the data-collection day. International reference prices (IRPs) from Management Sciences for Health (2015) were used to compute Median Price Ratio (MPR). The affordability of treatments for common diseases was computed as the number of days' wages of the lowest-paid unskilled government worker needed to purchase medicines prescribed at a standard dose. Statistic analysis was done using R software version 4.1.1.
RESULTS
The mean availability of originator brands (OBs) and lowest-priced generics (LPGs) was 0.7%, 63.2% in the public sector, and 13.7%, 47.9% in the private sector, respectively. In private medicine outlets, the mean availability of both OBs and LPGs in urban areas was significantly higher than that in rural areas (p = 0.0013 and 0.0306, respectively). In the public sector, LPGs' prices were nearly equal to their IRPs (median MPRs = 0.95). In the private medicine outlets, OBs were generally sold at 6.24 times their IRPs while this figure for LPGs was 1.65. The affordability of LPGs in both sectors was good for all conditions, with standard treatments costing a day's wage or less.
CONCLUSION
In both sectors, generic medicines were the predominant product type available. The availability of EMs was fairly high but still lower than WHO's benchmark. A national-scale study should be conducted to provide a comprehensive picture of the availability, prices, and affordability of EMs, thereby helping the government to identify the urgent priorities and improving access to EMs in Vietnam.
目的
测量越南顺化省的药品价格、可及性和可负担性。
方法
采用世界卫生组织（WHO）和国际健康行动组织制定的标准化方法，于 2020 年在 30 家公共卫生机构和 35 家私人药店调查了 30 种基本药物（EMs）。药物的可及性是通过计算在数据收集日发现该药物的卫生机构的百分比来计算的。使用健康管理科学（2015 年）的国际参考价格（IRP）来计算中位数价格比（MPR）。常见疾病治疗的可负担性是通过购买标准剂量规定的药物所需的最低工资非技术政府工人的工资天数来计算的。统计分析使用 R 软件版本 4.1.1 进行。
结果
原研品牌（OBs）和最低价格仿制药（LPGs）的平均可得性分别为 0.7%和 63.2%，在公共部门，13.7%和 47.9%，在私人部门。在私人药店，城乡地区 OBs 和 LPGs 的平均可得性均显著较高（p = 0.0013 和 0.0306）。在公共部门，LPGs 的价格与国际参考价格基本相当（中位数 MPRs = 0.95）。在私人药店，OBs 的售价通常是国际参考价格的 6.24 倍，而 LPGs 的售价是国际参考价格的 1.65 倍。在两个部门，所有情况下 LPGs 的可负担性都很好，标准治疗费用不到一天的工资。
结论
在两个部门，仿制药都是主要的产品类型。EMs 的可及性相当高，但仍低于世卫组织的基准。应进行全国范围内的研究，以全面了解 EMs 的可及性、价格和可负担性，从而帮助政府确定紧急优先事项，并改善越南获得 EMs 的机会。
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