Chen Zhe, Li Siyu, Choonara Imti, Zeng Linan, Jia Zhi-Jun, Cheng Guo, Yu Qin, Zhang Lingli
West China School of Pharmacy, Sichuan University, Chengdu, China.
Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.
Front Pharmacol. 2022 Feb 16;13:828152. doi: 10.3389/fphar.2022.828152. eCollection 2022.
Essential medicines for children are those medicines that satisfy the priority health care needs of children. Access to essential medicines for children is a big challenge, particularly in low- and middle-income countries. Our study aimed to assess the accessibility of essential medicines for children in public sector in Sichuan Province of China, based on availability, affordability, and price. We adopted the modified World Health Organization/Health Action International (WHO/HAI) standardization methodology to measure the availability, affordability, and prices of 30 essential medicines for children in 20 public hospitals in nine regions of the Sichuan Province, China. Availability was expressed as the percentage of public medicine outlets that stocked surveyed medicines on the day of data collection, and prices were expressed as median price ratio (MPR). Affordability was assessed as the number of Sichuan Province's daily wages required for the lowest-paid government unskilled worker (11.03 USD per day) to purchase one standard treatment of an acute disease or treatment for chronic disease for a month. The mean availability of originator brands (OBs) and lowest priced generics (LPGs) were 9.7 and 46.5% in public sector. MPRs of only 3 OBs could be calculated, ranging from 0.55 to 13.37. MPRs of 18 LPGs ranged from 0.07 to 25.05. Among them, 2 OBs and 11 LPGs were priced at more than 1.5 times their international reference prices (IRPs) in public sector, most of which were injections. Except for cefazolin injection and ceftriaxone injection, most LPGs were affordable for the treatment of childhood diseases in public sector, as they each cost one or less than the daily wage for the lowest-paid unskilled government worker. Although the availability of LPGs for children was higher than OBs in public sector, the availability of children's essential medicines was low in surveyed public sector in Sichuan Province, which was similar to previous studies in other provinces of China. The price of most medicines surveyed was higher than their IRPs in surveyed public sector, especially for some injections. The affordability of most surveyed LPGs was reasonable in surveyed public sector, except for ceftriaxone injection and cefazolin injection.
儿童基本药物是指那些能满足儿童优先医疗保健需求的药物。获取儿童基本药物是一项巨大挑战，在低收入和中等收入国家尤其如此。我们的研究旨在基于可及性、可负担性和价格，评估中国四川省公共部门儿童基本药物的可及性。我们采用经修改的世界卫生组织/国际卫生行动组织（WHO/HAI）标准化方法，来衡量中国四川省九个地区20家公立医院中30种儿童基本药物的可及性、可负担性和价格。可及性以数据收集当天备有被调查药物的公立药店的百分比表示，价格以中位数价格比（MPR）表示。可负担性评估为四川省收入最低的政府非技术工人（日薪11.03美元）购买一种急性疾病的标准疗程或一个月慢性病治疗所需该省日工资的数量。公立部门中原创品牌药（OBs）和最低价仿制药（LPGs）的平均可及性分别为9.7%和46.5%。仅能计算3种OBs的MPR，范围为0.55至13.37。18种LPGs的MPR范围为0.07至25.05。其中，公立部门有2种OBs和11种LPGs的价格超过其国际参考价格（IRPs）的1.5倍，其中大部分是注射剂。除头孢唑林注射液和头孢曲松注射液外，大多数LPGs在公立部门用于治疗儿童疾病是可负担得起的，因为它们每种的费用为收入最低的政府非技术工人日工资的1倍或不到1倍。虽然公立部门儿童LPGs的可及性高于OBs，但四川省被调查的公立部门中儿童基本药物的可及性较低，这与中国其他省份之前的研究类似。在被调查的公立部门中，大多数被调查药物的价格高于其IRPs价格，尤其是一些注射剂。除头孢曲松注射液和头孢唑林注射液外，大多数被调查LPGs在被调查的公立部门中的可负担性是合理的。
