Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.
Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.
Front Public Health. 2022 Nov 4;10:980969. doi: 10.3389/fpubh.2022.980969. eCollection 2022.
Compared with high-income countries, the survival rate of childhood cancer is lower in low- and middle-income countries. Access to essential anticancer medicines is an indispensable component of pediatric cancer treatment, which is still a big challenge in low- and middle-income countries.
To assess the accessibility of essential anticancer medicines for children in public hospitals in the Sichuan Province of China.
Based on the data of the Sichuan Province Drug Use Monitoring Platform in 2020, a retrospective study was conducted to investigate the original brands and generics of 34 anticancer and three supportive essential medicines for children (a total of 97 specific strengths) in Sichuan Province. The availability, price, and affordability of surveyed medicines were evaluated in all 152 tertiary public hospitals (120 general hospitals, 31 children's hospitals, and one cancer hospital) that could diagnose and treat cancer for children.
The average availability of generics and original brands was 18.5% and 2.6%, respectively. In regions with different gross domestic product (GDP) per capita levels, the average availability was similar, but the city with lower GDP per capita levels had fewer tertiary public hospitals. The prices of most original brands were higher than the lowest-priced generics, and the median price ratios of 31 lowest-priced generics and 16 original brands were 0.744 (P25P75, 0.4462.791) and 2.908 (1.719~6.465). After paying medical insurance for medicines, the affordability of essential anticancer medicines was improved. The monthly medicine cost did not exceed 10% of the monthly household income for 78.9% (30/38) of the lowest-priced generics and 50.0% (8/16) of the original brands.
The availability of lowest-priced generics was higher than original brands in public hospitals, but the availability of both was low, which was similar to previous studies in low- and middle-income countries. About half of the lowest-priced generics and 87.5% of the original brands cost more than 1.5 times the International Reference Price. Although the National Basic Medical Insurance greatly improved the affordability of essential anticancer medicines for children, higher subsidies for essential medicines for cancer treatment to limit catastrophic health expenditures are still recommended.
与高收入国家相比，中低收入国家儿童癌症的生存率较低。获得基本抗癌药物是儿童癌症治疗不可或缺的组成部分，但在中低收入国家仍然是一个巨大的挑战。
评估中国四川省公立医院儿童基本抗癌药物的可及性。
基于 2020 年四川省药物使用监测平台的数据，对四川省 34 种儿童抗癌药物和 3 种支持性基本药物（共 97 种特定强度）的原研药和仿制药进行回顾性研究。评估了 152 家可诊断和治疗儿童癌症的三级公立儿童医院（120 家综合医院、31 家儿童医院和 1 家癌症医院）中调查药物的可获得性、价格和可负担性。
仿制药和原研药的平均可获得性分别为 18.5%和 2.6%。在不同人均国内生产总值（GDP）水平的地区，平均可获得性相似，但人均 GDP 较低的城市拥有的三级公立医院较少。大多数原研药的价格均高于最低价仿制药，31 种最低价仿制药和 16 种原研药中，中位数价格比为 0.744（P25P75，0.4462.791）和 2.908（1.719~6.465）。在支付药品医疗保险后，基本抗癌药物的可负担性得到改善。对于 78.9%（30/38）的最低价仿制药和 50.0%（8/16）的原研药，每月药物费用不超过家庭月收入的 10%。
公立医院中最低价仿制药的可获得性高于原研药，但两者的可获得性都较低，与中低收入国家以往的研究结果相似。约一半的最低价仿制药和 87.5%的原研药的价格是国际参考价的 1.5 倍以上。虽然国家基本医疗保险大大提高了儿童基本抗癌药物的可负担性，但仍建议对癌症治疗的基本药物进行更高的补贴，以限制灾难性的卫生支出。
Zotero 插件