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衡量儿童可用药品和可负担性的可持续发展目标指标:概念验证研究。

Sustainable Development Goal indicator for measuring availability and affordability of medicines for children: a proof-of-concept study.

机构信息

Utrecht WHO Collaborating Centre for Pharmaceutical Policy and Regulation, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.

WHO Collaborating Centre for Pharmaceutical Policy and Evidence Based Practice, Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

出版信息

BMJ Open. 2023 Apr 11;13(4):e065929. doi: 10.1136/bmjopen-2022-065929.

Abstract

OBJECTIVES

To complement Sustainable Development Goal (SDG) indicator 3.b.3 that monitors access to medicines for all, a corresponding child-specific methodology was developed tailored to the health needs of children. This methodology could aid countries in monitoring accessibility to paediatric medicines in a validated manner and on a longitudinal basis. We aimed to provide proof of concept of this adapted methodology by applying the method to historical datasets.

METHOD

A core set of child-appropriate medicines was selected for two groups of children: children aged 1-59 months and children aged 5-12 years. To enable calculation of affordability of medicines for children, the was created, incorporating the recommended dosage and duration of treatment for the specific age group. The adapted methodology was applied to health facility survey data from Burundi (2013), China (2012) and Haiti (2011) for one age group. SDG indicator 3.b.3 scores and (mean) individual facility scores were calculated per country and sector.

RESULTS

We were able to calculate SDG indicator 3.b.3 based on historical data from Burundi, China and Haiti with the adapted methodology. In this case study, all individual facilities failed to reach the 80% benchmark of accessible medicines, resulting in SDG indicator 3.b.3 scores of 0% for all 3 countries. Mean facility scores ranged from 22.2% in Haiti to 40.3% in Burundi for lowest-price generic medicines. Mean facility scores for originator brands were 0%, 16.5% and 9.9% for Burundi, China and Haiti, respectively. The low scores seemed to stem from the low availability of medicines.

CONCLUSION

The child-specific methodology was successfully applied to historical data from Burundi, China and Haiti, providing proof of concept of this methodology. The proposed validation steps and sensitivity analyses will help determine its robustness and could lead to further improvements.

摘要

目的

为了补充监测所有人获得药物的可持续发展目标(SDG)指标 3.b.3,我们制定了相应的儿童特定方法,以满足儿童的健康需求。该方法可以帮助各国以经过验证的方式和纵向方式监测儿科药物的可及性。我们旨在通过将该方法应用于历史数据集来提供该适应性方法的概念验证。

方法

为两组儿童选择了一组核心儿童适用药物:1-59 个月大的儿童和 5-12 岁的儿童。为了能够计算儿童药物的可负担性,创建了,其中包含特定年龄组的推荐剂量和治疗持续时间。将适应性方法应用于布隆迪(2013 年)、中国(2012 年)和海地(2011 年)的卫生机构调查数据,适用于一个年龄组。根据每个国家和部门计算了 SDG 指标 3.b.3 得分和(平均)个别机构得分。

结果

我们能够使用适应性方法根据布隆迪、中国和海地的历史数据计算 SDG 指标 3.b.3。在这个案例研究中,所有的个别机构都未能达到 80%的可获得药物基准,导致所有 3 个国家的 SDG 指标 3.b.3 得分为 0%。最低价仿制药的平均机构得分范围从海地的 22.2%到布隆迪的 40.3%。布隆迪、中国和海地的原创品牌的平均机构得分分别为 0%、16.5%和 9.9%。低分数似乎源于药物的低可用性。

结论

儿童特定方法成功应用于布隆迪、中国和海地的历史数据,提供了该方法的概念验证。所提出的验证步骤和敏感性分析将有助于确定其稳健性,并可能导致进一步改进。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4418/10106062/d835161bc9ba/bmjopen-2022-065929f01.jpg

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