斯里兰卡社区药房 100 种基本药物的注册产品、可及性、价格和可负担性的全国调查。
A national survey on registered products, availability, prices, and affordability of 100 essential medicines in community pharmacies across Sri Lanka.
机构信息
Department of Pharmacology, Faculty of Medicine, University of Colombo, 25 Kynsey Rd, Colombo, 00800, Sri Lanka.
出版信息
BMC Health Serv Res. 2023 Oct 19;23(1):1121. doi: 10.1186/s12913-023-10137-y.
INTRODUCTION
Availability of essential medicines that meet the expected quality standards, in appropriate dosage forms at affordable prices is a fundamental prerequisite to fulfill healthcare needs of given a population. This study assessed available products, prices and affordability of essential medicines (EM) in community pharmacies in Sri Lanka with comparison of registration status from the National Medicines Regulatory Authority(NMRA).
METHODS
A cross-sectional island-wide survey of 80 pharmacies was conducted according to World Health Organization and Health Action International Manual (WHO/HAI). Hundred medicines were selected from the global core list(n = 14), regional core list(n = 16) and the Sri Lanka Essential Medicine List (SL-EML) (n = 70) based on healthcare needs. Number of registered products in 2015 and 2021 were compared.
FINDINGS
Average availability was 85.4%(± 12.31) and availability was lowest in the Northern province (69.38 ± 21.18%)(p = 0.008). Availability between the state owned, franchise and privately owned pharmacies was not significantly different (p > 0.05). 89.4% medicines were affordable except for amiodarone, hydroxychloroquine, sitagliptin, soluble insulin, isophane insulin, losartan, levodopa carbidopa combination, clonazepam and ceftriaxone. The median price ratio (MPR) of 33.7% of medicines was less than 1 and MPR of 37.1% originator brands (OB) was over 3. Median number of generic brands in the market was 8(range 2-44), 9% of medicines had 20 or more products in the market and 72.7% medicines had more products available than the number registered in 2015. The average number of registered products were similar in 2015 (8.27) and 2021(7.59) (p = 0.15).
CONCLUSION
The overall availability of EMs in Sri Lanka was high in all categories of community pharmacies. Medicines were largely affordable and reasonably priced in 2015, although OBs were generally more expensive. Majority of medicines had more products in the market than the number of registered products.
简介
提供符合预期质量标准、以可负担价格供应适当剂型的基本药物是满足特定人群医疗保健需求的基本前提。本研究评估了斯里兰卡社区药房基本药物（EM）的现有产品、价格和可负担性，并与国家药品监管局（NMRA）的注册状况进行了比较。
方法
根据世界卫生组织和健康行动国际手册（WHO/HAI），对 80 家药店进行了一项跨岛的横断面调查。根据医疗需求，从全球核心清单（n=14）、区域核心清单（n=16）和斯里兰卡基本药物清单（SL-EML）（n=70）中选择了 100 种药物。比较了 2015 年和 2021 年的注册产品数量。
结果
平均可获得率为 85.4%（±12.31），北部省的可获得率最低（69.38±21.18%）（p=0.008）。国有、特许经营和私营药店之间的可获得性没有显著差异（p>0.05）。除了胺碘酮、羟氯喹、西他列汀、可溶性胰岛素、异胰岛素、氯沙坦、左旋多巴卡比多巴复方、氯硝西泮和头孢曲松外，89.4%的药物价格都可以负担得起。33.7%的药物的中位数价格比（MPR）小于 1，37.1%的原研药（OB）的 MPR 超过 3。市场上通用品牌的中位数数量为 8（范围 2-44），20 种或更多产品的药物占 9%，72.7%的药物的可获得产品数量超过 2015 年的注册数量。2015 年（8.27）和 2021 年（7.59）的注册产品平均数量相似（p=0.15）。
结论
斯里兰卡所有类型社区药房的基本药物总体供应情况都很高。2015 年，尽管原研药通常更贵，但大多数药物的价格都在可承受范围内，且可负担性较高。市场上的大多数药物的产品数量都超过了注册数量。
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