School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 210009, People's Republic of China.
Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, People's Republic of China.
Int J Clin Pharm. 2024 Jun;46(3):694-703. doi: 10.1007/s11096-024-01706-0. Epub 2024 Mar 12.
The global prevalence of hepatitis B virus (HBV) has presented a persistent challenge for public health prevention and treatment. However, studies that assess the public's access to anti-HBV drugs are absent.
To examine the availability, pricing, and affordability of anti-HBV drugs in Jiangsu province, China and provide recommendations for improvement.
An enhanced methodology developed by the World Health Organization (WHO) and Health Action International was applied in a cross-sectional study that included 1026 healthcare facilities distributed in 13 prefectural-level cities in Jiangsu province.
Since almost all drugs had an availability of less than 30%, the accessibility of anti-HBV drugs was notably low. Primary healthcare facilities had the lowest availability, reporting 1.4% for Original Brands (OBs) and 1.7% for lowest-priced generics (LPGs). Furthermore, the northern Jiangsu region recorded the lowest availability at 0.7%. LPGs demonstrated higher availability than OBs, with median availability probabilities of 2.6% and 1.4%, respectively. The drugs listed on the WHO Essential Medicines List exhibited higher availability than those on other lists. The median price ratios for OBs, LPGs, and volume-based purchasing drugs were 0.83, 0.50, and 0.27, respectively, less than 1.5 times the international reference price. Despite favorable pricing, affordability rate was 23% for urban residents and 0% for rural residents, which was discouraging.
Low availability and affordability of anti-HBV drugs were observed. Policy recommendations should emphasize the improvement of LPG availability by incentivizing priority prescribing. Healthcare subsidies should be provided more effectively and equitably.
全球乙型肝炎病毒 (HBV) 的流行一直对公共卫生预防和治疗构成持续挑战。然而，目前缺乏评估公众获取抗 HBV 药物的研究。
评估中国江苏省抗 HBV 药物的可及性、定价和可负担性，并提出改进建议。
采用世界卫生组织（WHO）和国际健康行动组织制定的强化方法，在江苏省 13 个地级市的 1026 家医疗机构中进行横断面研究。
由于几乎所有药物的可获得性都低于 30%，因此抗 HBV 药物的可及性明显较低。基层医疗机构的可获得性最低，原研药（OBs）为 1.4%，最低价仿制药（LPGs）为 1.7%。此外，苏北地区的可获得性最低，为 0.7%。LPGs 的可获得性高于 OBs，中位数的可获得性概率分别为 2.6%和 1.4%。WHO 基本药物清单上的药物比其他清单上的药物具有更高的可获得性。OBs、LPGs 和按剂量采购药物的价格比率中位数分别为 0.83、0.50 和 0.27，均低于国际参考价的 1.5 倍。尽管价格有利，但城市居民的可负担率为 23%，农村居民为 0%，令人沮丧。
观察到抗 HBV 药物的可获得性和可负担性较低。政策建议应强调通过激励优先处方来提高 LPG 的可获得性。应更有效地和公平地提供医疗保健补贴。
