School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, 211198, China.
The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, 639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, 211198, China.
BMC Public Health. 2024 Aug 21;24(1):2268. doi: 10.1186/s12889-024-19786-y.
High clinical value national reimbursement anticancer medications (NRAMs) are pivotal treatments for patients with cancer. However, the availability of NRAMs in medical institutions is unknown. This study aimed to assess the availability of NRAMs in national and provincial medical institutions.
This cross-sectional study utilized national health insurance data to access the availability of NRAMs in national and provincial medical institutions. Further statistical analyses and visualizations were conducted in terms of medical institution level and daily cost. Using the Spearman's rank correlation test (α = 0.05), we calculated the correlation between the availability rates of NRAMs and their negotiation access time, daily cost, per capita disposable income, provincial gross product, and number of policy releases.
Overall, 81 NRAMs, with an average availability rate of approximately 1.01% nationwide, were included. There were significant differences between provinces for each drug, and the availability of NRAMs gradually decreased in tertiary (13.41%), secondary (1.58%), and primary medical institutions (< 0.05%). Differences were also observed in the availability rate of NRAMs in various daily drug cost ranges. Among the factors examined, negotiation access time (r = 0.425), daily cost (r = - 0.326), per capita disposable income (r = 0.645), provincial gross product (r4 = 0.433), and number of policy releases (r = 0.461) were all correlated with the availability of NRAMs.
The low availability of NRAMs in national and provincial medical institutions indicates that their willingness to equip NRAMs needs to be improved. All factors examined in this study affected the availability of NRAMs. Our findings can guide policymakers in improving relevant policies.
高临床价值国家医保抗癌药物（NRAMs）是癌症患者的重要治疗手段。然而，医疗机构中 NRAMs 的可及性尚不清楚。本研究旨在评估国家和省级医疗机构中 NRAMs 的可及性。
本横断面研究利用国家医疗保险数据评估国家和省级医疗机构中 NRAMs 的可及性。进一步在医疗机构水平和日费用方面进行了统计分析和可视化。使用 Spearman 秩相关检验（α=0.05），计算了 NRAMs 的可及率与其谈判准入时间、日费用、人均可支配收入、省级生产总值和政策发布数量之间的相关性。
总体而言，共纳入 81 种 NRAMs，全国平均可及率约为 1.01%。每一种药物在各省之间都存在显著差异，NRAMs 的可及性在三级（13.41%）、二级（1.58%）和一级医疗机构中逐渐降低（<0.05%）。在各种日费用范围的 NRAMs 可及率方面也存在差异。在所检查的因素中，谈判准入时间（r=0.425）、日费用（r=-0.326）、人均可支配收入（r=0.645）、省级生产总值（r4=0.433）和政策发布数量（r=0.461）与 NRAMs 的可及性均相关。
国家和省级医疗机构中 NRAMs 的可及性较低，表明其配备 NRAMs 的意愿有待提高。本研究中检查的所有因素都影响了 NRAMs 的可及性。我们的研究结果可以为政策制定者提供指导，以改进相关政策。
