Olivier J. Wouters (
Jouni Kuha, London School of Economics and Political Science.
Health Aff (Millwood). 2024 Oct;43(10):1410-1419. doi: 10.1377/hlthaff.2024.00089.
Little is known about how long it takes for new medicines to reach countries with different income levels. We analyzed data, sourced from IQVIA, on the timing of new drug launches in seventy-five low-, middle-, and high-income markets from 1982 to 2024. The sample captured the majority of essential medicines (as designated by the World Health Organization in the twenty-third Model List of Essential Medicines) that first came into medical use anywhere globally from 1982 onward. Kaplan-Meier estimates were used to quantify delays in launches across countries. Our analysis comprised 119 medicines with 6,871 observed launches. Nearly three-quarters (74 percent) of first launches occurred in just eight countries (in order of the most first launches, the US, the Netherlands, Sweden, Switzerland, the United Kingdom, France, Germany, and Japan). From the first launch globally, the median time to availability was 2.7 years for high-income countries, 4.5 years for upper-middle-income countries, 6.9 years for lower-middle-income countries, and 8.0 years for low-income countries. The gap between richer (high- and upper-middle-income) and poorer (lower-middle- and low-income) countries remained largely unchanged over time. Strategies to address the disparities highlighted by this analysis are urgently needed.
对于新药物到达不同收入水平的国家需要多长时间，我们知之甚少。我们分析了 IQVIA 提供的从 1982 年到 2024 年 75 个低、中、高收入市场新药推出时间的数据。该样本涵盖了自 1982 年以来在全球任何地方首次投入医疗使用的大多数基本药物（世界卫生组织在第 23 版《基本药物示范清单》中指定）。Kaplan-Meier 估计用于量化各国推出的延迟。我们的分析包括 119 种药物和 6871 次观察到的推出。近四分之三（74%）的首次推出发生在仅八个国家（按首次推出最多的国家排序，美国、荷兰、瑞典、瑞士、英国、法国、德国和日本）。从全球首次推出到可获得性的中位数时间为高收入国家 2.7 年，中上收入国家 4.5 年，中下收入国家 6.9 年，低收入国家 8.0 年。随着时间的推移，富裕国家（高收入和中上收入）和贫困国家（中下收入和低收入）之间的差距基本保持不变。迫切需要采取策略来解决该分析强调的差距。
