上海市青浦区公立医疗卫生机构基本药物可获得性的实证研究

摘要

OBJECTIVE:To investigate the affordability of essential medicines in public health and medical institutions of Shanghai Qingpu district after the implementation of the national essential medicines,and provide the basis for subsequent formula-tion and improvement of relevant policies. METHODS:Based on the WHO/HAI standardized approach,a survey on the affordabili-ty of 30 essential medicines was conducted in public health and medical institutions of Shanghai Qingpu district in aspects of equip-ping staffing,drug availability and the relativity in different levels of public health and institutions for investigation and evaluation. RESULTS:The equipping rate of 30 essential medicines in Shanghai Qingpu District varied from 53.33%-86.67%,while the date of original drugs varied from 16.67%-53.33%,the equipping rate in secondary and tertiary hospitals was high. The availability of 30 essential medicines with Approved Drug Names in secondary and tertiary hospitals (77.78%) was generally higher than that in community health service center(63.00%),while the availability of original drugs was relatively low. The essential medicines with more than 50% relativity in community health service center and tertiary hospitals were only 6 kinds of drugs. CONCLUSIONS:The equipping rate and availability of essential medicines in primary health and medical institutions are lower than that of second-ary and tertiary hospitals in Qingpu district,as well as the relativity. It is suggested to further improve equipping policy for essential medicines from the relativity to improve match rate of production place;while further study and improvement for generic drugs from bioequivalence to improve its bioequivalence with original drugs and ensure clinical efficacy.%目的：了解实施国家基本药物制度以来上海市青浦区公立医疗卫生机构基本药物的可获得性情况，为后续制定和完善相关政策提供依据。方法：采用世界卫生组织/国际健康行动组织标准调查法对上海市青浦区公立医疗卫生机构中30种基本药物的配备情况、可获得性情况以及不同级别医疗卫生机构所用基本药物的相关性进行调查和评价。结果：上海市青浦区公立医疗卫生机构30种基本药物的通用名药品配备率为53.33％～86.67％，原研药配备率为16.67％～53.33％，二、三级医院配备率较高。二、三级医院30种基本药物的通用名药品可获得率普遍高于社区卫生服务中心（平均分别为77.78％、63.00％），而原研药可获得率二、三级医院和社区卫生服务中心均相对较低。社区卫生服务中心与三级医院所用基本药物的产地相符率超过50％的只有6种药品。结论：青浦区基层医疗卫生机构基本药物的配备率和可获得性较二、三级医疗卫生机构低，基层医疗卫生机构与三级医疗卫生机构所用基本药物相关性较差。建议青浦区基本药物配备政策可从基本药物的相关性方面进一步改善，提高本地区基本药物产地相符率；而对于仿制药应从生物等效性方面进一步研究和改进，提高其与原研药的生物等效性，从而保证其临床疗效。