基于WHO/HAI标准调查方法的南京市基本药物可获得性及可负担性调查分析

摘要

OBJECTIVE:To understand the availability and affordability of essential medicines in Nanjing after implementing national essential medicine system,and to provide evidence for formulating and completing related policy. METHODS:With inves-tigation subjects of 6 classes of diseases with high incidence,WHO/HAI standard survey method was adopted to select 24 essential medicines and investigate and evaluate the availability and affordability of them in governmental health institutions and social retail pharmacies in Nanjing. RESULTS:Availability of essential medicines in community health service centers in Nanjing was lower than governmental hospitals and social retail pharmacies,and availability of lowest price generic drugs (LPGs) was much higher than original brand drugs (OBs);affordability was totally good,however,there were large gap in the affordability between OBs and LPGs,the affordability of OBs was relatively poor. CONCLUSIONS:The national essential medicine system has made some progress in Nanjing,but worse than expected. It is suggested to update and adjust the essential medicine list based on the clinical medication requirement,guarantee the equipment of essential medicines in medical and health institutions,popularize the knowl-edge about essential medicines,properly adjust the price of original brand drugs and ease the treatment burden.%目的：了解实施国家基本药物制度以来南京市基本药物的可获得性及可负担性情况，为后续制订和完善相关政策提供依据。方法：采用世界卫生组织（WHO）和国际健康行动组织（HAI）共同制定的标准调查方法，以6种临床发病率高的疾病为调查对象，选取24种基本药物，对其在南京市公立医疗卫生机构和社会零售药店的可获得性及可负担性情况进行抽样调查和评价。结果：南京市基本药物在社区卫生服务中心的可获得性低于公立医院和社会零售药店，最低价格仿制药（LPGs）可获得性远远高于原研药（OBs）；可负担性总体状况较好，但OBs与LPGs之间的可负担性水平存在很大的差距，OBs可负担性相对较差。结论：国家基本药物制度在南京市的实施已取得一定效果，但是离预期目标仍然有差距。建议根据临床用药需求更新、调整基本药物目录，保障各级医疗卫生机构在基本药物的品种配备，普及基本药物知识，并适度调整原研药价格，减轻用药负担。