#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Evaluating access to oral anti-diabetic medicines: A cross-sectional survey of prices, availability and affordability in Shaanxi Province, Western China


Autoři: Caijun Yang aff001;  Shuchen Hu aff001;  Yanbing Zhu aff003;  Wenwen Zhu aff001;  Zongjie Li aff001;  Yu Fang aff001
Působiště autorů: The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi’an, China aff001;  The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi’an, China aff002;  Department of Pharmacology, Health Science Center, Xi’an Jiaotong University, Xi’an, China aff003;  Shaanxi Food and Drug Administration, Xi’an, China aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0223769

Souhrn

Objectives

To assess the availability and affordability of oral anti-diabetic medicines in Shaanxi Province, Western China.

Methods

In 2015, the prices and availability of 8 anti-diabetic medicines covering 31 different dosage forms and strengths were collected in six cities of Shaanxi Province. A total of 72 public hospitals and 72 private pharmacies were sampled, using a modified methodology developed by the World Health Organization (WHO) and Health Action International (HAI). Medicine prices were compared with international reference prices to obtain a median price ratio. For urban residents, affordability was assessed as the lowest-paid unskilled government workers to purchase cost of standard treatment in days’ wages; for rural residents, days’ net income was used.

Results

The mean availabilities of originator brands (OBs) and generics were 34.3% and 28.7% in public hospitals, and 44.1% and 64.4% in the private pharmacies. OBs and the lowest priced generics (LPGs) were procured at 12.38 and 4.52 times the international reference price in public hospitals, and 10.26 and 2.81 times the international reference prices in private pharmacies. Treatments with OBs were unaffordable even for urban residents. The affordability of the LPGs was good, except for acarbose, repaglinide and pioglitazone.

Conclusions

Most anti-diabetic medicines cannot met the WHO’s availability target (80% availability) in Shaanxi Province. The high prices of OBs had severely influenced the affordability of medicines, especially for the rural residents. Effective policies should be initiated to ensure the Chinese people a better access to more affordable anti-diabetic medicines.

Klíčová slova:

Medicine and health sciences – Health economics – Insulin – Drugs – Salaries – China – Global health


Zdroje

1. International Diabetes Federation. IDF Diabetes Atlas. Brussels, Belgium: International Diabetes Federation, 2015.

2. Li LM, Rao KQ, Kong LZ, Yao CH, Xiang HD, Zhai FY, et al. Technical Working Group of China National Nutrition and Health Survey. A description on the Chinese national nutrition and health survey in 2002. Chinese journal of epidemiology. 2005; 26: 478–484. 16334996

3. Wang L, Gao P, Zhang M, Huang Z, Zhang D, Deng Q, et al. Prevalence and ethnic pattern of diabetes and pre-diabetes in China in 2013. JAMA. 2017; 317(24): 2515–2523. doi: 10.1001/jama.2017.7596 28655017

4. Seshasai SR, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, et al. Emerging Risk Factors Collaboration. Diabetes mellitus, fasting glucose, and risk of cause-specific death. New England Journal Medicine. 2011; 364(9):829–841.

5. American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013; 36:1033–1046. doi: 10.2337/dc12-2625 23468086

6. Kankeu HT, Saksena P, Xu K, Evans DB. The financial burden from non-communicable diseases in low-and middle-income countries: a literature review. Health Research Policy and Systems. 2013; 11(1): 31.

7. National Health and Family Planning Commission of the People’s Republic of China. Statistical bulletin on the development of health and family planning in China. 18 Aug 2017. http://www.moh.gov.cn/guihuaxxs/s10748/201708/d82fa7141696407abb4ef764f3edf095.shtml?winzoom=1. Accessed 1 Jan 2018.

8. Liu Q, Liu M, Zhang J, Chu Y, Li A, Wang D. Direct Cost and Medication Usage Among Insured Type 2 Diabetes Patients with Chronic Kidney Disease under Hospitalization in Beijing and Tianjin, China. Value in Health the Journal of the International Society for Pharmacoeconomics & Outcomes Research. 2015; 18(7):A605.

9. Gwatidzo SD, Williams JS. Diabetes mellitus medication use and catastrophic healthcare expenditure among adults aged 50+ years in China and India: results from the WHO study on global AGEing and adult health (SAGE). BMC Geriatrics. 2017; 17(1):14. doi: 10.1186/s12877-016-0408-x 28077072

10. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New England Journal of Medicine. 1993; 329:977–86. doi: 10.1056/NEJM199309303291401 8366922

11. Xu Y, Wang L, He J, Bi Y, Li M, Wang T, et al. Prevalence and control of diabetes in Chinese adults. JAMA. 2013; 310(9):948–959. doi: 10.1001/jama.2013.168118 24002281

12. Mendis S, Abegunde D, Yusuf S, Ebrahim S, Shaper G, Ghannem H, et al. WHO study on Prevention of recurrences of Myocardial Infarction and Stroke(WHO-PREMISE). Bulletin of the World Health Organization. 2005; 83(11):820–828. 16302038

13. Liu C, Zhang X, Liu C, Ewen M, Zhang Z, Liu G. Insulin prices, availability and affordability: a cross-sectional survey of pharmacies in hubei province, china. BMC Health Services Research. 2017; 17(1):597. doi: 10.1186/s12913-017-2553-0 28836974

14. Progress in China's Human Rights in 2014. Beijing, the state council information Office of the People's Republic of China, 2015.

15. Zhou S. Comparative analysis of the treatment of medical insurance for urban and rural residents and the new rural cooperative medical system. Shandong Human Resources and Social Security. 2015; 10: 33–35.

16. Li Y, Ying C, Sufang G, Brant P, Bin L, Hipgrave D. Evaluation, in three provinces, of the introduction and impact of China's National Essential Medicines Scheme. Bulletin of the World Health Organization. 2013; 91(3):184–94. doi: 10.2471/BLT.11.097998 23476091

17. Financing, pricing, and utilization of pharmaceuticals in China: the road to reform policy (Vol. 2): Main report (Chinese).Washington, DC: World Bank, 2010. http://documents.worldbank.org/curated/en/590351468018625366/Main-report. Accessed 1 Jan 2018.

18. Fang Y, Wagner AK, Yang S, Jiang M, Zhang F, Ross-Degnan D. Access to affordable medicines after health reform: evidence from two cross-sectional surveys in Shaanxi Province, western China. Lancet Global health. 2013; 1(4):e227–e237. doi: 10.1016/S2214-109X(13)70072-X 25104348

19. Li Z, Feng Q, Kabba JA, Yang C, Chang J, Jiang M, et al. Prices, availability and affordability of insulin products: a cross-sectional survey in shaanxi province, western china. Tropical Medicine & International Health. 2019; 24(1): 43–52.

20. Wang X, Fang Y, Yang S, Jiang M, Yan K, Wu L, et al. Access to paediatric essential medicines: a survey of prices, availability, affordability and price components in Shaanxi Province, China. Plos One, 2014, 9(3): e90365. doi: 10.1371/journal.pone.0090365 24595099

21. Jiang M, Yang S, Yan K, Liu J, Zhao J, Fang Y. Measuring access to medicines: a survey of prices, availability and affordability in Shaanxi Province of China. Plos One, 2013, 8(8): e70836. doi: 10.1371/journal.pone.0070836 23936471

22. Saeed A, Saeed H, Saleem Z, Fang Y, Babar ZU. Evaluation of prices, availability and affordability of essential medicines in Lahore Division, Pakistan: A cross-sectional survey using WHO/HAI methodology. Plos One, 2019, 14(4): e0216122. doi: 10.1371/journal.pone.0216122 31022276

23. Jiang M, Zhou Z, Wu L, Shen Q, Lv B, Wang X, Yang S, Fang Y. Medicine prices, availability, and affordability in the Shaanxi Province in China: implications for the future. International Journal of Clinical Pharmacy, 2015, 37(1): 12–17. doi: 10.1007/s11096-014-0037-4 25425142

24. The State Council. (2016). National Bureau of Statistics of China. (Beijing: The State Council).

25. WHO. The western area health initiative. 2012. (Available from: http://www.wpro.who.int/china/areas/western_area_health_initiative/en/) [20 Aug 2019].

26. Ewen M, Joosse HJ, Beran D, Laing R. Insulin prices, availability and affordability in 13 low-income and middle-income countries. BMJ Global Health. 2019; 4: e001410. doi: 10.1136/bmjgh-2019-001410 31263585

27. Center for Health Statistics and Information, NHFPC. An Analysis Report of National Health Services Survey in China, 2013. Peking Union Medical College Press, 2015.

28. Chinese Diabetes Society. Standards of care for type 2 diabetes in China. Chinese Journal Diabetes Mellitus. 2014; 6(7):447–498.

29. The Editorial board of Standard Therapeutic Guidelines for National Essential Drugs. Standard Therapeutic Guidelines for National Essential Drugs. Beijing: People's Medical Publishing House, 2009.

30. World Health Organization. Availability and affordability: an international comparison of chronic disease medicines. 2006. http://apps.who.int/iris/handle/10665/116493. Accessed 1 Jan 2018.

31. Management Sciences for Health (MSH). International drug price indicator guide. http://erc.msh.org. Accessed 1 Jan 2018.

32. Department of Human Resources and Social Security of Shaanxi Province. The announcement of adjusting the standard of lowest wages. 2015. http://www.shaanxihrss.gov.cn/admin/pub_newsshow.asp?id=1009128&chid=100077. Accessed 1 Jan 2018.

33. Shaanxi Provincial Bureau of Statistics. The income of urban and rural residents in Shaanxi Province. 22 Feb 2016. http://www.shaanxitj.gov.cn/site/1/html/126/131/138/12422.htm. Accessed 1 Jan 2018.

34. Ewen M, Zweekhorst M, Regeer B, Laing R. Baseline assessment of WHO's target for both availability and affordability of essential medicines to treat non-communicable diseases. PLoS ONE. 2017; 12(2): e0171284. doi: 10.1371/journal.pone.0171284 28170413

35. Yip WC, Hsiao WC, Chen W, Hu SL, Ma J, et al. Early appraisal of China’s huge and complex health-care reforms. Lancet. 2012; 379:833–42. doi: 10.1016/S0140-6736(11)61880-1 22386036

36. Zhao M, Wu J. Impacts of regulated competition on pricing in Chinese pharmaceutical market under basic medical insurance. Expert Rev Pharmacoecon Outcomes Res. 2017; 17: 311–320. doi: 10.1080/14737167.2017.1251318 27762144

37. Chinese Ministry of Health. The Administrative Rules for Prescription. 14 Feb 2006. http://www.moh.gov.cn/mohyzs/s3572/200804/29279.shtml. Accessed 1 Jan 2018.

38. Guan X, Xin X, Liu Y, Wang T, Shi L. Empirical Study on Availability of Essential Medicine in China. China Pharmacy. 2013; 24(24): 2216–2219.


Článok vyšiel v časopise

PLOS One


2019 Číslo 10
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Aktuální možnosti diagnostiky a léčby litiáz
nový kurz
Autori: MUDr. Tomáš Ürge, PhD.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#