中国儿童基本药品可及性多中心研究  

A multicenter survey of the accessibility of essential medicines for children in China

作　　者：戴仪 李智平 徐虹 朱琳 朱逸清 成华[4] 陈泽彬[5] 黄强增 雷莉 李仁秋[8] 李根 李毅 廖明[11] 卢庆红[12] 侍晓萍 孙华君[14] 史天陆 吴学新 王增寿[17] 许静[18] 赵赶[19] 张古英[20] 陈超 Dai Yi;Li Zhiping;Xu Hong;Zhu Lin;Zhu Yiqing;Cheng Hua;Chen Zebin;Huang Qiangzeng;Lei Li;Li Renqiu;Li Gen;Li Yi;Liao Ming;Lu Qinghong;Shi Xiaoping;Sun Huajun;Shi Tianlu;Wu Xuexin;Wang Zengshou;Xu Jing;Zhao Gan;Zhang Guying;Chen Chao(Department of Neonatology,Children′s Hospital of Fudan University,Shanghai 201102,China;Department of Pharmacy,Children′s Hospital of Fudan University,Shanghai 201102,China;Department of Nephrology,Children′s Hospital of Fudan University,Shanghai 201102,China;Department of Pharmacy,Xi′an Children′s Hospital,Xi′an 710003,China;Department of Pharmacy,Shenzhen Children′s Hospital,Shenzhen 518038,China;Department of Pharmacy,Fuzhou Children′s Hospital,Fuzhou 350005,China;Department of Pharmacy,Children′s Hospital of Urumqi,Urumqi 830000,China;Department of Pharmacy,Kunming Children′s Hospital,Kunming 650228,China;Department of Pharmacy,Chengdu Women's and Children′s Central Hospital,Chengdu 610091,China;Department of Pharmacy,Qingdao Women and Children′s Hospital,Qingdao 266000,China;Department of Pharmacy,Guiyang Maternal and Child Health Hospital,Guiyang 550003,China;Department of Pharmacy,Jiangxi Provincial Children′s Hospital,Nanchang 330006,China;Department of Pharmacy,Dalian Children′s Hospital,Dalian 116012,China;Department of Pharmacy,Children′s Hospital of Shanghai,Shanghai 200062,China;Department of Pharmacy,the First Affiliated Hospital of University of Science and Technology of China,Anhui Provincial Hospital,Hefei 230001,China;Department of Pharmacy,Qilu Children′s Hospital of Shandong University,Jinan 250022,China;Department of Pharmacy,the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University,Wenzhou 325000,China;Department of Pharmacy,Children′s Hospital of Nanjing Medical University,Nanjing 210019,China;Department of Pharmacy,Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,China;Department of Pharmacy,Hebei Children′s Hospital,Shijiazhuang 050031,China)

机构地区：[1]复旦大学附属儿科医院新生儿科,上海201102 [2]复旦大学附属儿科医院药剂科,上海201102 [3]复旦大学附属儿科医院肾脏科,上海201102 [4]西安市儿童医院药剂科,710003 [5]深圳市儿童医院药剂科,518038 [6]福建省福州儿童医院药剂科,350005 [7]乌鲁木齐儿童医院药剂科,830000 [8]昆明市儿童医院药剂科,650228 [9]成都市妇女儿童中心医院药剂科,610091 [10]青岛妇女儿童医院药剂科,266000 [11]贵阳市妇幼保健院药剂科,550003 [12]江西省儿童医院药剂科,南昌330006 [13]大连医科大学附属大连市儿童医院药剂科,116012 [14]上海市儿童医院药剂科,200062 [15]中国科技大学附属第一医院安徽省立医院药剂科,合肥230001 [16]山东大学齐鲁儿童医院药剂科,济南250022 [17]温州医科大学附属第二医院育英儿童医院药剂科,325000 [18]南京医科大学附属儿童医院药剂科,210019 [19]广西壮族自治区妇幼保健院药剂科,南宁530003 [20]河北省儿童医院药剂科,石家庄050031

出　　处：《中华儿科杂志》2020年第4期301-307,共7页Chinese Journal of Pediatrics

基　　金：中国-世界卫生组织2016-2017双年合作项目(2017/731497-0)。

摘　　要：目的调查我国儿童基本药品的可及性现状,为提高我国儿童基本药品可及性,促进儿童合理用药提供依据。方法采用现况调查方法,于2017年5月26日至6月2日选取我国东部、中南部、西部和北部地区17个省或直辖市的55家公立医院,以调查表的形式对42种儿童基本药品进行可及性调查。每个药品调查原研药和仿制药两个品种。研究内容包括可获得性、价格、可承受性。42种儿童基本药品在所有调查机构中可以得到的百分比,即为该药品的可获得性。价格研究采用中位价格比值(MPR),即某一种药品单位价格的中位数与国际参考价格的比值,并针对所有药物得出中位MPR。药品费用的可承受性研究,是将治疗某一标准疗程疾病所需的费用,折算成赚取全国日最低工资所花费的天数,计算治疗该常见疾病的可承受性。对可获得性、价格、可承受性指标进行描述性分析。结果在42种调查药品中,原研药和仿制药的平均可获得性分别为33%和32%。原研药和仿制药的中位MPR分别为5.43和1.55;既有原研药又有仿制药的19种药品价格比较,原研药和仿制药的中位MPR分别为7.73和2.04。针对4种常见儿童疾病(肺炎、消化性溃疡、先天性甲状腺功能减低症、难治性肾病)的5种基本药品进行可承受性研究,使用仿制药需要花费0.63(0.16~6.17)d全国日最低工资,使用原研药需要花费1.03(0.16~11.53)d全国日最低工资。结论在42种儿童基本药品中,原研药和仿制药的可获得性均较低。仿制药价格基本合理,可承受性较好;原研药价格明显高于国际参考价,可承受性较差。需进一步提高我国儿童基本药品可及性。Objective To investigate the availability,prices and affordability of essential medicines in pediatric population across China,in the hope of improving rational use of medicines.Methods A multicenter cross-sectional survey of medicine prices,availability and affordability was conducted in 17 provinces,municipalities and autonomous region across east,south-central part,west and north of China.Data on 42 medicines used in pediatric population,both original and generic,were collected in 55 public hospitals from May 26 to June 2,2017.Availability was expressed as the percentage of hospitals with stock of the target medicine on the day of data collection,and median price ratio(MPR)was the ratio of price upon investigation to international reference.Based on national minimum daily wage,affordability represents the number of working days needed to earn the expense which covers a standard course using the target medicine.Statistical software SPSS 13.0 was applied for descriptive analysis of availability,MPR and affordability.Results Mean Availability of original and generic medicine was 33%and 32%,with median MPR being 5.43 and 1.55.Among the 19 medicines with price information for both original and generic product,the median MPR was 7.73 and 2.04 respectively.Regarding the five medicines used to treat four common pediatric diseases(pneumonia,peptic ulcer,congenital hypothyroidism,refractory nephrotic syndrome),the affordability was 0.63(0.16-6.17)d for generic medicine,and 1.03(0.16-11.53)d for its original counterpart.Conclusions The availability to both original and generic products of the 42 medicines used in pediatric population was low in China.The prices of generic medicines seem to be lower and affordability higher than those of original medicines.There is an urgent need to improve the availability and affordability of pediatric medicines.

关 键 词：中国 儿童 必备 药物 多中心研究 

分 类 号：R9[医药卫生—药学]