《国家基本药物目录》与《世界卫生组织基本药物标准清单》的比较

目的:比较我国《国家基本药物目录》2009年基层版与《世界卫生组织基本药物标准清单》第16版的异同,为我国日后的调整、遴选目录提供实证依据。方法:分析已从历年的WHO目录中删掉、但仍存在于我国目录上的药物,判断从我国基本药物目录剔除这些药物的必要性。结果:被历年的WHO目录删除但仍在我国目录中的药物共15种,存在安全性隐患的药物应首先考虑删除。已被替代、用量少的药物也考虑删除。结论:我国基本药物目录应当充分利用WHO目录,规范遴选原则和程序、进一步精简完善我国目录。     

The Health Benefits of Yoga

Abstract

Natural Medicines is an online database of practical, clinical, and current evidence-based information about thousands of herbs, vitamins, minerals, and other supplements. The database includes references to the information content provided, along with separate consumer information and education handouts conveniently formatted as PDFs.     

主成分分析法研究理气类中草药微量元素间的协同作用

运用主成分分析法研究5种理气类中草药中的微量元素之间的相关关系,并对这5种理气类中草药进行综合排名,分析总结出了微量元素的作用。研究为理气类中草药的研发提供一定的理论依据。     

中药材市场部分中药材的调查分析

目的为进一步规范中药材市场,正确使用中药材,保障人民用药安全有效。方法以《中国药典》（2005年版一部）以及《广东省中药材标准》（第一册）为依据,对广州市中药材市场上流通的中药材进行调查、比较和鉴别。结果发现16种常用中药材的来源与《中国药典》或《广东省中药材标准》收载的品种存在差异;另外,部分中药材名称不规范。结论务必正本清源,正确使用《中国药典》和《广东省中药材标准》规定的中药材,合理使用广东习用药材,防止混用和误用。     

Medicines access programs to cancer medicines in Australia and New Zealand: An exploratory study

Medicines Access Programs (MAP) offer access to publicly unfunded medicines at the discretion of pharmaceutical companies. Limited literature is available on their extent and scope in Australia and New Zealand. This study aims to identify MAPs for cancer medicines that were operational in 2014-15 in Australia and New Zealand and describe their characteristics. A preliminary list of MAPs was sent to hospital pharmacists in Australia and New Zealand to validate and collect further information. Pharmaceutical companies were contacted directly to provide information regarding MAPs offered. Key stakeholders were interviewed to identify issues with MAPs. Fifty-one MAPs were identified covering a range of indications. The majority of MAPs were provided free of charge to the patient for medicines that were registered or in the process of being registered but were not funded. Variability in the number of MAPs across institutions and characteristics was observed. Australia offered more MAPs than New Zealand. Only two of 17 pharmaceutical companies contacted agreed to provide information on their MAPs. Eight stakeholder interviews were conducted. This identified that while MAPs are widely operational there is lack of clinical monitoring, inequity to access, operational issues and lack of transparency. Our results suggest a need for a standardised and mandated policy to mitigate issues with MAPs.     

5种中草药中7种元素含量测定研究

用火焰原子吸收法 ,对 5种中草药中K、Ca、Mg、Cu、Zn、Fe、Mn进行了测定分析 ,结果表明与中药的药理作用有相关性     

《WHO儿童基本药物示范目录》和《WHO基本药物示范目录》比较研究

目的：对《WHO儿童基本药物示范目录》和《WHD基本药物示范目录》进行比较研究，为我国制定儿童基本药物目录提供启示。方法：采用文献法搜集《WHO儿童基本药物示范目录》和（WHO基本药物示范目录》方面的相关资料，分析两目录的共同点和差异。结果：《WHO儿童基本药物示范目录》和《WHO基本药物示范目录》的共同点有：目录组成和纳入条件一致，目录内采用的标识情况基本一致，对剂型的说明一致，药物剂型的排列规则一致；不同点有：发展历史不同，针对人群不同，包含的药品种类不同，《WHO儿童基本药物示范目录》中增加了一些特定标示和一些限制性规定。     

基本药物制度对浙江省试点机构门诊平均处方用药数的作用

目的:评价浙江省基本药物制度对门诊处方用药数量的影响。方法:选择实施基本药物制度的杭州市下城区社区卫生服务中心、义乌市义亭镇中心卫生院作为政策干预组,没有实施的东阳市六石镇卫生院作为对照组,形成非随机对照前后测量的类实验设计。利用电子信息系统导出基本药物制度开展一年前及开展后的门诊电子数据,采取双差法(double differences)的评估设计和数据分析。结果:通过负二项回归,控制了年龄、性别的影响和两组基线差异后,结果表明基本药物制度试点改革使门诊平均处方用药数下降11.2%(P=0.000)。结论:基本药物制度的实施对促进合理用药,降低平均处方用药数有积极作用。     

处方点评是促进合理用药的有效方法

依据卫生部颁发的《处方点评管理办法》等规范,组织临床药师对外科Ⅰ类切口预防性抗菌药物临床应用、中药注射剂、心脑血管用药等进行回顾性处方点评,有效干预了医生不合理用药行为,促进了临床合理用药.     

How to address medicines shortages: Findings from a cross-sectional study of 24 countries

Shortages of medicines have become a major public health challenge. The aim of this study was to survey national measures to manage and combat these shortages. A questionnaire survey was conducted with public authorities involved in the Pharmaceutical Pricing and Reimbursement Information (PPRI) network. Reponses relating to measures as of March / April 2020 were received from 24 countries (22 European countries, Canada and Israel). In 20 countries, manufacturers are requested to notify – usually on an obligatory basis – upcoming and existing shortages, which are recorded in a register. Further measures include a regular dialogue with relevant stakeholders (18 countries), financial sanctions for manufacturers in cases of non-supply and/or non-compliance with reporting or stocking requirements (15 countries) and simplified regulatory procedures (20 countries). For defined medicines, supply reserves have been established (14 countries), and legal provisions allow the issuing of export bans (10 countries). Some measures have been introduced since the end of 2019 and countries are planning and discussing further action. While governments reacted by taking national measures, the COVID-19 crisis might serve as an opportunity to join forces in cross-country collaboration and develop joint (e.g. European) solutions to address the shortage issue in a sustainable manner. A practical first step could be to work on a harmonisation of the national registers.     

国家基本药物目录合理性分析

我国2009版基本药物目录与世界卫生组织(WHO)和及相关国家的基本药物目录(EML)的比较分析,并以我国疾病负担为依据,对我国基本药物目录的合理性加以探析,提出相应的政策建议。     

Retailing Policies for Generic Medicines

As there is general disagreement about the way generic medicines should be commercialized, two retailing policies are analyzed, taking into account their effects on the welfare of patients, government, pharmacies and physicians. In the first policy scenario, pharmacies are allowed to substitute generic medicines for branded ones, while in the second, substitution is forbidden. In both cases a pharmacies association is allowed to have a share in the production of generic medicines. The model predicts that under some conditions patients may prefer substitution by pharmacies but when doctors decisions are binding, they are never excessively bad. However, the policy choice belongs to the government, which prefers to allow for substitution more often than patients would like.     

数据库规范设计

数据库设计既是一项涉及多学科的综合性技术,又是一项庞大的工程项目。人们努力探索,利用数据库规范设计方法设计出符合需要的数据库系统。     

Is Europe still heading to a common price level for on-patent medicines? An exploratory study among 15 Western European countries

Background

Previous studies have suggested that medicines prices in Europe converge over time as a result of policy measures such as external price referencing.

Objective

To explore whether ex-factory prices of on-patented medicines in Western European countries have converged over a recent period of time.

Methods

Prices of ten on-patent medicines in five years (2007, 2008, 2010, 2011, 2012) of 15 European countries were analyzed. The unit of analysis was the ex-factory price in Euro per defined daily dose (exchange rate indexed to 2007). A score (deviation from the average price) per country as well as the ranges were calculated for all medicines.

Results

The prices between countries and selected products varied to a great extent from as low as an average price of € 1.3/DDD for sitagliptin in 2010–2012 to an average of € 221.5/DDD for alemtuzumab in 2011. Between 2008 and 2012, a price divergence was seen which was fully driven by two countries, Germany (up to 27% more expensive than the average) and Greece (up to 32% cheaper than the average). All other countries had stable prices and centered around the country average. Prices of less expensive as well as expensive medicines remained relatively stable or decreased over time, while only the price of sirolimus relatively increased.

Conclusions

Our study period included the time of the recession and several pricing policy measures may have affected the prices of medicines. Instead of the expected price convergence we observed a price divergence driven by price changes in only two of the 15 countries. All other European countries remained stable around the country average. Further research is needed to expand the study to a bigger sample size, and include prescribing data and Eastern European countries.     

利用“军字一号”医嘱摆药系统管理毒麻药品

目的改进HIS信息化条件下毒麻药品调配及统计方法,使医嘱药品摆药更加具有科学性、先进性。方法在HIS医嘱摆药系统增加毒麻药品专用调配及处方统计程序。结果通过对HIS医嘱摆药系统进行优化升级,利于毒麻药品的使用及管理。结论在HIS中增加毒麻药品专用操作程序,提高医疗单位的信息化管理水平,使用操作简单,统计准确率高,提高工作效率。     

上海市基本药物目录的初步研究

依据《国家基本药物目录》(2009版),对上海市基本药物目录进行初步探索性研究,为推动国家基本药物制度的有效实施提供参考。上海市各级医疗机构使用的,与国家目录内相同通用名和剂型的药品,以购进口径的全年基本药物总金额在28亿元左右。各级医疗机构基本药物的使用比例都很低,总体上只有15%左右,一级医疗机构不到25%。基本药物种类比例也呈现了与购进金额比例同样的规律,二、三级医疗机构均低于一级医疗机构。按中西药分型发现,基本药物中西药品规比例(25.29%)高于中药(14.34%)。     

选择性支气管动脉灌注抗癌药物治疗晚期肺癌(附43例报告)

本组对４３例资料齐全,经细胞学或组织学确诊为晚期肺癌的病人,采用Ｓｌｄｉｎｇｅｒ技术,行选择性支气管动脉灌注抗癌物治疗共９３例次,结果表明,肺癌肿块完全消失或缩小者３７例。占８６％,临床症状消失或部分缓解者４０例,占９３％。５例患者经二次灌注,行手术治疗,手术切除率１１．６％。     

Distributive Justice and the Introduction of Generic Medicines

Introduction: All countries face theissue of choice in healthcare. Allocation ofhealthcare resources is clearly associated withthe concept of distributive justice and to theexistence of a right to healthcare.Nevertheless, there is still the question ofwhether this right should include all types ofhealthcare services or if it should be limitedto selected types. It follows that choices mustbe made, priorities must be set and thatefficiency of healthcare services should bemaximum. Objectives and methods: Distributivejustice aims at ensuring that everyone hasaccess to necessary care based on thesubstantive ethical principles of equity andsolidarity. Resource allocation is paramount inpublic policy particularly with regardspharmacoeconomics. The objective of this studyis to determine the leading issues regardingthe marketing and trade of generic medicinesanalysing the reasons why there are hugedisparities between European countries withregards generic drugs acceptance bypractitioners. Results and conclusion: Distributivejustice aims at ensuring that everyone hasaccess to reasonable care based on the ethicalprinciples of equity and solidarity. However,universality implies always choice in accessand efficiency in delivery. It follows thatresource allocation is instrumental in publicpolicy particularly with regardspharmacoeconomics. The acceptance ofdistributive justice as a new ethical paradigmfor professional ethics implies that as long asthe best interest of the patient is not atstake physicians should regard the use ofgeneric drugs as a valid instrument to promotethe efficiency of the system and therefore as away to facilitate citizen's global access tohealthcare.