中国东部某省儿童基本药物可获得性、价格及可负担性调查分析

目的：分析儿童用药政策实施以来儿童基本药物可获得性、价格及可负担性的现状，为后续制定和完善相关政策提供实证依据。方法：利用中国东部某省基本药物采购平台数据库中2012、2016年数据，依据世界卫生组织（WHO）和国际健康行动组织（HAI）推荐的标准药物调查方法，对49种儿童基本药物的可获得性、价格及可负担性现状进行分析。结果：儿童基本药物可获得性、价格及可负担性整体较好。（1）可获得性方面，2016年较2012年总体出现下降；且2016年、2012年三级医疗机构均高于二级医疗机构和一级医疗机构；仿制药高于原研药。（2）价格方面，2016年较2012年8种原研药价格下降；26种仿制药价格下降，16种仿制药价格上升。（3）可负担性方面，2016年较2012年总体可负担性提高；仿制药总体可负担性优于原研药。结论：（1）三级医疗机构总体可获得性高于一、二级医疗机构。低年龄段儿童基本药物可获得性较差，缺少适宜品种、剂型和规格的药品。（2）儿童基本药物原研药的价格高于国际参考价格，仿制药的价格相对较低。（3）儿童基本药物可负担性较好，2016年较2012年总体可负担性提高，仿制药总体可负担性优于原研药。

A Surveyon the availability, price and affordability of essential medicine for children in Eastern China

Objective: To analyze the availability, price and affordability of essential medicine for children in Eastern China, reference being taken from since the implementation of the children''s medicine policy in China, and to provide evidence for the subsequent development and improvement of relevant policies. Methods: Using the 2012-2016 Data in the database of basic drug procurement platform of a Province in Eastern China, the availability, price and affordability of essential medicines for children were analyzed according to the World Health Organization (WHO) and International Health Action Organization (HAI) standard drug investigation method. Results: The availability, price and affordability of essential medicines for children were generally better. (1) In terms of availability, the overall availability of 2016 (30.99%) was lower than that of 2012 (39.84%). This was concretized by the fact that in 2016 and 2012, the availability of tertiary hospitals was higher than that of the secondary and primary hospitals; and generic drugs were higher than the original ones. (2) In regard to the price, 8 kinds of original drugs in 2016 dropped in price compared with the case in 2012 (88.9%); 26 generic drugs cost decreased (61.9%), while other 16 generic drugs experienced an increasing trend (accounting for 38.1%). (3) For the affordability, all of it was higher in 2016 than that in 2012 (accounting for 89.1%); whereby for generic drugs the overall affordability (accounting for 89.2%) was superior to that of original drugs (which accounted for 88.9%). Conclusions: (1) The overall availability of tertiary hospitals was higher than that of primary and secondary hospitals. Children in the lower age group had poor access to essential medicines and lack various appropriate and suitable medicines, dosage forms and specifications. (2) The price of original drugs for essential pediatric medicines was higher than provided by the standard of international reference price for various medicines, and that of generic drugs was relatively low. (3) The basic affordability of essential medicines for children is good. In 2016, the overall affordability was higher than that recorded in 2012. For generic drugs, the overall affordability was better compared to that of original drugs.