上海市社区口服降糖药的可负担性评价

目的：评价上海市社区口服降糖药的可负担性。方法：采用世界卫生组织/国际健康行动组织（WHO/HAI）的标准化调查方法进行价格调查，采用WHO/HAI标准化可负担性评价方法、贫化法和灾化法3种方法对口服降糖药物的可负担性进行评价。结果：在社区医疗机构，大部分口服降糖药的可负担性较差，仿制药的负担性均优于原研药；城镇居民与农村居民相比负担较重，不同种类的口服降糖药在上海市居民中致贫作用差异较大，约20倍；5种口服降糖药会导致上海市10多万居民陷入灾难性支出。医保政策可以大幅降低口服降糖药带来的负担，缩小高价药品与低价药品之间的致贫差距。结论：上海市口服降糖药的可负担性较差，建议相关部门做好原研药品价格调整与监管，鼓励和引导仿制药品的研发，推进异地医保对接，以提高糖尿病患者的可负担性。

Affordability of oral antidiabetic agents in community healthcare center in Shanghai

OBJECTIVE To evaluate the affordability of oral antidiabetic drugs in community healthcare center in Shanghai.METHODS A standard methodology developed by World Health Origination (WHO) and Health Action International (HAI) was adopted to investigate the prices of oral antidiabetic drugs in Qingpu district of Shanghai, and the affordability of oral antidiabetic drugs was evaluated by three different methods.RESULTS In community medical centers, most of those drugs were less affordable and the burden of generic drugs was superior to that of the original drugs. The urban residents had heavier burdens than those of the rural residents. The difference of poverty effection between different types of oral antidiabetic drugs among residents of Shanghai was huge, by about 20 times. Five original drugs led more than 10 millions of people to be strapped for catastrophic expenditure. Medical insurance policy dramatically reduced the burden of oral antidiabetic and narrowed the gap between high-priced and low-priced drugs.CONCLUSION The affordability of oral antidiabetic agents is in unfavorable situation. The government should make effforts to supervise and adjust the prices of original medications, and the drug manufactures have to speed up the research and development of cheap generic drugs. Moreover, it is nesessary to promote the docking of medical insurance in different provinces to improve the affordability of diabetes patients.