陕西省零售药店药品价格与可获得性评估研究_姜明欢

2013868··1*21113311．7100612．7100493．710065【摘要】目的:探析实施国家基本药物制度对陕西省零售药店药品价格与可获得性产生的影响，为政策调整提出相应建议。方法:利用第二版WHO-HAI标准化调查方法，分别于2010年和2012年对陕西省6个地市的36家和72家零售药店进行调查，将44种药品的价格、可获得性和可负担性数据进行比较。结果:样本药店中原研药和最低价格仿制药的可获得性略有降低;原研药的零售价明显降低，而最低价格仿制药零售价升高，慢性病药物零售价升高较明显;两年来，患者对药物的支付性明显提高。结论:基本药物制度实施后陕西省零售药店原研药品价格降低，患者的可负担性改善明显，但调研药品的可获得性却显著降低。建议:政府部门应进一步完善药品价格政策，加大对零售药店的扶持力度;零售药店提高药学服务水平，加强品牌基本药物营销力度;适当降低慢性病药物仿制药的价格，减轻慢性病患者的医疗负担;开展药品价格组分研究，防止部分药品因价格过高影响患者的可负担性。【关键词】国家基本药物制度;零售药店;价格;可获得性;可负担性中图分类号:Ｒ951文献标识码:Adoi:10．3969/j．issn．1674-2982．2013．08．007EvaluationofmedicinepriceandavailabilityinretailpharmaciesinShaanxiProvinceJIANGMing-huan1ZHOUZhong-liang2FANGYu1WANGLe1WANGWen-juan1HOUHong-jun3ZHUYan-bing3YANGShi-min11．SchoolofPharmacyHealthScienceCenterXi'anJiaotongUniversityShaanxiXi'an710061China2．CerterforHealthManagementandPolicySchoolofPublicPolicyandAdministrationXi'anJiaotongUniversityShaanxiXi'an710049China3．ShaanxiFoodandDrugAdministrationShaanxiXi'an710065China【Abstract】ObjectiveTheobjectiveofthisstudywastoevaluatetheimpactoftheimplementationofnationalessentialmedicinesystemonmedicinepriceandavailabilityinretailpharmaciesinShaanxiProvinceandtoprovidefurtherinsightintothepolicyadjustment．MethodByusingastandardizedmethodology2008EditiondevelopedbytheWorldHealthOrganizationWHOandHealthActionInternationalHAIwesurveyed36and72retailpharmaciesin6citiesofShaanxiProvincein2010and2012respectively．Dataonthepricesavailabilityandaf-fordabilityof44medicinescollectedintwosurveyswerecompared．ＲesultsTheavailabilityoforiginatorbrandsandthelowestpricedgenericswasslightlylowerin2012thanin2010．Theretailpriceoforiginatorbrandsdecreasedob-viouslyandtheretailpriceofthelowestpricedgenericsincreasedespeciallyforthemedicinestreatingchronicdisea-ses．Theaffordabilityimprovedthroughthetwoyears．ConclusionsThepricesoforiginatorbrandswerehigheral-thoughaffordabilitywasbettertherewereconcerningdecreasesinmedicinesavailabilityinretailpharmaciesin2012comparingto2010．Thegovernmentmayconsidertoadjustthepricingmechanismandprovidemoresupporttoretailpharmacies．Theretailpharmaciesshouldimprovethelevelofpharmaceuticalcareservicesenhancetheconceptof73*71103141/G03082011jdhz6210E0661987—。[e-mail]。[e-mail]PolicyAugust2013Vol.6No.8brandmanagementanddecreasethepricesofchronicmedicinesappropriatelytoreducepatients'burdenofmedicaltreatment．Meanwhileweshouldconductresearchonmedicinepricecomponentstoavoidthesituationthatsomehighpricemedicinesaffectpatients'affordability．【Keywords】NationalessentialmedicinesystemＲetailpharmacyPriceAvailabilityAffordability201142。1。22009“”。3、。。4、“”。520102012、。11.16GDP6-7、、、。2010201236721。20122010、、、。1201020127128125125126125123672GDP。44、。312009《》13。4421232。2201020124421、、、、、、、、、、、、、、、、17、、、423、、、、、、、、、、、、、14、、、、、、、、931131.2WHO－HAI8OriginatorbrandsOBsLowest-pricedge-nericsLPGs。OBs。LPGs832013868、、。2010WHO-HAII。9。Availa-bility、Medianretailprice、Affordability。。。。2010201222.083329.5833。10-11730。22.12010—20123.0%6.7%。。2010201212.4%11.0%49.5%40.1%。。1。2.22010201227.1%41.3%。10.3%10.7%。。52.9%42.1%2。1201020124422010201220102012%OBs163.3262.424－27.171.3881.298－6.594.2142.472－41.352.6832.7060.9114.0001.885－52.9LPGs380.4160.45910.3270.1500.16610.7111.3151.223－7.0170.4530.442－2.4210.3800.54042.1。2.3WHO《》WHO-HAI19。3。113.00.793ChineseJournalofHealthPolicyAugust2013Vol.6No.8。5.3。32010201220102012OBs7.35.0LPGs1.51.3OBs8.76.1LPGs7.65.3OBs11.52.5LPGs1.71.2OBs12.68.6LPGs—1.8OBs5.13.5LPGs2.21.9OBs1.51.1LPGs0.50.4OBs——LPGs0.70.5OBs13.22.6LPGs3.3—OBs18.013.0LPGs0.90.7“—”。33.1、。31“”。。2。。3、。4、、。3.21998—201330。20113281621300。1220122010。1342.1%1。2。3。3.32010—2012。10-11。11.52.513.22.6。5.3042013868。。。4、、4.1“”。。。4.2。。4.3。。4.42010—2012。。1．2011EB/OL．2012-10-102013-05-10．http//．sda．gov．cn/WS01/CL0108/75333．html．2．J．20118334-36．3．—J．20113154-57．4．J．201120131155-1157．5．“”J．2011363364-3366．6．2010EB/OL．2011-04-072013-05-20．http//．sn．stats．gov．cn/news/tjsj/20114795407．htm．7．2012“”EB/OL．2013-02-012013-05-20．http//．sn．stats．14ChineseJournalofHealthPolicyAugust2013Vol.6No.8gov．cn/news/tjsj/201321104458．htm．8WorldHealthOriganizationandHealthActionInternational．Measuringmedicinepricesavailabilityaffordabilityandpricecomponents2008editionEB/OL．2013-05-20．http//．who．int/medicines/areas/access/OMS_Medi-cine_prices．pdf．9YangSFangY．Medicinepricesavailabilityandafford-abilitysurveyinShaanxiProvinceWesternChinaEB/OL．2013-05-20．http//．haiweb．org/medicine-prices/surveys/201009CNX/sdocs/survey_report_shaanxi_Final．pdf10．EB/OL．2010-12-242013-05-20．http//．shaanxihrss．gov．cn/Html/2010-12-24/161718．Html．11．EB/OL．2011-12-232013-05-20．http//．shaanxihrss．gov．cn/Html/2011-12-23/095336．Html．12．16221%EB/OL．2011-03-292013-05-20．http//poli-tics．people．com．cn/GB/1027/14260094．html．13．1997—2011J．20114946-52．2013-05-062013-07-04··《2013》2013815《2013》。。。。。。。2000—20105%13%。、。、、、。。24