A survey of availability, price and affordability of essential medicines from 2011 to 2016 in Chinese secondary and tertiary hospitals

Guan, Xiaodong; Hu, Huajie; Man, Chunxia; Shi, Luwen

doi:10.1186/s12939-018-0870-5

Cited by 24 publications

(37 citation statements)

References 20 publications

(16 reference statements)

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“…And when medicines are prescribed in PHCs, I have to go to a tertiary hospital to get them.” Therefore, national essential drug list should be expanded, and measures such as increasing the use of non-essential drugs at the grassroots level should be taken. Some cities have conducted pilot reforms, but the effect needs further verification [24, 26, 27].…”

Section: Discussionmentioning

confidence: 99%

Satisfaction with service coverage and drug list may influence patients’ acceptance of general practitioner contract service: a cross-sectional study in Guangdong, China

Chen

Feng

Tang

et al. 2019

BMC Health Serv Res

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Background General practitioner (GP) system is proved to be effective in over 50 countries worldwide. Guangdong province, as a reform pilot in China, initiated its patient-GP contract service reform in 2014. This study is designed to assess the patients’ acceptance of General Practitioners Contract (GPC) reform and explore its influencing factors. Methods This survey interviewed 1010 participants from 16 primary health centers (PHCs) chosen from 4 pilot cities in Guangdong during July and December in 2015. Data were collected through face-to-face interviews. The questionnaire was developed to discover the acceptance of GPC and covered three parts: respondents’ socio-demographic characteristics, health service utilization, and the patients’ assessment of primary health care centers. A binary logistic regression model was used to measure the influencing factors of respondents’ acceptance of GPC policy. Results A total of 611(60.5%) participants accepted GPC policy. Compared to patients visited PHCs over 7 times in the previous year, those visited PHCs fewer times reported lower acceptance of GPC policy (OR:0.68, 95% CI:0.49–0.96 for visits ≤3 times and OR:0.57, 95% CI:0.38–0.84 for visits = 4–6 times). Patients’ satisfaction with medical service coverage was positively associated with patients’ acceptance of GPC (OR: 1.72, 95% CI:1.01–3.98 for the satisfied versus the dissatisfied; OR: 1.38, 95% CI:0.92–3.30 for neutral versus the dissatisfied), and the satisfaction with drug list also positively influenced patients’ acceptance of GPC policy (OR: 1.44, 95% CI:1.26–2.73 for the satisfied versus the dissatisfied; OR:1.61, 95% CI:1.36–2.99 for neutral versus the dissatisfied). Meanwhile, age and education had positive impacts on the acceptance of the GPC policy. Conclusion This study finds out that patients’ satisfaction with medical service coverage and drug list are the influencing factors for the acceptance of GPC policy. Therefore, improvement of medical service accessibility such as better follow-up of patients with chronic diseases and enhanced referral service, as well as the expansion of drug list, will improve patients’ acceptance of GPC policy. It also finds that patients using more primary health service are inclined to accept GPC policy, so more attractive and high-quality service should be provided in PHCs. Electronic supplementary material The online version of this article (10.1186/s12913-019-4053-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Satisfaction with service coverage and drug list may influence patients’ acceptance of general practitioner contract service: a cross-sectional study in Guangdong, China

Chen

Feng

Tang

et al. 2019

BMC Health Serv Res

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“…Differences in research conclusions may be due to the use of data from different regions, research period or study design. But overall, these findings have demonstrated that the NEMP interventions are effective: the availability of essential medicines had improved,56 57 but remains at a low level58 59 and had a problem of regional inequity60; drug prices were reduced significantly,57 61–63 and the affordability of essential medicines has improved57 59 60; and the rational use of medicine has effectively improved, but remained poor 56 64–67. In the subjective questionnaire surveys, patients were satisfied with the price and quality of essential medicines 68.…”

Section: Coverage Of Health Servicesmentioning

confidence: 96%

Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China

et al. 2020

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Universal health coverage (UHC) has been identified as a priority for the global health agenda. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. We conducted a secondary data analysis and combined it with a literature review, analysing the overview of UHC in China with regard to financial protection, coverage of health services and the reported coverage of the WHO and the World Bank UHC indicators. The results include the following: out-of-pocket expenditures as a percentage of current health expenditures in China have dropped dramatically from 60.13% in 2000 to 35.91% in 2016; the health insurance coverage of the total population jumped from 22.1% in 2003 to 95.1% in 2013; the average life expectancy increased from 72.0 to 76.4, maternal mortality dropped from 59 to 29 per 100 000 live births, the under-5 mortality rate dropped from 36.8 to 9.3 per 1000 live births, and neonatal mortality dropped from 21.4 to 4.7 per 1000 live births between 2000 and 2017; and so on. Our findings show that while China appears to be well on the path to UHC, there are identifiable gaps in service quality and a requirement for ongoing strengthening of financial protections. Some of the key challenges remain to be faced, such as the fragmented and inequitable health delivery system, and the increasing demand for high-quality and value-based service delivery. Given that China has committed to achieving UHC and ‘Healthy China 2030’, the evidence from this study can be suggestive of furthering on in the UHC journey and taking the policy steps necessary to secure change.

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“…A standardized method was developed by the World Health Organization (WHO) and Health Action International (HAI) and has been used in Malaysia, China, Pakistan, Thailand, Sri Lanka, Ethiopia, India, Malawi, Haiti, etc. Most surveys focused on the essential medicines for adults [24,25,26,27,28] and children [29,30,31,32]. Some others focused on medicines for cardiovascular patients [33,34], antidiabetics [35,36], and orphans [37,38].…”

Section: Introductionmentioning

confidence: 99%

Availability, Price and Affordability of Anticancer Medicines: Evidence from Two Cross-Sectional Surveys in the Jiangsu Province, China

Zhu

Wang

Sun

et al. 2019

IJERPH

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Objectives: With the increasing incidence of cancer, poor access to affordable anticancer medicines has been a serious public health problem in China. To help address this issue, we assessed the availability, price and affordability of pharmacotherapy for cancer in public hospitals in the Jiangsu Province, China. Methods: In 2012 and 2016, anticancer medicine availability and price information in the capital and five other cities was collected. A total of six cancer care hospitals, 26 tertiary general hospitals and 28 secondary general hospitals were sampled, using an adaptation of the World Health Organization/Health Action International methodology. Data was collected for the anticancer medicines in stock at the time of the surveys. Prices were expressed as inflation-adjusted median unit prices (MUPs). Medicine was affordable if the overall cost of all the prescribed anticancer medicines was less than 20% of the household’s capacity to pay. We used generalized estimating equations to estimate the significance of differences in availability from 2012 to 2016 and the Wilcoxon rank test to estimate the significance of differences in MUPs. Multivariate logistic regression was computed to measure predictors of affordability. Results: From 2012 to 2016 there was a significant decrease in the mean availability of originator brands (OBs) (from 7.79% to 5.71%, p = 0.012) and lowest-priced generics (LPGs) (36.29% to 32.67%, p = 0.009). The mean availability of anticancer medicines in secondary general hospitals was significantly lower than the cancer care, as well as in tertiary general hospitals. The MUPs of OBs (difference: −21.29%, p < 0.01) and their LPGs (−22.63%, p < 0.01) decreased significantly from 2012 to 2016. The OBs (16.67%) of all the anticancer medicines were found to be less affordable than LPGs (34.62% for urban residents and 30.77% for rural residents); their affordability varied among the different income regions. From 2012 to 2016, the proportion of LPGs with low availability and low affordability dropped from 30.77% to 19.23% in urban areas and 34.62% to 26.92% in rural areas, respectively. Generic substitution and medicine covered by basic medical insurance are factors facilitating affordability. Conclusion: There were concerning decreases in the availability of anticancer medicines in 2016 from already low availability in 2012. Anticancer medicines were more affordable for the patients in high-income regions than the patients in low-income regions. Governments should consider using their bargaining power to reduce procurement prices and abolish taxes on anticancer medicines. Policy should focus on the special health insurance plan for low-income patients with cancer. The goal of drug policy should ensure that first-line generic drugs are available for cancer patients and preferentially prescribed.

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A survey of availability, price and affordability of essential medicines from 2011 to 2016 in Chinese secondary and tertiary hospitals

Cited by 24 publications

References 20 publications

Satisfaction with service coverage and drug list may influence patients’ acceptance of general practitioner contract service: a cross-sectional study in Guangdong, China

Satisfaction with service coverage and drug list may influence patients’ acceptance of general practitioner contract service: a cross-sectional study in Guangdong, China

Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China

Availability, Price and Affordability of Anticancer Medicines: Evidence from Two Cross-Sectional Surveys in the Jiangsu Province, China

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