The availability, price and affordability of essential antibacterials in Hubei province, China

Wu, Guangjie; Gong, Shiwei; Cai, Hongbing; Ding, Yong

doi:10.1186/s12913-018-3835-x

Cited by 13 publications

(12 citation statements)

References 23 publications

(23 reference statements)

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“…Availability in each province is reported as the percentage of outlets in which each medicine was found on the day of data collection. Most WHO/HAI surveys use the criteria of availability of medicines as follows: very low: < 30%, low: 30–49%, fairly high: 50–80%, high: > 80% ( Sharma et al, 2016 ; Kibira et al, 2017 ; Liu et al, 2017 ; Gong et al, 2018 ; Sun et al, 2018 ; Wu et al, 2018 ; Kasonde et al, 2019 ). Median unit prices (MUPs) for each medicine is calculated in RMB (yuan, ¥).…”

Section: Methodsmentioning

confidence: 99%

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Yang

et al. 2020

Front. Pharmacol.

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Objectives: To evaluate the price and availability of medicines in China.Methods: A standard methodology developed by WHO and Health Action International was used to collect medicine price and availability data. We obtained cross-sectional data for 48 medicines from 519 facilities (280 public hospitals and 239 private retail pharmacies) in five provinces in China in 2018. We also collected longitudinal data for 31 medicines in Shaanxi Province in 2010, 2012, 2014, and 2018. Medicine price was compared with the international reference price to obtain a median price ratio (MPR). The availability and price in five provinces were compared in matched sets. We used general estimating equations to calculate differences in availability and median prices from 2010 to 2018.Findings: Mean availability of surveyed medicines in five provinces was low in both public (4.29–32.87%) and private sectors (13.50–43.75%). The MPR for lowest priced generics (LPGs) was acceptable (1.80–3.02) and for originator brands (OBs) was much higher (9.14–12.65). The variation was significant for both availability and price of medicines across provinces. In Shaanxi Province, the availability of medicines decreased between 2010 and 2018, but this was not significant in the public or private sector. Compared with 2010, the median adjusted patient price was significantly lower in 2018 for nine OBs (difference −22.4%; p = 0.005) and 20 LPGs (−20.5%; p = 0.046) in the public sector and 10 OBs (−10.2%; p = 0.047) in the private sector.Conclusion: Access to medicines was found to be poor and unequal across China in 2018. Future interventions are needed, and possible strategies include effective and efficient procurement, promoting the development of retail pharmacies and increasing medicine price transparency.

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Section: Methodsmentioning

confidence: 99%

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Yang

et al. 2020

Front. Pharmacol.

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“…However, vital parameters, such as the length of the follow-up period, baseline risk factors, and clinical definitions, vary significantly (1). There is not enough research based in China, a country often considered to have a high incidence of antibiotic abuse and nosocomial infections (10,11). Hence, determining objective and easily obtainable indicators to predict SAI in stroke patients in China is of essence.…”

Section: Introductionmentioning

confidence: 99%

Nomogram Including Neutrophil-to-Lymphocyte Ratio for the Prediction of Stroke-Associated Infections

et al. 2020

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Stroke has been a leading cause of mortality in China. Stroke-associated infections (SAI) are common complications, occurring in 5-65% of stroke patients. Faced with SAI, clinicians often are placed in a considerable dilemma. On the one hand, preventive overuse of antibiotics will lead to the emergence of drug-resistant bacteria. On the other hand, treatment delay of the infection will likely result in a poor outcome. Therefore, it is necessary to determine the early predictors of post-stroke infection to screen patients with high infection risk for early clinical intervention, thereby promoting and improving survival rates. We assessed 257 patients with acute ischemic stroke from a consecutive retrospective cohort. Data of these patients were obtained from three hospitals (TongJi Hospital and its two branches) between August 2018 and June 2019. Of these patients, 59 (23.0%) developed SAI. SAI was defined according to the modified Centers for Disease Control and Prevention criteria. There were 38 patients (64.4%) who developed pneumonia, 11 with urinary tract infections (18.6%), and 10 with other infections (16.9%). We found that a higher neutrophil-to-lymphocyte ratio (adjusted odds ratio [aOR] = 1.16; 95% confidence interval [CI], 1.01-1.33; P = 0.034), National Institutes of Health Stroke Scale score (aOR = 1.18; CI, 1.09-1.27; p < 0.001), and dysphagia (aOR = 2.95; CI, 1.40-6.22; P = 0.004) were risk factors for SAI. Of note, hypertriglyceridemia (aOR = 0.35; CI, 0.13-0.90; P = 0.029) was a protective factor, lowering the risk of SAI. To this end, a reliable nomogram was constructed for the prediction of SAI in our study (mean C-index value ± standard deviation = 0.821 ± 0.03). It has the potential to be widely used and may help identify patients at high risk for SAI and make timely clinical decisions. Given our study was based on relatively small dataset, the results should be interpreted with care and external validation in independent datasets is very necessary.

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“…Recently, most of domestic studies on essential medicines focused on antibacterial drugs and medications for chronic diseases [8][9][10] . Their study can re ect the common problems in the availability and affordability of essential drugs in China, however, the question regarding whether it is the same case for anticancer still awaits further investigation.…”

Section: Resultsmentioning

confidence: 99%

“…The supplementary medicines can greatly alleviate the burden of cancer treatment. After the implementation of the national essential medicine system, the production cost of essential medicines and unreasonable pro t margins can be well controlled.Recently, most of domestic studies on essential medicines focused on antibacterial drugs and medications for chronic diseases [8][9][10] . Their study can re ect the common problems in the availability and affordability of essential drugs in China, however, the question regarding whether it is the same case for anticancer still awaits further investigation.…”

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confidence: 99%

What Factors Hindered the Access to Essential Anti-Cancer Medicine in Public Hospitals amongst the Local Population in Hubei Province, China?

Chen

Feng

Yan

et al. 2021

Preprint

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BackgroundCancer poses a serious threat to one’s health, which caused significant economic burden on the family and society. Poor availability and affordability resulted in some essential medicines failing to meet the basic health needs of this group of patients. The objective of this study was to evaluate the availability, prices and affordability of 32 anticancer essential medicines in Hubei Province, China.MethodsData on the availability and price related information of 32 essential anticancer medicines in the capital and five other cities of Hubei Province were collected. A total of 28 hospitals were sampled, which included 13 tertiary hospitals and 15 secondary hospitals. We used the standard methods developed by the World Health Organization (WHO) and Health Action International (HAI) to compare the differences in drug price, availability and affordability between secondary hospitals and tertiary hospitals. ResultsOverall, the availability of medicine was higher in tertiary hospitals. The average availability of originator brand (OBs) was 13.70% (tertiary hospitals) VS 6.67% (secondary hospitals), and lowest-priced generic (LPGs) was 62.83% (tertiary hospitals) VS 42.92% (secondary hospitals). The MPR value of most sampled medicines in secondary hospitals were less than 1. In contrast, the MPR of Cytarabine (17.15), Oxaliplatin (12.73) were significantly higher than the international reference price. The top three OBs’ total expenses for 30-day treatment were Irinotecan, Oxaliplatin, Bicalutamide. Further, their affordability was relative low, as the costs for one course using these medicines were much higher than 20% of the minimum family monthly income.ConclusionThough the “Zero Mark-Up” and “Two Vote” Policies have been implemented in China, the availability issue yet to be addressed. High price and low affordability were the major barriers to the access of essential anticancer medicines. Measures should be taken to provide sufficient, available and affordable medicines to patients in need.

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The availability, price and affordability of essential antibacterials in Hubei province, China

Cited by 13 publications

References 23 publications

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Nomogram Including Neutrophil-to-Lymphocyte Ratio for the Prediction of Stroke-Associated Infections

What Factors Hindered the Access to Essential Anti-Cancer Medicine in Public Hospitals amongst the Local Population in Hubei Province, China?

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