Research On Methods Of Essential Medicines Selection

BACKGROUNDIn August 2009, after the impulse of the New Medical Reform, China launched her first National Drug Policy, aiming at effectively solving the problem of difficult and costly access to medicines, and toward balancing the service equality for the social vulnerable people, by initial establishment of the essential medicines system in the three years from 2009 to 2011. The selection of essential medicines is the jumping-off, key, and hard point for the subsequent process of production, supply, usage, reimbursement, clinical guide, and rational use of the essential medicines. However, the current research on the methodology of essential medicines selection is limited by the experts personal decision-making, and the objective, quantitative methods are in need, both domestically and internationally. The future jobs of updating the list of essential medicines per 3 years will also demand the improvement of the selection methodology.PURPOSEFor better implement of the National Drug Policy and widening the system of essential medicines, this article is aiming at systematically concluding the several methods of essential medicines selection, by which it will supplement more quantitative, objective methods for the current subjective decision-making, and by the synthetic evaluation and systematical comparison of these different methods,it will provide more choices for the future update of the list of essential medicines and help the health managers to choose the proper method, according to the characteristics of every method, measure for measure.METHOD Based on the theories of public management, health governing management, evidence-based evaluation, social medicine, pharmacoeconomics, operations research, this dissertation systematically analyzed 6 methods of essential medicines selections, and then designed "structure-process-result" indicators of drugs policy, to quantitatively evaluate and compare the different methods by a scoring model.RESULTTake the medicines class of Benzylpenicillin for example, the experiment presented the sample of application of the above 6 methods, which resulted in 6 cases of lists of essential medicines with scorings by fuzzy synthetic evaluation.CONCLUSIONThe creative method of selection by Knapsack model ranked first in all the six methods and the method of World Health Organization Experts Committee took the second place in the synthetic evaluation. The method of Analytic Hierarchy Process and current method of China's Experts Review showed nice performances among the six methods. The Pharmacoeconomics method and the evidence-based evaluation got the lowest marks and were not that good to be used separately. Finally, this dissertation also gave some suggestions on the medical information construction for the future application of the quantitative methods, and proposed a new plan of computer-based information integration system for selection of essential medicines for Chinese children.