Study On Availability Of Enssential Medicines Among Counties And Towns In Hubei Province

ObjectIn order to evaluate the status quo of access to essential medicines and provide reference for policy adjustment, a survey based on the method recommend by World Health Organization and Health Action International Europe was conducted in rural areas of Hubei province.Data and MethodsLiterature review, field investigation, DELPHI and statistical method were used in this study. The data included: literature data on access to essential medicines; data on availability and price in hospitals and retail pharmacies of counties and towns surveyed, including procurement price and retail price of essential medicines and prescriptions in hospitals, while retail price in retail pharmacies.ContentIllustrating the status quo of access to essential medicines and promotion strategies to improve access to essential medicinesResults and Conclusions(1) Low availability of essential medicines, ever innovator brand or generics surveyed, was found in both sectors, and more in the hospitals. The median availability of innovator brand was 28% and 39% in hospitals and retail pharmacies, while 39% and 50% for generics.(2) The median MPRs of procurement prices for LPGs (80% of the MSH reference price) had indicated efficient procurement, being at a middle level between Shandong and Shanghai but higher than the rational procurement price in India. In contrast, the procurement price of innovator brand was much higher than Shandong and Shanghai. For retail prices in hospitals, the median MPRs of innovator brands and generics were 12.1 and 1.1 times the international reference prices, respectively. Even though the hospitals received a good procurement prices, the markups between procurement and retail prices were high (median markups rate of innovator brands and generics: 20.5% and 32.5%, respectively). Therefore, the hospitals still attained a lot of profits from selling medicines and the benefits of low procurement prices were not transferred to the patients.(3) The median MPRs of retail price for innovator brand in hospitals were only half of the one in private retail pharmacies.(4) The affordability was chiefly determined by the availability and price. For the low-income population, even the expenditure of essential medicines for treatments was unaffordable, namely the common diseases would cause poverty. For the social average income population, the affordability was much optimistic.(5) The average number of drugs per prescription was 2.6, higher than 2, which indicated that the prescribers were inclined to offer excessive medicines. The percentage usage of essential medicines belonged to WHO Essential Medicine List (2007), National Essential Medicine List (2004, China) and New Rural Cooperative Medical System Essential Medicine List (Second Edition) were 44.3%,77.5%and 71.8%, respectively, which showed the patterns of preparations was far from the recommendation by WHO. Therefore, the irrational use of medicines would raise more obstacles to access to essential medicines. Suggestions(1) The modified WHO/HAI methodology could be included into national evaluation system for essential medicine policy.(2) Some measures, such as centralized distribution and regulating the prescription of hospitals, should be used to enhance the availability and affordability of essential medicines in rural areas.(3) Improve acceptance of essential medicines in rural residentsInnovation(1) Introducing the method to evaluate access to essential medicines in the middle and west rural areas of China.(2) Adjusting the method based on the national conditions for collecting data well, reflecting the actual situation and conducting international comparisons.(3) The study was such a current research that variation trends of availability, price and affordability could not be expounded.