Comparison Of The Accessibility Levels Of Monoclonal Drugs In Public General Hospitals In Hubei Province Before And After The New Medical Reform And Its Influencing Factors

Objective: To know the influence of the new medical reform on the accessibility of monoclonal antibody drugs in public general hospitals of Hubei Province(abbreviated as general hospitals)and find the main obstacle factors of the accessibility of monotherapy drugs in hospitals in Hubei province,and promote the feasibility policies of monoclonal antibody of patients accessibility in China.Method: Based on the literature research method,questionnaire survey method and expert consultation method,the WHO/HAI standard survey method of drug accessibility was used to analyze and compare the differences of availability and affordability of all monoclonal antibody drugs marketed in China and accessibility barriers before and after the new medical reform in Hubei province.Results: In terms of drug availability,the average availability rate of 13 monoclonal antibodies marketed in China in 2016 was 10.16% in 28 general hospitals in Hubei Province;while the average availability rate of 22 monoclonal antibodies marketed in in China 2018 was 10.33%,an increase of 0.17%.However,the availability of monoclonal antibodies before and after the new medical reform is still at an extremely low level.In terms of drug price,the average retail price of 11 monoclonal antibody drugs available in 2016 was 6,975.66 yuan compared to 4,427.33 yuan for 15 monoclonal antibody drugs available in 2018,with an average price reduction of 38.72%.In terms of drug affordability,the average cost of 11 monoclonal antibody drugs in 2016 was equivalent to 744.45 days of disposable income of the general resident,and all monoclonal antibody drugs were unaffordable(>1).In 2018,the average cost of 15 monoclonal antibody drugs was equivalent to 297.20 days of disposable income of the general resident.All the monoclonal antibody drugs were still unaffordable(>1)in 2018,but compared with 2016,there were 447.25 days' reduction of drug affordablility.The results of expert consultation showed that the main obstacles affecting the accessibility of monoclonal antibody in general hospitals in Hubei province in 2018 included high drug price,low clinical demand of drug,no hospital procurement catalogue,low patient income,medication restriction of clinical department,lack of monoclonal antibody drugs suppliers and low coverage and reimbursement rate of medical insurance for monoclonal antibody drugs.Conclusion: After the implementation of the new medical reform policy,the availability and affordability of monoclonal antibodies marketed in China have increased.It can be seen that the new medical reform pol icy has played a certain role in promoting the availability of monoclonal antibodies in Hubei Province.However,the level of availability and affordability of monoclonal antibodies is still very low.In order to alleviate the problem of “difficult to use and expensive to use” of monoclonal antibodies for patients,the government should propose improvement measures based on existing policies.