Background The 2018 edition of the National Essential drugs List came into effect in September 2018. Relevant policies require that all primary medical and health institutions should supply national essential drugs, while secondary and tertiary medical and health institutions should supply a certain percentage of essential drugs. Methods Our research used the standard methods of WHO and HAI, selected 50 basic drugs, combined with the actual situation of Hefei City, selected 30 medical institutions and 30 pharmacies, conducted drug availability and affordability studies. Results The availability of the lowest-price generics (LPGs) of essential drug in Hefei is much higher than that of the Originator brands (OBs); the overall affordability is better, but there is a large gap between the affordability levels of OBs and LPGs. OBs are relatively poorly affordable. Conclusion The implementation of the national essential drug system in Hefei has achieved certain results, but there is still a gap from the expected target. It is recommended to update and adjust the list of essential drugs in accordance with the demand for clinical medicines, ensure that medical and health institutions at all levels supply essential drugs, popularize knowledge of essential drugs, and moderately adjust the price of OBs to reduce the medication burden.
Objective To evaluate the availability, prices, and affordability of essential medicines in Zhejiang Province, China. Methods The survey was carried out in Zhejiang Province in 2018 following the methodology of the World Health Organization (WHO) and Health Action International (HAI). This method is an international standard method.Data on 50 medicines were collected from public health facilities and private pharmacies. Medication prices were compared with international reference prices to obtain a median price ratio. The affordability of medicines was measured based on the daily wage of the lowest-paid unskilled government worker. In private pharmacies, the mean availability of Originator Brands (OBs) and Lowest-priced Generics (LPGs) was 36.7% and 40.3%, respectively. Findings The effects of the mean availability of OBs and LPGs were seen in private pharmacies. Correspondingly, the average availability of OBs and LPGs was 41.8% and 35.1% in the public sector, respectively. In the public sector, the median price ratios (MPRs) were 5.21 for generics and 13.49 for OBs. In the private sector, the MPRs were 4.94 for generics and 14.75 for OBs. Treating common diseases with LPGs was generally affordable, while treatment with OBs was less affordable. Conclusions In Zhejiang Province, low availability was observed for medicines surveyed in the public and private sectors. Price differences between originator brands and generics in both sectors are apparent. OBs were more expensive than LPGs in both the public and private sectors. Low availability affects access to essential medicines. Policy measures should be taken to improve the availability of essential medicines.
A series of novel 3‐(thiophen‐2‐ylthio)pyridine derivatives as insulin‐like growth factor 1 receptor (IGF‐1R) inhibitors was designed and synthesized. IGF‐1R kinase inhibitory activities and cytotoxicities against HepG2 and WSU‐DLCL2 cell lines were tested. For all of these compounds, potent cancer cell proliferation inhibitory activities were observed, but not through the inhibition of IGR‐1R. Selected compounds were further screened against various kinases. Typical compound 22 (50% inhibitory concentration [IC50] values, HepG2: 2.98 ± 1.11 μM and WSU‐DLCL2: 4.34 ± 0.84 μM) exhibited good inhibitory activities against fibroblast growth factor receptor‐2 (FGFR2), FGFR3, epidermal growth factor receptor, Janus kinase, and RON (receptor originated from Nantes), with IC50 values ranging from 2.14 to 12.20 μM. Additionally, the cell‐cycle analysis showed that compound 22 could arrest HepG2 cells in the G1/G0 phase. Taken together, all the experiments confirmed that the compounds in this series were multitarget anticancer agents worth further optimizing.
Currently, as there is no systematic norm or standard for drug safety and inspection, it cannot be judged whether the regulatory authority or regulators have fulfilled their administrative responsibilities entirely or not, when a drug safety-related incident occurs. And there is a probability that some may even be wrongly punished. In this study, we have analyzed the risk of not having appropriate norms in place and also put forward recommendations for the government or the regulatory authorities to set up norms to be fulfilled for drug safety and inspection issues. This, on one hand, could provide a basic guideline for the regulatory authorities and regulators to improve their professional levels and administrative acumen and on the other hand, it could also provide a baseline for society to judge whether the regulatory authorities and regulators have fulfilled their responsibilities correctly and thereby also help prevent regulators from being mistakenly punished. This study proposes that a systematic and functional norm for drug safety and inspection could be set up relating to the determination of the responsibilities of regulatory authorities and scope of various inspections, number and frequency of inspections, number and qualifications of regulators, handling of inspection results, inspection records, and disciplinary codes for inspectors. This study also puts forward suggestions on who should be responsible for drafting the norms and what are the factors that need to be considered while formulating the norms.
BackgroundPeripherally inserted central catheter (PICC) and centrally inserted totally implanted access port (PORT) are two types of intravenous infusion devices that are widely used in clinical practice. PORTs are more expensive to insert than PICCs but have fewer complications. Two cost-utility analyses of PICCs and PORTs in China have been published, but had conflicting findings. This study aimed to compare the cost-utility of PICCs and PORTs.MethodsWe conducted a prospective observational trial including 404 patients with cancer and a cross-sectional study to calculate cost and complications of a PICC and PORT. Utility was measured using the EuroQol five-dimensional questionnaire (EQ-5D-5L). A cost-utility analysis was performed from a healthcare system perspective in China.ResultsThe average total cost of PICCs and PORTs were ¥ 4,091.7 and ¥ 4,566.8, which yielded 0.46 and 0.475 quality-adjusted life-years (QALYs) in a 6-month dwell time, respectively. The incremental cost-utility ratio (ICUR) was ¥ 31,670.9 per QALY. A one-way sensitivity analysis showed that the base-case results were robust, and the probabilistic sensitivity analysis showed that at a willingness-to-pay (WTP) threshold of ¥ 80,976 per QALY (China's per capita GDP in 2021) the probability of a PORT being cost-effective was 96%.ConclusionPORTs were more cost-effective than PICCs for a 6 and 12-month dwell time. The total cost for a PORT was also less than that of a PICC. PORT is therefore recommended as a medium to long-term intravenous delivery device in clinical practice.
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