Availability of essential medicines, progress and regional distribution in China: a systematic review and meta-analysis

Zhang, Miao; Zou, Kun; Liu, Zheng; Liu, Dan; Wang, Xiuli; Shi, Yuqing; Chen, Zhe; Cheng, Xiao; Lang, Bingchen; Li, Hailong; Zeng, Linan; Tang, Yong; Zhao, Shaoyang; Jiang, Yongmu; Choonara, Imti; Zhang, Lingli

doi:10.3389/fpubh.2023.1149838

Cited by 2 publications

(1 citation statement)

References 49 publications

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“…There is a need and opportunity for health reform to improve access, affordability and equity of health products [14]. Essential medicines should meet the priority health needs of the population [15]. One of the obstacles linked to access is the high cost of medicines and the increase in the number of medicines prescribed for prescription in structures.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with the Financial Accessibility of Medicines in Public Health Structures in Conakry, Guinea

Youla,

Bah,

Bangoura

et al. 2024

CAJPH

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The aim of this study is to analyze the factors associated with financial accessibility to medicines in public health structures in Matoto, Guinea, 2022. This was a cross-sectional study, lasting six months. It concerned patients admitted for consultation in one of the public health structures in Matoto, who had received a medical prescription and who presented themselves at the point of sale of the structure where they were consulted. We performed a chi2, Fischer Exact test to compare the proportions with each other. Bivariate logistic regression analysis was performed. A total of 573 patients, predominantly female 63% and single 52%, voluntarily participated in this study. We found that 30% of patients carried out a liberal activity compared to 5.93% who were civil servants. 3.14% of the subjects surveyed came from outside Conakry. We estimated the frequency of financial inaccessibility to medicines at 56.54%. This study revealed that financial accessibility to medicines in public health structures in Matoto (Guinea) is a challenge for 56.54% of patients. The associated factors are: Gender, socio-professional status, origin and age.

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Section: Introductionmentioning

confidence: 99%

Factors Associated with the Financial Accessibility of Medicines in Public Health Structures in Conakry, Guinea

Youla,

Bah,

Bangoura

et al. 2024

CAJPH

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Short- and long-term impacts of the National Essential Medicines Policy on drug availability, price, and usage in a deprived rural county in southwestern China: an interrupted time series analysis across 8 years

Xiong,

Huo,

Zhou

et al. 2024

Front. Public Health

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BackgroundChina’s National Essential Medicines Policy (NEMP) has been implemented for over 15 years; yet empirical evidence on its long-term impacts is lacking, particularly in remote and rural regions. This study aims to assess the short-and long-term effects of NEMP on the drug availability, price, and usage in a deprived rural county in southwestern China.MethodsA quasi-experimental design was employed, featuring a single-group pre-and-post comparison. We gathered 74,436 procurement records spanning from 2009 to 2016 from the drug warehouses of local medical institutions. Pharmaceutical data were analyzed quarterly, considering various policy and therapeutic attributes. Fisher’s Drug Price Index (DPI-F) was calibrated for the retail and wholesale prices of a consistent collection of 405 medications. We conducted interrupted time-series analysis to examine the immediate and enduring impacts of NEMP’s initial (commencing in January 2011) and second (starting from December 2015) stages.ResultsAfter initiation of NEMP, the number of available essential medicines surged by 115 but subsequently faced a steady quarterly decline (−9.1) in township healthcare centers (THCs, primary care). Conversely, county hospitals (secondary care) initially saw a reduction of 40 in drug availability but later exhibited a steady increase (+4.2 per quarter) up to the second-stage NEMP. Regarding price, THCs encountered abrupt (−26.1%/−15.9% in retail/wholesale price) and sustained (−0.2%/−0.3% per quarter) price drops after NEMP. The immediate price change after NEMP in county hospitals were milder but significant in non-essential medicines, and long-term declines were also observed in all drugs. As for total sales, a significant long-term disparity emerged between THCs (+0.9% per quarter) and county hospitals (+3.3% per quarter). Following the second-stage NEMP, retail prices in county hospitals further decreased, although wholesale prices did not; however, following price upward trends were observed in both THCs and county hospitals. Lastly, the influences of NEMP varied across different therapeutical categories of medicines.ConclusionNEMP has successfully regulated drug prices in primary and secondary healthcare facilities in remote and rural areas, both short-term and long-term. However, a remarkable disparity in medicine availability and utilization was observed between different levels of facilities over time. Continuous monitoring is essential, with increased attention needed on the uneven impacts of the policy on diverse drugs, facilities, regions, and demographics.

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Availability of essential medicines, progress and regional distribution in China: a systematic review and meta-analysis

Cited by 2 publications

References 49 publications

Factors Associated with the Financial Accessibility of Medicines in Public Health Structures in Conakry, Guinea

Factors Associated with the Financial Accessibility of Medicines in Public Health Structures in Conakry, Guinea

Short- and long-term impacts of the National Essential Medicines Policy on drug availability, price, and usage in a deprived rural county in southwestern China: an interrupted time series analysis across 8 years

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