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Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces

BACKGROUND: The current health care reform in China launched in 2009 tackles the problem of access to appropriate medicines for its 1.3 billion people by focusing on providing essential medicines to all. To provide evidence for the reform process, we investigated the manufacturing, purchasing, and p...

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Autores principales: Chen, Wen, Tang, Shenglan, Sun, Jing, Ross-Degnan, Dennis, Wagner, Anita K
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915989/
https://www.ncbi.nlm.nih.gov/pubmed/20637116
http://dx.doi.org/10.1186/1472-6963-10-211
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author Chen, Wen
Tang, Shenglan
Sun, Jing
Ross-Degnan, Dennis
Wagner, Anita K
author_facet Chen, Wen
Tang, Shenglan
Sun, Jing
Ross-Degnan, Dennis
Wagner, Anita K
author_sort Chen, Wen
collection PubMed
description BACKGROUND: The current health care reform in China launched in 2009 tackles the problem of access to appropriate medicines for its 1.3 billion people by focusing on providing essential medicines to all. To provide evidence for the reform process, we investigated the manufacturing, purchasing, and prescribing of essential medicines in two provinces. METHODS: We conducted surveys in 2007 of all manufacturers (n = 253) and of 59 purposively selected retail and 63 hospital pharmacies in Shandong and Gansu provinces to assess production and supply of products on the 2004 National Essential Medicines List (NEML), as well as factors underlying decision making about production and supply. We also reviewed prescriptions (n = 5456) in health facilities to calculate standard indicators of appropriate medicines use. RESULTS: Overall, manufacturers in Shandong and Gansu produced only 62% and 50%, respectively, of the essential medicines they were licensed to produce. Of a randomly selected 10% of NEML products, retail pharmacies stocked up to 60% of Western products. Median availability in hospital pharmacies ranged from 19% to 69%. Manufacturer and retail pharmacy managers based decisions on medicines production and stocking on economic considerations, while hospital pharmacy managers cited clinical need. Between 64% and 86% of prescriptions contained an essential medicine. However, overprescribing of antibiotics (34%-77% of prescriptions) and injectables (22%-61%) for adult non-infectious outpatient consultations was common. CONCLUSIONS: We found that manufacturers, retail pharmacies, and hospital pharmacies paid limited attention to China's 2004 NEML in their decisions to manufacture, purchase, and stock essential medicines. We also found that prescribing of essential medicines was frequently inappropriate. These results should inform strategies to improve affordable access to essential medicines under the current health care reform.
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spelling pubmed-29159892010-08-05 Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces Chen, Wen Tang, Shenglan Sun, Jing Ross-Degnan, Dennis Wagner, Anita K BMC Health Serv Res Research Article BACKGROUND: The current health care reform in China launched in 2009 tackles the problem of access to appropriate medicines for its 1.3 billion people by focusing on providing essential medicines to all. To provide evidence for the reform process, we investigated the manufacturing, purchasing, and prescribing of essential medicines in two provinces. METHODS: We conducted surveys in 2007 of all manufacturers (n = 253) and of 59 purposively selected retail and 63 hospital pharmacies in Shandong and Gansu provinces to assess production and supply of products on the 2004 National Essential Medicines List (NEML), as well as factors underlying decision making about production and supply. We also reviewed prescriptions (n = 5456) in health facilities to calculate standard indicators of appropriate medicines use. RESULTS: Overall, manufacturers in Shandong and Gansu produced only 62% and 50%, respectively, of the essential medicines they were licensed to produce. Of a randomly selected 10% of NEML products, retail pharmacies stocked up to 60% of Western products. Median availability in hospital pharmacies ranged from 19% to 69%. Manufacturer and retail pharmacy managers based decisions on medicines production and stocking on economic considerations, while hospital pharmacy managers cited clinical need. Between 64% and 86% of prescriptions contained an essential medicine. However, overprescribing of antibiotics (34%-77% of prescriptions) and injectables (22%-61%) for adult non-infectious outpatient consultations was common. CONCLUSIONS: We found that manufacturers, retail pharmacies, and hospital pharmacies paid limited attention to China's 2004 NEML in their decisions to manufacture, purchase, and stock essential medicines. We also found that prescribing of essential medicines was frequently inappropriate. These results should inform strategies to improve affordable access to essential medicines under the current health care reform. BioMed Central 2010-07-17 /pmc/articles/PMC2915989/ /pubmed/20637116 http://dx.doi.org/10.1186/1472-6963-10-211 Text en Copyright ©2010 Chen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Chen, Wen
Tang, Shenglan
Sun, Jing
Ross-Degnan, Dennis
Wagner, Anita K
Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces
title Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces
title_full Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces
title_fullStr Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces
title_full_unstemmed Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces
title_short Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces
title_sort availability and use of essential medicines in china: manufacturing, supply, and prescribing in shandong and gansu provinces
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915989/
https://www.ncbi.nlm.nih.gov/pubmed/20637116
http://dx.doi.org/10.1186/1472-6963-10-211
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