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Effects of the National Essential Medicine System in reducing drug prices: an empirical study in four Chinese provinces

OBJECTIVES: The rapid increase in drug expenditure has become a major source of public criticism in China. In 2009, the National Essential Medicine System (NEMS) was launched in China to control drug prices and improve access to medicines. This study investigated whether and to what extent the price...

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Autores principales: Song, Yan, Bian, Ying, Petzold, Max, Li, Lingui, Yin, Aitian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180053/
https://www.ncbi.nlm.nih.gov/pubmed/25317336
http://dx.doi.org/10.1186/2052-3211-7-12
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author Song, Yan
Bian, Ying
Petzold, Max
Li, Lingui
Yin, Aitian
author_facet Song, Yan
Bian, Ying
Petzold, Max
Li, Lingui
Yin, Aitian
author_sort Song, Yan
collection PubMed
description OBJECTIVES: The rapid increase in drug expenditure has become a major source of public criticism in China. In 2009, the National Essential Medicine System (NEMS) was launched in China to control drug prices and improve access to medicines. This study investigated whether and to what extent the prices of essential medicines were reduced after the introduction of NEMS. METHODS: Data were obtained from 149 public primary healthcare centers (PHCs) in four Chinese provinces (Shandong, Zhejiang, Anhui and Ningxia) using a facility-based survey. In total, 10,988 essential medicines were investigated. Individual price differences and a price index were used to measure price changes for three different lists: 2009–2010, 2010–2011, and 2009–2011. RESULTS: In the comparison between 2009 and 2010, a median decrease of 34.4% [95% confidence interval: 30.4%–39.1%] was observed in drug prices and the number of drug sales increased by 1.5%. The higher the retail price in 2010, the more the drug sales increased compared with 2009 (χ(2) = 75.9, p < 0.01). The drug revenues in 100 of the 149 surveyed PHCs decreased by an average of 39%. Where the available data allowed price changes for 2009–2011 to be assessed, drug prices were reduced significantly in 2010, but a modest decrease was seen in 2011. The Laspeyres index was less than 100 and the Paasche index was larger than the Laspeyres index in 2010 and 2011, which indicated that the frequently prescribed drugs usually had higher prices and any price reduction was milder. CONCLUSIONS: The introduction of NEMS in PHCs in China led to price reductions in essential medicines. However, more-expensive drugs were preferred in the postreform period. Most PHCs had less drug revenue and could encounter financing dilemmas after the implementation of NEMS. Policy options such as improving the compensation mechanism and rational use of drugs should be further promoted in PHCs.
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spelling pubmed-41800532014-10-14 Effects of the National Essential Medicine System in reducing drug prices: an empirical study in four Chinese provinces Song, Yan Bian, Ying Petzold, Max Li, Lingui Yin, Aitian J Pharm Policy Pract Research OBJECTIVES: The rapid increase in drug expenditure has become a major source of public criticism in China. In 2009, the National Essential Medicine System (NEMS) was launched in China to control drug prices and improve access to medicines. This study investigated whether and to what extent the prices of essential medicines were reduced after the introduction of NEMS. METHODS: Data were obtained from 149 public primary healthcare centers (PHCs) in four Chinese provinces (Shandong, Zhejiang, Anhui and Ningxia) using a facility-based survey. In total, 10,988 essential medicines were investigated. Individual price differences and a price index were used to measure price changes for three different lists: 2009–2010, 2010–2011, and 2009–2011. RESULTS: In the comparison between 2009 and 2010, a median decrease of 34.4% [95% confidence interval: 30.4%–39.1%] was observed in drug prices and the number of drug sales increased by 1.5%. The higher the retail price in 2010, the more the drug sales increased compared with 2009 (χ(2) = 75.9, p < 0.01). The drug revenues in 100 of the 149 surveyed PHCs decreased by an average of 39%. Where the available data allowed price changes for 2009–2011 to be assessed, drug prices were reduced significantly in 2010, but a modest decrease was seen in 2011. The Laspeyres index was less than 100 and the Paasche index was larger than the Laspeyres index in 2010 and 2011, which indicated that the frequently prescribed drugs usually had higher prices and any price reduction was milder. CONCLUSIONS: The introduction of NEMS in PHCs in China led to price reductions in essential medicines. However, more-expensive drugs were preferred in the postreform period. Most PHCs had less drug revenue and could encounter financing dilemmas after the implementation of NEMS. Policy options such as improving the compensation mechanism and rational use of drugs should be further promoted in PHCs. BioMed Central 2014-09-17 /pmc/articles/PMC4180053/ /pubmed/25317336 http://dx.doi.org/10.1186/2052-3211-7-12 Text en © Song et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. 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 credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Song, Yan
Bian, Ying
Petzold, Max
Li, Lingui
Yin, Aitian
Effects of the National Essential Medicine System in reducing drug prices: an empirical study in four Chinese provinces
title Effects of the National Essential Medicine System in reducing drug prices: an empirical study in four Chinese provinces
title_full Effects of the National Essential Medicine System in reducing drug prices: an empirical study in four Chinese provinces
title_fullStr Effects of the National Essential Medicine System in reducing drug prices: an empirical study in four Chinese provinces
title_full_unstemmed Effects of the National Essential Medicine System in reducing drug prices: an empirical study in four Chinese provinces
title_short Effects of the National Essential Medicine System in reducing drug prices: an empirical study in four Chinese provinces
title_sort effects of the national essential medicine system in reducing drug prices: an empirical study in four chinese provinces
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180053/
https://www.ncbi.nlm.nih.gov/pubmed/25317336
http://dx.doi.org/10.1186/2052-3211-7-12
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