目的:为了评估可用性,成本,南京抗癌药物的承受能力,江苏。
方法:于2016-2020年对南京市26家医疗机构的24种基本抗癌药物(EAM)和17种创新抗癌药物(IAM)进行纵向跟踪调查。可用性,成本,研究了EAM和IAM的药物利用和可负担性。
结果:在南京,EAM的可用性没有显着变化,但IAMs的可用性在2018年和2019年表现出显著增长,并在2020年趋于稳定。对于EAM,LPG(最低价格的仿制药)的DDDc(定义的每日剂量成本)没有显着变化,OBs(OriginatorBrands)和IAMs的DDDc显著下降。EAM(LPG)的DDDs(定义的每日剂量)自2016年以来呈下降趋势,2019年再次上升。总的来说,2016年至2020年,EAM(LPG)的DDDs下降了25.18%,但2020年选择用于临床治疗的比例仍为67.35%.EAM(OBs)和IAM的DDDs均呈逐年上升趋势,比例增长207.72%和652.68%,分别;但2020年选择用于临床治疗的比例分别仅为16.09%和16.56%。EAM(LPG)对城市居民的承受能力较好,但对农村居民的承受能力较差;EAM(OBs)和IAM对城乡居民的承受能力较差。
结论:EAM(LPG)的可用性和成本没有显着变化,较低的价格显示出更好的负担能力。尽管它们在药物利用方面的相对变化呈下降趋势,他们仍然主导着临床治疗。在国家药品价格谈判(NDPN)政策的推动下,IAMs的可用性正在上升。有必要进一步制定和加强基本药物采购评估政策,以提高EAM的可及性。
OBJECTIVE: To evaluate the availability, cost, affordability of anti-cancer medicines in Nanjing, Jiangsu.
METHODS: A longitudinal tracking investigation study was performed to collect information about 24 essential anti-cancer medicines (EAMs) and 17 innovative anti-cancer medicines (IAMs) in 26 healthcare institutions in Nanjing from 2016 to 2020. The availability, cost, drug utilization and affordability of EAMs and IAMs were investigated.
RESULTS: The availability of EAMs showed no significant changes in Nanjing, but the availability of IAMs showed a significant increase in 2018 and 2019 and tended to stabilize in 2020. For EAMs, the DDDc(Defined Daily Dose cost) of LPGs (Lowest-Priced Generics) showed no significant changes, and the DDDc of OBs (Originator Brands) and IAMs significantly decreased. The DDDs(Defined Daily Doses) of EAMs (LPGs) showed a decreasing trend since 2016 and rose again in 2019. Overall, the DDDs of EAMs (LPGs) decreased by 25.18% between 2016 and 2020, but the proportion selected for clinical treatment remained at 67.35% in 2020. The DDDs of EAMs (OBs) and IAMs both showed an increasing trend year by year, with a proportional increase of 207.72% and 652.68%, respectively; but the proportion selected for clinical treatment was only 16.09% and 16.56% respectively in 2020. EAMs (LPGs) had good affordability for urban residents but poor affordability for rural residents; the affordability of EAMs (OBs) and IAMs was poor for both urban and rural residents.
CONCLUSIONS: There were no significant changes in the availability and cost of EAMs (LPGs), whose lower prices showed better affordability. Although their relative change in drug utilization showed a decreasing trend, they still dominated clinical treatment. Driven by the national drug price negotiation (NDPN) policy, the availability of IAMs was on the rise. It is necessary to further develop and strengthen policies for essential medicines procurement assessment to improve the accessibility of EAMs.