Frontiers in Pharmacology (May 2023)
The price and affordability of essential medicines, progress and regional distribution in China: a systematic review
- Zheng Liu,
- Zheng Liu,
- Zheng Liu,
- Zheng Liu,
- Zheng Liu,
- Kun Zou,
- Kun Zou,
- Kun Zou,
- Kun Zou,
- Dan Liu,
- Dan Liu,
- Dan Liu,
- Dan Liu,
- Dan Liu,
- Miao Zhang,
- Miao Zhang,
- Miao Zhang,
- Miao Zhang,
- Miao Zhang,
- Yuqing Shi,
- Yuqing Shi,
- Yuqing Shi,
- Yuqing Shi,
- Yuqing Shi,
- Zhe Chen,
- Zhe Chen,
- Zhe Chen,
- Zhe Chen,
- Zhe Chen,
- Bingchen Lang,
- Bingchen Lang,
- Bingchen Lang,
- Bingchen Lang,
- Xiao Cheng,
- Xiao Cheng,
- Xiao Cheng,
- Xiao Cheng,
- Hailong Li,
- Hailong Li,
- Hailong Li,
- Hailong Li,
- Linan Zeng,
- Linan Zeng,
- Linan Zeng,
- Linan Zeng,
- Yong Tang,
- Shaoyang Zhao,
- Imti Choonara,
- Yongmu Jiang,
- Lingli Zhang,
- Lingli Zhang,
- Lingli Zhang,
- Lingli Zhang,
- Lingli Zhang
Affiliations
- Zheng Liu
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Zheng Liu
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Zheng Liu
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Zheng Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Zheng Liu
- West China School of Medicine, Sichuan University, Chengdu, China
- Kun Zou
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Kun Zou
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Kun Zou
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Kun Zou
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Dan Liu
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Dan Liu
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Dan Liu
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Dan Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Dan Liu
- West China School of Pharmacy, Sichuan University, Chengdu, China
- Miao Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Miao Zhang
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Miao Zhang
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Miao Zhang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Miao Zhang
- West China School of Pharmacy, Sichuan University, Chengdu, China
- Yuqing Shi
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Yuqing Shi
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Yuqing Shi
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Yuqing Shi
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Yuqing Shi
- West China School of Pharmacy, Sichuan University, Chengdu, China
- Zhe Chen
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Zhe Chen
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Zhe Chen
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Zhe Chen
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Zhe Chen
- West China School of Pharmacy, Sichuan University, Chengdu, China
- Bingchen Lang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Bingchen Lang
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Bingchen Lang
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Bingchen Lang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Xiao Cheng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Xiao Cheng
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Xiao Cheng
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Xiao Cheng
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Hailong Li
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Hailong Li
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Hailong Li
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Hailong Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Linan Zeng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Linan Zeng
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Linan Zeng
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Linan Zeng
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Yong Tang
- School of Economics, Sichuan University, Chengdu, China
- Shaoyang Zhao
- School of Economics, Sichuan University, Chengdu, China
- Imti Choonara
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Yongmu Jiang
- School of Economics, Sichuan University, Chengdu, China
- Lingli Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Lingli Zhang
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Lingli Zhang
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Lingli Zhang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Lingli Zhang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- DOI
- https://doi.org/10.3389/fphar.2023.1153972
- Journal volume & issue
-
Vol. 14
Abstract
Background: Essential medicine is a vital component to assure universal access to quality healthcare. However, the trend of affordability to essential medicines in China and its regional differences were not yet fully understood. This study aimed to systematically evaluate the price and affordability of essential medicines, their progress, and regional distribution in China in the last decades.Methods: We searched seven databases and three websites for potentially eligible studies from inception until March 2022. Studies on the price and affordability of essential medicines investigated in China were included. Median and interquartile range (IQR) was used to describe the price and affordability of essential medicines, and compared in three periods, before 2009, from 2009 to 2014, and from 2015 to 2019. Subgroup analysis was performed to examine the price and affordability by regions, health facilities, and ATC categories of medicines. The study was registered with PROSPERO (CRD42022310173).Results: A total of 65 studies including 11,639 health facilities investigated between 2006 and 2019 were included in this review. Median price ratios (MPR) and affordability of essential medicines were reported in 44 studies and 50 studies, respectively. The median MPRs of essential medicines in China was 1.59 (IQR: 5.39), with a tendency to rise first and then fall from 2006 to 2019. And the median affordability was equal to 0.88 (IQR: 2.58) days’ wage of the lowest paid unskilled government worker, but steadily rose from 2006 to 2019. Subgroup analysis showed that the affordability in the western region (1.40, IQR: 2.88), urban area (0.95, IQR: 2.80), private sector (0.90, IQR: 2.30), of originator brands (OB) (2.90, IQR: 6.68), and antineoplastic and immunomodulating agents (5.68, IQR: 56.47) were worse than their counterparts.Conclusion: The prices of essential medicine were higher than international level, the overall affordability of essential medicines in China is acceptable but poor in the western region, for OB drugs and anti-cancer medicines. Further national essential medicine policies are needed to reduce regional disparities and improve the affordability of expensive drugs.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/#recordDetails
Keywords
