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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Main Authors:	Chen, W., Tang, S. L., Sun, J., Ross-Degnan, D., Wagner, A. K.
Format:	Journal Article
Language:	EN
Published:	2012
Online Access:	http://hdl.handle.net/10986/5200

id	okr-10986-5200
recordtype	oai_dc
spelling	okr-10986-52002021-05-05T13:23:25Z Availability and Use of Essential Medicines in China : Manufacturing, Supply, and Prescribing in Shandong and Gansu Provinces Chen, W. Tang, S. L. Sun, J. Ross-Degnan, D. Wagner, A. K. 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 noninfectious 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. 2012-03-30T07:31:46Z 2012-03-30T07:31:46Z 2010 Journal Article Bmc Health Services Research 1472-6963 http://hdl.handle.net/10986/5200 EN http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Journal Article China
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	EN
geographic_facet	China
relation	http://creativecommons.org/licenses/by-nc-nd/3.0/igo
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 noninfectious 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.
format	Journal Article
author	Chen, W. Tang, S. L. Sun, J. Ross-Degnan, D. Wagner, A. K.
spellingShingle	Chen, W. Tang, S. L. Sun, J. Ross-Degnan, D. Wagner, A. K. Availability and Use of Essential Medicines in China : Manufacturing, Supply, and Prescribing in Shandong and Gansu Provinces
author_facet	Chen, W. Tang, S. L. Sun, J. Ross-Degnan, D. Wagner, A. K.
author_sort	Chen, W.
title	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_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_sort	availability and use of essential medicines in china : manufacturing, supply, and prescribing in shandong and gansu provinces
publishDate	2012
url	http://hdl.handle.net/10986/5200
_version_	1764394290861047808

Availability and Use of Essential Medicines in China : Manufacturing, Supply, and Prescribing in Shandong and Gansu Provinces

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