PDG18 Availability, Cost and Affordability of Selected Antibiotics and Antiviral Medicines Against Infectious Diseases from 2013 to 2019 in Nanjing, China

Abstract

As economic globalization develops in-depth, infectious diseases that occur in a country or region no longer remains a regional issue. Antibiotics and antiviral medicines are essential medicines for the therapy of infectious diseases. This study aims to evaluate the availability, cost and affordability of antibiotics and antiviral medicines against infectious diseases from 2013 to 2019 in Nanjing, China. Data on the availability and price of 17 antibiotics and 6 antiviral medicines in 41 public hospitals were obtained from the Jiangsu Institute of Medicine Information. We adopted the World Health Organization/Health Action International methodology to measure the availability, cost and affordability of these medicines. Availability was defined as the proportion of all the survey institutions where the drug was in stock on the day of data collection. The cost was reported as the daily defined dose cost (DDDc) of each medicine surveyed in this study, which was calculated based on the defined daily dose. Medicine was affordable if the daily defined dose cost of each medicine was less than the resident disposable daily income. The availability of selected medicines was fairly low; the median availability of originator brands(OBs) and lowest-priced generics(LPGs) during the survey period was an approach to 0 and less than 50%, respectively. Total availability was low in primary hospitals as compared to secondary and tertiary hospitals. The median DDDc of OBs was higher than LPGs. The affordability of most surveyed medicines was reasonable, which showed significant improvement over time; while the daily cost of a few medicines for OBs was over the average daily wage of a citizen. There should be a great concern for improving the reserve system of anti-infective medicines in health-care institutions. Policy should focus on improving the availability of generic drugs in health-care institutions and encouraging them to be prescribed preferentially.