Abstract
BackgroundThe National Essential Medicine System (NEMS) is a new policy in China launched in 2009 to improve the appropriate use of medications. This study aims to examine the outcomes of the NEMS objectives in terms of the rational use of medicines in primary health care facilities in China.MethodsA total of 28,651 prescriptions were collected from 146 township health centers in four provinces of China by means of a field survey conducted in 2010–2011. Indicators of rational drug use were extracted and compared using a pre/post design and then evaluated with regard to the World Health Organization (WHO) Standard Guidelines and data from previous research.ResultsThe average number of drugs per prescription decreased from 3.64 to 3.46 (p < 0.01) between 2009 and 2010. Little effect was found for the NEMS on the average number of antibiotics per prescription, but the percentage of prescriptions including antibiotics decreased from 60.26 to 58.48% (p < 0.01). Prescriptions for injections or adrenal corticosteroids also decreased, to 40.31 and 11.16% of all prescriptions, respectively. All these positive issues were also recorded in 2011. However, each of the above values remained higher than WHO standards. The percentage of drugs prescribed from the Essential Drug List increased after the implementation of the NEMS (p < 0.01). Where the available data allowed changes in costs to be assessed, the average expense per prescription increased significantly, from 25.77 to 27.09 yuan (p < 0.01).ConclusionsThe NEMS effectively improved rational medicine use in China. However, polypharmacy and the over-prescription of antibiotics and injections remain common. There is still a large unfinished agenda requiring policy improvements. Treatment guidelines, intensive support supervision, and continuing training for both professionals and consumers are the essential actions that need to be taken.
Highlights
The National Essential Medicine System (NEMS) is a new policy in China launched in 2009 to improve the appropriate use of medications
It was estimated that about 2.5 million patients each year were admitted to the hospital owing to serious Adverse Drug Reaction (ADR), and 60% of cases of acquired deafness in children were caused by irrational use of ototoxic drugs [6]
Fewer drugs were prescribed per prescription after the NEMS (p < 0.01)
Summary
The National Essential Medicine System (NEMS) is a new policy in China launched in 2009 to improve the appropriate use of medications. Rational drug use (RDU) requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community [1]. All countries, both rich and poor, have encountered problems with the insufficient use form of medicine abuse in China. In China, hospitals can charge 15% over the wholesale price for drugs This drug mark-up was initially introduced to compensate facilities for providing services below cost, as stipulated in the required fee schedule set by the government. It was estimated that about 2.5 million patients each year were admitted to the hospital owing to serious ADRs, and 60% of cases of acquired deafness in children were caused by irrational use of ototoxic drugs [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
