Abstract
BackgroundChanges in the national drug policy always have impact on the drug utilization. In the context of China health care reform, what changes had happened in the trend of drug utilization in public hospitals? Has this change met the expectations of policy design? This study was conducted to explore the trend of medicine consumption in county public hospitals before and after health care reform, and to provide real-world evidence to help assess the effectiveness of national drug policy.MethodsA cross-sectional study was performed to investigate the drug utilization trends of 6 county public hospitals in Anhui Province, which is the first pilot area of China health care reform. Data were collected before and after the implementation of the China National Essential Medicine Policy (NEMP) to analyse the drug utilization indicators, such as the drug utilization constituent ratio, the rate of essential medicine usage and the rate of antibiotic consumption.ResultsChemicals are used most frequently and account for 60%~ 70%, followed by oral agents of proprietary Chinese medicine. The results also show increased consumption of Chinese medicine injections (χ2 = 28.428, P < 0.01). The top 3 chemical medicines consumed were anti-infective drugs (12.92%), cardiovascular system drugs (11.61%), and digestive system drugs (8.42%). For Chinese traditional medicine, the top 3 drugs consumed were internal medicine drugs (66.03%), surgical drugs (8.45%), and gynaecological drugs (7.70%). The total sales amounts of drugs covered by medical insurance are at a high level (all above 80%), whereas essential medicines are less than 50% at almost all county-level medical institutions.ConclusionsThis study uncovered the changing tendency of medicine usage under the implementation of the reform. Chinese medicine injections and anti-infective drugs have always been a sustained concern of pharmacovigilance. It is noteworthy that although essential medicines are advocated for as a priority for use in the government-run hospital, the consumption proportion of these medicines is lower than expected.
Highlights
Changes in the national drug policy always have impact on the drug utilization
Sample selection To ensure the representativeness of the samples, subject-stratified sampling was conducted in three districts of the North, Middle and South areas of Anhui Province based on the characteristics of economic and administrative divisions in Anhui Province; one county public hospital and one county traditional Chinese medicine hospital were selected in each city
According to the analysis of the constitution of drug utilization classified by pharmaceutical dosage forms, the results showed a significant difference in varieties dosage form of drugs when comparing the three regions in the 3 years (2011 to 2013)
Summary
Changes in the national drug policy always have impact on the drug utilization. In the context of China health care reform, what changes had happened in the trend of drug utilization in public hospitals? This study was conducted to explore the trend of medicine consumption in county public hospitals before and after health care reform, and to provide real-world evidence to help assess the effectiveness of national drug policy. Promoting the rational allocation of medicine resources and ensuring drug safety application should be the essential goal of health care reform regardless of whether reform occurs in developing countries or developed countries. Since 2009, China has been pushing forward with a new round of the phased implementation of health care system reform centred on the China National Essential Medicine Policy (NEMP) [1]. There has been a great change in the system of preferential use of essential medicines in hospitals, zero-profit sales and centralized bidding and purchasing of medicines, which have a great impact on the hospital pharmacy delivery model
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