An analysis on rational use and affordability of medicine after the implementation of National Essential Medicines Policy and Zero Mark-up Policy in Hangzhou, China

PLoS One. 2019 Mar 14;14(3):e0213638. doi: 10.1371/journal.pone.0213638. eCollection 2019.

Abstract

Background: The National Essential Medicine Policy and the Zero Mark-up Policy was introduced to improve the rational use and affordability of medicine. This study analyzed the changes of medicine use at different Health Care Institutions in Hangzhou city after the implementation of National Essential Medicine Policy and the Zero Mark-up Policy.

Methods: Facility based survey was conducted in 17 Health Care Institutions and 16406 outpatient prescriptions in 2011 and 2013 were collected. Average number of medicines, average number of antibiotics and average expenditure per prescription were analyzed. Comparisons between 2011 and 2013, among different levels of Health Care Institutions and age groups were conducted.

Results: The average number of medicines per prescription, use of antibiotics, intramuscular (IM) injections and intravenous (IV) injections decreased while the use of hormones increased. No significant change of the average medicine expenditure per prescription was observed. Disparities among different levels of Health Care Institutions and different age groups existed.

Conclusion: The problems of poly-pharmacy, overuse of antibiotics, intramuscular (IM) injections and intravenous (IV) injections and hormones still existed, however mitigated after the implementation of The National Essential Medicine Policy and the Zero Mark-up Policy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Anti-Bacterial Agents / economics
  • Child
  • Child, Preschool
  • China
  • Drug Costs*
  • Drug Prescriptions / statistics & numerical data
  • Drug and Narcotic Control / trends*
  • Drugs, Essential / economics
  • Drugs, Essential / therapeutic use*
  • Health Expenditures
  • Health Policy*
  • Health Services Accessibility
  • Humans
  • Infant
  • Infant, Newborn
  • Injections, Intramuscular
  • Injections, Intravenous
  • Middle Aged
  • Outpatients
  • Pharmacies
  • Practice Patterns, Physicians' / statistics & numerical data
  • Primary Health Care / statistics & numerical data
  • World Health Organization
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Drugs, Essential

Grants and funding

This research was funded by Alliance for Health Policy and Systems Research (AHPSR), the World Health Organization (ATM2012-01-CHINA). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.