Page 7 - 202011

·药事管理·

基本药物目录中的抗菌药物在南京地区医疗机构中的可及性调

查研究 Δ

1＊
1 #
3
2
张 亮 ，周秋云 ，张雪萌 ，俞 颖 ，王杉杉 ，邵 蓉 （1.中国药科大学国家药物政策与医药产业经济研究
4
5
中心，南京 211198；2.南京市胸科医院药学部，南京 210029；3.南京市第一医院药学部，南京 210006；4.南
京医科大学第二附属医院药学部，南京 210011；5.南京脑科医院药学部，南京 210029）
中图分类号 R95 文献标志码 A 文章编号 1001-0408（2020）11-1281-07
DOI 10.6039/j.issn.1001-0408.2020.11.01

摘 要 目的：了解基本药物目录中的抗菌药物在南京地区医疗机构的可及性，为后续制订和完善相关药品政策提供依据。方
法：以原研和仿制两种来源的药物为调查对象，采用世界卫生组织（WHO）/国际健康行动组织（HAI）共同制定的标准调查方法，选
取基本药物目录（2018年版）和国际药品价格指南（2015年版）共同收录的35种抗菌药物，于2019年1－6月通过线上问卷的方式
分别从可获得性（可提供该药品的机构占比）、药价水平[以中位价格比（MPR）计算]和可负担性（药品支出与非技术政府工人每日
最低工资的比值）等3个维度对南京市13家二级及以上医疗机构进行调查，并提出药物政策制订建议。结果：原研药可获得性的
中位数为0，区间范围为0～100％；仿制药的可获得性的中位数为30.80％，区间范围为0～100％。原研药价的MPR为5.54，区间
范围为1.96～18.83；仿制药价的MPR为1.76，区间范围为0.16～7.66。原研药可负担性的中位数为8.68，区间范围为1.19～41.79；
仿制药可负担性的中位数为0.52，区间范围为0.03～16.80。结论：与原研药相比，仿制药的可获得性更高；原研药的价格普遍很
高，仿制药的价格大多较低；原研药总体可负担性较差，仿制药总体可负担性较好。基本药物的整体可及性尚有进一步提升的空
间，当前保证原研药的可及性有助于满足临床治疗的需求。建议根据临床用药需求更新、调整基本药物目录，普及基本药物知识，并
适度调整原研药价格，减轻患者用药负担。制订药物政策时需充分考虑地域因素和不同性质医疗机构的个性化使用需求。
关键词 基本药物；抗菌药物；可及性；医疗机构；南京

Investigation and Study on the Accessibility of Antibiotics in Essential Medicine List in Medical Institutions
of Nanjing Area
ZHANG Liang ，ZHOU Qiuyun ，ZHANG Xuemeng ，YU Ying ，WANG Shanshan ，SHAO Rong（1.The Research
4
2
3
1
1
5
Center of National Drug Policy & Ecosystem，China Pharmaceutical University，Nanjing 211198，China；2.
Dept. of Pharmacy，Nanjing Chest Hospital，Nanjing 210029，China；3.Dept. of Pharmacy，Nanjing First
Hospital，Nanjing 210006，China；4. Dept. of Pharmacy，the Second Affiliated Hospital of Nanjing Medical
University，Nanjing 210011，China；5. Dept. of Pharmacy，Nanjing Brain Hospital，Nanjing 210029，China）
ABSTRACT OBJECTIVE：To investigate the accessibility of antibiotics in essential medicine list in medical institutions of
Nanjing area，and to provide reference for formulating and improving related drug policy. METHODS：Taking the original and
imitated drugs as the objects of investigation，the standard investigation method jointly formulated by WHO/HAI was adopted to
select 35 kinds of antibiotics which were included in Essential Medicine List（2018 edition）and International Drug Price Indicator
Guide（2015 edition），and to investigate 3 dimenions such as the availability（proportion of institutions that could provide this
drug），price（calculated by MPR）and affordability（the ratio of drug expenditure to the daily minimum wage of non-technical
government workers） of them in 13 second-class or above medical institutions in Nanjing area by online questionnaires during
Jan.-Jun. 2019，so as to put forward the suggestions for drug policy formulation. RESULTS：The median availability of original
drugs was 0，with a range of 0 to 100％；the median availability of generic drugs was 30.80％，with a range of 0 to 100％. The
median MPR of original drugs was 5.54，with a range of 1.96 to 18.83；the median MPR of generic drugs was 1.76，with a range
of 0.16 to 7.66. Median affordability of original drugs was 8.68，with a range of 1.19 to 41.79；the median affordability of generic
drugs was 0.52， with a range of 0.03 to 16.80.
Δ 基金项目：国家社会科学基金重大项目（No.15ZDB167）；中国
CONCLUSIONS：Generic drugs are more available than the
药科大学“双一流”学科创新团队建设项目（No.CPU2018GY39）
originals. The price of original drugs is generally very high，
＊博士研究生。研究方向：医院药学、医药政策法规。电话：
while the price of generic drugs is mostly cheaper. The
025-58619845。E-mail：zhshine310@163.com
# 通信作者：教授，博士生导师，博士。研究方向：医药政策与法 affordability of original drugs is really poor， and the
规。E-mail：shaorong118@163.com affordability of generic drugs is totally good. There are still

中国药房 2020年第31卷第11期 China Pharmacy 2020 Vol. 31 No. 11 ·1281 ·