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OBJECTIVE：To provide reference for helping poor patients with chronic diseases to get rid of poverty and enjoy drug welfare. METHODS ：A overall general questionnaire was designed and conducted in Lianyungang City and Changzhou City of Jiangsu Province ，and then conducted formal investigation in Gansu ，Hebei and Sichuan. Factor analysis was used to analyze the survey results ，and the drug welfare effects of 4 kinds of chronic diseases were scored ，the difference and main influential factors of drug welfare effect for different chronic disease patients were found out. RESULTS ：A total of 745 questionnaires were sent out ， and 721 effective questionnaires were finally collected ，with an effective recovery rate of 96.8％. Factor analysis results showed that the drug welfare effect of patients with chronic diseases can be divided into 5 dimensions such as drug health effect ，drug fair effet，drug price effect ，drug availability effect and personal economic level effect. The average score of comprehensive drug welfare effect of chronic disease patients was 2.56（general）. The average scores of comprehensive drug welfare effects in patients with diabetes，cardiovascular and cerebrovascular diseases ，chronic respiratory system diseases and malignant tumors were 3.12（good）， 2.73（general），2.56（general）and 1.90（poor）. The key factors influencing the drug welfare of the patients with chronic diseases were health effect ，drug fair effect ，and drug price effect. CONCLUSIONS ：In formulating relevant policies ，the state should take drug health effect ，drug fair effect ，drug price effect and drug availability of chronic diseases into consideration ，and formulate more comprehensive and effective drug policy.
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OBJECTIVE： To provide decision basis for antiplatelet therapy in ACS patients. METHODS： Markov model was established by collecting the related data in PLATO and TREAR study. Total bleeding risk， major bleeding risk， secondary bleeding risk and fatal bleeding risk in ACS patients who using ticagrelor or clopidogrel were calculated. Transfer probability， the cost and utility value between each state were collected and calculated according to previous literatures. The medical expenses of different methods were calculated by using TreeAge Pro 2011 software to obtain quality-adjusted life years （QALYs） and increment-cost- effectiveness ratio （ICER）. Furthermore， single-factor sensitivity analysis and probability sensitivity analysis were carried out. RESULTS： The average total cost of ticagrelor group was 66 449.38 yuan， obtaining 7.34 QALYs； the average total cost of clopidogrel group was 53 846.03 yuan， obtaining 6.68 QALYs. Compared with the clopidogrel group， the ICER of the ticagrelor group was 19 095.98 yuan/QALYs， that is， for each additional QALYs obtained， the cost of ticagrelor group was 19 095.98 yuan， less than willingness to pay threshold （64 644 yuan）. Sensitivity analysis was consistent with above analysis. CONCLUSIONS： Compared with clopidogrel， ticagrelor has less economic burden in ACS patients， especially in the patients with adverse bleeding events.
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OBJECTIVE： To provide reference for improving the efficiency of drug supply emergency management in China. METHODS： Referring to the general principle of multi-agent system， the multi-agent information interaction mechanism of drug supply emergency management was constructed by using drug production and distribution enterprises， medical institutions， government， patients and media as the main bodies. RESULTS & CONCLUSIONS： In this study， a multi-agent information interaction mechanism of drug supply emergency management was preliminarily established， which was composed of risk information transfer coordination mechanism， information sharing mechanism and emergency task decomposition mechanism. The process can be divided into four stages as risk prevention， risk early warning， risk response and risk mitigation. The multi-agent information interaction mechanism of drug supply emergency management had certain applicability to improve the transmission efficiency of key information in the process of drug supply emergency management， which can provide new ideas for relevant departments to improve the ability of drug supply risk identification and response， and then improve China’s drug information monitoring system and supply guarantee system.
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OBJECTIVE： To study the benefit incidence equity and its influential factors of drug welfare for chronic diseases patients under the background of health poverty alleviation policy， and to provide reference for precision health poverty alleviation. METHODS： According to the National Natural Science Foundation project “Study on the Optimization of Precision Health Poverty Alleviation Policy Based on the Improvement of Drug Welfare Effects of Chronic Diseases Patients”， the research data of Jiangsu， Sichuan and Zhejiang provinces were used as samples （during Oct. 2016-May 2018）. Taking patients’ personal income as economic measurement index， drug expenditure （including reimbursement） as drug welfare index under government health policy， by benefit incidence analysis， Lorentz curve， Gini coefficient， concentration index， concentration curve and Kakwani index were used to analyze the absolute equity and relative equity of drug welfare benefits of patients with chronic diseases. Anderson health service utilization model was used to incorporate the factors that may affect the distribution of drug benefits among the poor patients with chronic diseases. Multivariate linear regression analysis was used to identify the main influential factors. RESULTS： The absolute fairness and relative fairness of drug welfare distribution in patients with chronic diseases were poor， and there were unfair phenomena that were beneficial to the rich and unfavorable to the poor chronic disease patients. Economic income， education level， types of medical insurance and patients’ health level had effects on drug welfare with statistical significance （P＜0.05）. CONCLUSIONS： The health poverty alleviation policy brings drug welfare to patients with chronic diseases，but there are still unfairness. The policy should be more biased towards the poor people，also more chronic disease “life-saving drugs” and commonly used drugs should be included in the medical insurance catalogue. Health education for chronic diseases in primary medical institutions should be strengthened to improve the health literacy and health of patients with chronic diseases.
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OBJECTIVE:To analyze the research hotspots of pharmacoeconomics at home and abroad, and find out the shortcomings of pharmacoeconomics research in China. METHODS:Using"Pharmacoeconomice"as English subject and"pharmacoeconomics"as Chinese subject,SCI source journal,EI source journal,Chinese core journal and CSSCI literatures were retrieved from Web of Science core collection database and CNKI. The research hotspots and trend of pharmacoeconomics at home and abroad during Jan. 2007-Oct. 2017 were studied by using CiteSpace software in respects of subject analysis,topic analysis, citation analysis and keyword cluster analysis. RESULTS:A total of 912 English literatures and 486 Chinese literatures were included. Subject analysis showed that foreign researches on pharmacoeconomics focused on"pharmacology and pharmacy""health science and service",etc;domestic researches focused on"pharmacy""industrial economics",etc. Topic analysis showed that key words such as"quality of life"and"cost benefit analysis"appeared frequently in English literatures;key words such as"cost effectiveness analysis""pharmacoeconomic evaluation"appeared frequently in Chinese literatures. Citation analysis showed that the top 5 cited literatures in English literatures were mostly issued or put forward by related government departments or organizations' research reports;the top 5 cited literatures in Chinese literature were mostly research papers written by individuals. Cluster analysis showed that domestic pharmacoeconomics research mainly focused on drug price,drug policy and cost-effectiveness analysis of different drugs and treatment programs;compared with English literature,Chinese literature pharmacoeconomics still lacked in drug long-term safety,drug risk assessment and patient health. CONCLUSIONS:Domestic pharmacoeconomic researches are still focused on cost-effectiveness analysis of different treatment plans,but lack of research on residents'health care,quality adjustment life year compared with foreign researches. In addition,domestic pharmacoeconomic research were not enough,and research quality is in low level,which limits the application of pharmacoeconomics in China.
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OBJECTIVE:To evaluate the economical efficiency of gemcitabine(G),gemcitabine combined with oxaliplatin (GM),gemcitabine combined with S-1(GS)in the treatment of advanced pancreatic cancer(APC). METHODS:From the perspective of patients,Markov model was constructed to calculate long-term cost and health outcomes of 3 chemotherapy regimens in Chinese APC patients aged 18-75 old. Cost-effectiveness analysis were used to determine the economic level according to willingness-to-pay(WTP). The sensitivity analysis was conducted for cost,effectiveness and other indexes. RESULTS:The results of cost-effectiveness analysis showed that the cost effectiveness ratio(C/E)of G regimen in the treatment of advanced pancreatic cancer was 145 228.52 yuan/12.26 QALMs;C/E of the GM regimen was 154 783.88 yuan/11.39 QALMs;C/E of GS regimen was 315 485.28 yuan/23.26 QALMs;and the G regimen was the best option. The incremental cost-effectiveness(ICER)of GS and G regimen was 15 479.64,exceeded the WTP(12 563 yuan)set in this sutdy,while ICER of GM and G regimen was -10 999.89, and the GM regimen was absolutely inferior. Results of sensitivity analysis showed that ICER of G regimen vs. GM regimen was unstable and influenced greatly by the parameters of the model. Results of ICER analysis of G regimen vs. GS regimen and GM regimen vs. GS regimen kept stable. Compared to GS regimen,G regimen showed cost-effectiveness characteristics and GM regimen showed economic characteristics;the superiority was relatively less obvious. CONCLUSIONS:Within the level of WTP, cost-effectiveness analysis shows that gemcitabine is the optimal solution. However,sensitivity analysis result can not yet determine which scheme is the best one.
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The study explores the current situation of the burden of chronic poor patients and the core essence of the accurate health poverty alleviation policy.More specifically, it aims to analyze the existing problems and practical dilemmas in the implementation of the accurate health poverty alleviation policy, and conveying recommendations for the policy formulation.The analysis shows that the problems in the implementation of the accurate health poverty alleviation policy in China are: the empowerment of the poor population is not accurate;the dynamic management and assessment mechanism is not accurate;and the allocation of poverty alleviation resources is not rational.In view of these problems, the following suggestions were put forward: the establishment of a multi-dimensional poverty identification system, the improvement of poor households through building up their card information;improve the accurate poverty alleviation dynamic supervision and assessment system;rational allocation of poverty alleviation resources, promote the supporting policies and institutional innovation.
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Objective To study the present development of human resource allocation and development trends of traditional Chinese medicine.Methods Literature review was used to study the present development of such human resources in China.Results As of 2015, TCM institutions accounted for 4.73 percent of the total medical institutions in China, and Chinese medicine personnel accounted for 7.40 percent of the total medical workers in the country.The number of staff with education below undergraduate degree in TCM hospital accounted for 35.6% of the total.Conclusions Education level of TCM hospital staff is expected to elevate, and their education needs to respect the law of growth for such human resources and professional development.Continuing education calls for greater attention for elevation of the human resources in general.
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OBJECTIVE:To realize reasonable regression of Chinese medicinal material price to deal with Chinese medicinal material“nominal high price”. METHODS:From the perspective of whole industry chain management,reasons for Chinese medici-nal material“nominal high price”were discussed and feasibility analysis of whole industry chain management of Chinese medicinal material was carried out by using Macro-environment analysis(including politics environment,economic environment,social envi-ronment and technology environment). RESULTS & CONCLUSIONS:At present, Chinese medicinal material“nominal high price”mainly results from lack of core organization,supply deficiency,demand expansion,nonstandard storage and circulation and other factors. Relevant management departments and enterprises should set up whole industry chain management model of Chinese medicinal material from aspects of political environment,economic environment,social environment and technology environment, including to establish industry chain management organization core,to practice standardized production in the upstream industry chain,to appropriately extend industry chain for middle and downstream and to build up modernized logistics service system.
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The concept of “disease prevention theory” contains a wealth of preventive medicine thought. Pre-ventive health care service in Traditional Chinese Medicine( TCM) is an important measure for enhancing health qual-ity and improving the quality of living. This contributes to the building of a harmonious society and suits the changing medical model. Despite a series of achievements, there are also some problems in preventative health care service. Based on an analysis of influencing factors on policy implementation, the problems are discussed in the paper. The study provides some suggestions on preventive health care services, including the perfection of operations and man-agement mechanisms, the improvement of awareness on preventive health care service, the strengthening of the talent team, an increase in funding, and an evaluation of policy implementation.