Analysis of antibiotic use and rationality for children in primary healthcare institutions from Beijing / 中国药房

OBJE CTIVE To inv estigate the antibiotic use and rationality for children in community health service institutions from Beijing ，and to provide reference for promoting rational use of antibiotics in primary healthcare institutions. METHODS All the prescriptions for children from primary healthcare institutions in 2019 were extracted from prescription review system of community health service institutions in Beijing. The use of antibiotics was described according to the related indicators of the World Health Organization/International Network for Rational Use of Drug （WHO/INRUD）. The structure of antibiotics use was analyzed according to the anatomical therapeutic chemical （ATC）classification as well as the WHO AWaRe classification and diagnosis. RESULTS A total of 288 primary healthcare institutions and 10 422 prescriptions for children were included. The number of institutions in high-income areas ，middle-income areas and low-income areas were 119，80 and 89 respectively，and the number of prescriptions involved were 2 430，2 163 and 5 829 respectively，including 1 447 prescriptions involving antibiotics （13.9％）. Among 1 447 prescriptions，the rate of prescriptions involving combined use of antibiotics was 1.4％（20 pieces）；the rate of prescriptions involving antibiotics injection was 9.7％（141 pieces）；4.8％ antibiotics prescriptions were rated as unreasonable （69 pieces）. The three most commonly used antibiotics were the macrolides （40.2％），the second-generation cephalosporins （26.5％） and the third-generati on cephalosporins （23.4％）. The proportion of antibioti cs prescriptions from groups of access ，caution， reserve and not recommended were 9.1％，92.1％，0.3％，and 0， respectively. The rate of antibiotics prescriptions fortonsillitis was the highest （31.9％ ）. Among 69 irrationalantibiotics prescriptions ，main of them were irrational drug use （56 pieces，81.2％）. CONCLUSIONS The rate of antibiotics prescriptions for children in primary healthcare institutions from Beijing is lower than the standard of WHO antibiotics prescription rate （20.0％-26.8％），but the use rate of antibiotics at caution grade is too high.

Correlation analysis between the judgment of medical damage liability disputes related to off-label drug use and evidence-based evidence / 中国药房

OBJECTIVE To explore wheth er there is a relationship between the judgment results of medical damage liability disputes related to off-label drug use and evidence-based evidence. METHODS By searching for medical damage liability disputes related to off-label drug use up to 2021 on pkulaw.cn ，documents were extracted to record objective factors ，subjective factors and judgment results ；whether there was evidence-based evidence was judged according to Off-label Drug Use List and Evidence-based Evaluation Standards for Off-label Drug Use of Guangdong Pharmaceutical Association ；univariate analysis was adopted to test the relationship between the judgment results and evidence-based evidence. RESULTS A total of 57 cases were included. Cases mainly occurred in the eastern China （63.2％）and tertiary hospitals （64.9％），the main appraisal agency was the appraisal center or institute（61.4％），and the most common type of off-label drug use was overdose drug use （45.6％）. Among the judgment results ， 23 cases（40.4％）of off-label drug use had a causal relationship with medical damage ，most of the responsibility of doctors was secondary responsibility （28.1％），and the actual compensation amount of the most cases were less than 100，000 yuan（54.4％）. There were 25 cases（43.9％）with evidence-based evidence. Univariate analysis found that for off-label drug use the claim amount of the case with evidence-based evidence was significantly higher than that of the case without evidence-based evidence （P＝ 0.040），and there was no significant correlation between evidence-based evidence and the actual compensation amount of the case （P＝0.741），causality determination （P＝0.256），liability type （P＝0.598）or appraisal agency （P≥0.260）. CONCLUSIONS There is no significant correlation between the judgment results of medical damage liability disputes related to off-label drug use and evidence-based evidence ，indicating that there may be certain differences between judicial trials and medical science. The off-label drug use should be regulated by establishing a complete off-label drug use management system and standardizing informed consent procedure for off-label drug use. 1610307322@pku.edu.cn

Systematic Review of Health and Economic Burden Caused by Antibiotic Resistance in China / 中国药房

OBJECTIVE：To provide scientific basis for evaluating the burden caused by antibiotic resistance （AbR）and reference for policy making on crubing AbR in China. METHODS ：Databases including CNKI ，Wanfang database ，VIP，PubMed， Scopus，Medline and EconoLite from Jan. 1st 2016 to Aug. 10th 2020 were searched to collect studies on burden caused by AbR in China . After independent literature screening anddata extraction ，Newcastle-Ottawa scale （NOS）was used to evaluate the literature quality ，and a descriptive analysis was conduced to evaluate the health and economic burden caused by AbR. RESULTS ：A total of 27 Chinese and English literatures were included. The NOS scores of i ncluded literatures were 4-6，and all of them were retrospective case-control study ； the patients were divided into case group （resistance infection ） and control group （susceptible infection or non-infection ）； mortality，length of stay and medical expenditure were commonly applied as the measurement indexes. In the included studies ，the mortality of patients infected with AbR bacteria was 0.7-12.0 times that of patients infected with susceptible bacteria ；the mean or medium value of total length of stay was 0.9-2.5 times that of patients infected with susceptible bacteria ；the mean or medium of total medical expenditure was 1.0-2.7 times that of patients with susceptible bacteria infection. The differences in these indicators were greater between patients infected with AbR infections and those without becterial infections. CONCLUSIONS ：Bacterial drug resistance could increase the health and economic burden. However ，the existing relevant studies were mainly single center researches，the sample representation was insufficient ；the research design did not adjust for time-dependent bias ；the repeatability was low ，and the perspective of evalution was limited. It is urgent to carry out multicenter studies with higher quality to comprehensively evaluate the health and economic burden caused by AbR in China.

Analysis of Provincial Antibiotic Classification Management Lists in China / 中国药房

OBJECTIVE：To provide re ference for scientific management and rational use of antibiotics. METHODS ：Provincial antibiotic classification management lists were retrieved from official websites of provincial health administrative departments ， CNKI and other search engines from Apr. 2012 to Mar. 2020. The difference and adjustment of those lists were analyzed descriptively. RESULTS & CONCLUSIONS ： Since April 2012， 30 provinces released provincial antibiotic classification management lists ，among which only 10 provinces updated the lists. In the provincial classification management lists ，the list of Jiangsu included the most antibiotics （208 kinds），that of Xinjiang involved the least （101 kinds）. Among the 253 antibiotics included in the provincial lists ，134 antibiotics had two management levels ，and 19 antibiotics had three management levels. The 10 antibiotics with the most times of adjustment in the provincial lists mainly include nitimidazoles ，β-lautam compound preparations and quinolones. There was the phenomenon that the same antibiotics were simultaneously included or withdrawn from the lists ，and the grading management level was increased or decreased in the provincial adjustment. Provincial classification management lists updated slowly in China ，and the quantity and classification of drugs selected in the list were quite different. It is suggested that provincial health administrative departments should continuously optimizeand improve classification management list of antibiotics ， and form a long-term mechanism of dynamic adjustment of list and inter-provincial evidence sharing ，so as to promote the rational clinical use of antibiotics ，and curb bacterial resistance.

Study on the Health Economic Burden of Hypertension Patients and Its Influential Factors in 7 County-level Public Hospitals from 6 Provinces of China / 中国药房

OBJECTIVE：To e xplore the health economic burden of hypertension patients at county-level areas and its influential factors in China. METHODS ：A questionnaire survey was conducted on hypertension patients in 7 county-level public hospitals from 6 provinces as Hebei ，Shandong，Shanxi provinces by using a convenient sampling method. Catastrophic health expenditure was defined by the standard of “medical and health expenditure exceeding 10％ of household income ”. The incidence ， average gap and relative gap of catastrophic health expenditure were analyzed. A multi-factor Logistic regression model analysis was used to analyze the influential factors that lead to catastrophi c health expenditure. RESULTS ：A total of 1 378 questionnaires were sent out ，and 925 valid questionnaires were collected with effective rate of 67.13％ . The incidence of catastrophic health expenditure，average gap and relative gap among hypertension patients were 23.03％，19.37％ and 84.12％，respectively. At different income levels ，the incidence of catastrophic health expenditure，average gap and relative gap were 72.67％ ， 96.79％ and 133.18％ in the poorest household group ，and were 1.94％ ，0.47％ and 24.23％ in the richest household group. Among different types of medical insurance ，the incidence of catastrophic health expenditure in patients covered by “New Rural Cooperative Medical Scheme （NRCMS）”the highest （31.30％）. The household income ，complications and the type of health insurance had significant impacts on the incidence of catastrophic health expenditure in hypertension patients （P＜0.05）. CONCLUSIONS：The incidence of catastrophic health expenditure in hypertension patients with different income levels is different. As the income level raised ，the incidence of catastrophic health expenditures continued to decrease. But the protection of household health expenditure by NRCMS is weak. It is suggested that a certain policy preference should be given to families with low income and patients with chronic diseases ，so as to ensure the rights and interests of patients with hypertension .

Study on the Effects of Full Coverage Policy for Essential Antihypertensive Medicines on the Equity of Medicine Expenditure Affordability in Taizhou City / 中国药房

OBJECTIVE：To provide reference for improving the equity of medicine in China ，and to provide reference for promoting the full coverage policy for essential medicine. METHODS ：Taking hypertension essential medicines full coverage policy in 4 areas of Taizhou in Zhejiang province as an example ，the electronic health records of patients in baseline year and the first ， second and third years after the implementation of the full coverage policy of hypertension were collected. The catastrophic expenditure of family drugs was used to measure the medicine cost burden ，and the effects of policy on the equity and change of local medicine cost burden were analyz ed by means of concentration index and its decomposition method. RESULTS ：With the increase of the proportion of patients taking free medicine ，the incidence of catastrophic expenditure on household medicines in the high，middle and low income group decreased year by year generally （decreasing from 6.3％，12.0％，16.4％ of baseline year to 4.7％，8.9％，12.4％ at the third year after the implementation of the policy ）；the gap among the three groups was in narrowed trendency. The concentration indexes of the baseline year and the first ，second，third year after the implementation of policy were －0.198，－0.186，－0.181，－0.202，the policy contribution rates of which were 0，－1.335％，－4.507％ and 1.936％；and the policy contribution rates in the change of the yearly concentration index were 20.8％，95.0％ and 57.6％. CONCLUSIONS ：The implementation of the full coverage policy for essential medicines is conducive to improving the equity of the medicine expenditure burden. The effect is affected by the implementation of policies and supporting systems ，but the comprehensive promotion of the equity of medicine requires multi-policy synergy.

Economic Evaluation on the Full Coverage Policy for Hypoglycemic Essential Medicines in Taizhou City / 中国药房

OBJECTIVE： To evaluate the economics of the full coverage policy for hypoglycemic essential medicines in Taizhou city， and to provide reference for improving medicine accessibility and essential medicine system in China. METHODS： The electronic health records and financial input data of diabetic patients were extracted from different districts and counties of Taizhou city during 2009-2016. In cohort study design， taking the implementation time of each district and county’s policies as the breakpoint， the data recorded annually were processed as annual data， forming the cohort data for 1 year before （baseline year） and 3 years after the implementation of the policies. According to the choice of free medicines after the implementation of the policy， they were divided into policy group and control group. Propensity score matching was used to balance the differences between two groups to get the final sample， and then the economics of the policy was evaluated with the methods of difference-in-differences. The cost and benefit of implementation policy were calculated. RESULTS： Totally 14 744 people of each group were got by propensity score matching. The mean annual financial expenses on free medicine per capita were 263.8 yuan. Compared with baseline year， mean annual medicine expenses per capita reduced by the policy were 649.2 yuan， and mean annual hospitalization expenses per capita were 624.7 yuan. Thus the input-output ratio of the policy was 1 ∶ 4.8. CONCLUSIONS： The implementation of the policy is beneficial to reduce the cost burden of patients and economical. It can be popularized and sustained through scientific design combined with relevant policies.

Analysis of the Impacts of the Full Coverage Policy for Essential Medicines on the Fairness of Medicine Expenditure Affor- dability of Diabetic Patients in Taizhou City / 中国药房

OBJECTIVE： To provide the empirical basis for improving full coverage policy of essential medicines in China and promoting the fairness and accessibility of medicine. METHODS： Taking Taizhou diabetes essential medicines full coverage policy as an example， the electronic health records of diabetic patients in Taizhou city from 2011 to 2017 were collected， and the cost burden of patients was evaluated by whether catastrophic expenditure of family drugs had occurred. The concentration index was used to analyze the fairness of catastrophic expenditure on household medicines， and the effects of various influencing factors on the fairness of local medicine expenditure affordability were evaluated by year-by-year comparing the relevant indexes from baseline year to the third year of policy implementation. RESULTS & CONCLUSIONS： The concentration index of catastrophic expenditure on household medicines is negative from baseline year to the third year of policy implementation， which indicates that catastrophic expenditure on household medicines for diabetic patients in Taizhou mainly occurs in low-income groups. From the result of decomposition of concentration index， among the factors that affect the fairness of catastrophic expenditure on drugs in diabetic families， the contribution rate of  “taking free essential medicines” keeps at top five places year by year， and the contribution value is positive， which shows that the implementation of policies is conductive to reducing the unfairness of catastrophic expenditure on household medicines in low-income families. Full coverage policy of essential medicines effectively improves the fairness of medicine expenditure affordability. In addition， scientific and reasonable essential medicines selection mechanism， the guarantee level of the policy， collaboration with multiple factors should be promoted so as to improve the fairness and accessibility of essential medicines.

Economic Evaluation of Full Coverage Policy for Essential Hypertension Medicines in Taizhou City / 中国药房

OBJECTIVE： To investigate the effects of full coverage policy for essential hypertension medicines on economic burden of hypertensive patients in Taizhou of Zhejiang Province， and to further provide reference for the practice and promotion of the policy for essential medicines. METHODS： By querying electronic health records database of hypertension patients and statistics of health bureaus in different districts and counties of Taizhou city， the data of electronic health records of hypertension patients were extracted 1 year before and during 3 years after the implementation of full coverage policy for essential medicines in all districts and counties. The patients who had consistently taken free medicines were included in the policy group； the patients who had never taken free medicines were included in the control group. The policy group and control group were matched 1 ∶ 1 by propensity score matching method. Per capita drug cost and per capita hospitalization cost of patients before and after the implementation of full coverage policy for essential medicines were calculated. The input-output ratios of the policy were calculated. RESULTS： During the 3 years after the implementation of the policy， each patient saved 91.3， 272.0 and 464.1 yuan respectively. The hospitalization cost for each patient increased by 65.6 and 46.2 yuan in the first and second year， and decreased by 352.8 yuan in the third year， respectively. A three-year per capita input of policy was 50.0， 147.2 and 278.5 yuan， with input-output ratio of 0.51， 1.28 and 2.25. CONCLUSIONS： The full coverage policy for essential hypertension medicines in Taizhou city demonstrates economic efficiency to some extent， but researches about the impact of policy on disease treatment needed to be conducted. It is necessary for the government departments to invest continuously for a long time and improve the supporting measures so as to make the policy more profitable.

Analysis of the Utilization of Opioids in China during 2014-2016 / 中国药房

OBJECTIVE： To analyze the current status and trend of opioids consumption in China， and to provide reference for rational use of opioids. METHODS： Purchasing data on five opioids as fentanyl， morphine， pethidine， oxycodone and hydromorphone， were extracted from the database of the Medicine Economic Information Network from 2014 to 2016. Drug consumption was measured by the daily dose per million population （unit： S-DDD）， and the consumption amount of all opioids and different dosage forms （including oral dosage form， injection and other form） in China and different districts were analyzed and compared. RESULTS： The consumption amount of five opioids increased from 69.62 S-DDD in 2014 to 78.64 S-DDD in 2016. The consumption amount of hydromorphone and oxycodone showed an upward trend， while the consumption amount of morphine was basically unchanged， and the consumption amount of fentanyl and pethidine showed a downward trend. The consumption amount of oral dosage form increased from 39.77 S-DDD in 2014 to 45.61 S-DDD in 2016， the consumption amount of the injection increased from 20.74 S-DDD in 2014 to 24.23 S-DDD in 2016， and the consumption amount of other form decreased from 9.11 S-DDD in 2014 to 8.81 S-DDD in 2016. The consumption amount of oral dosage form was around twice that of injection， with the gap expanding yearly. Regionally， the consumption amount of five opioids in the eastern region was the highest， followed by the western region， and the lowest but the highest growth rate in the central region from 2014 to 2016 （in 2016， consumption amount of eastern， western and central regions were 94.04， 67.90， 63.78 S-DDD， with increase rate of 8.50％， 11.77％， 16.17％， compared with 2014）. Morphine was the most widely used drug in all regions， followed by fentanyl； in the eastern and central regions， the use of oral and injection dosage form increased year by year； in western region， the use of oral dosage forms increased while that of injection decreased year by year. CONCLUSIONS： The opioids consumption in China is increasing overall， with regional differences. Nonetheless， the overall consumption is still low. On the premise of strict supervision， it is necessary to take measures to promote the rational use of opioids in different areas.

Situation and Analysis of Measurement Method for Antimicrobial Resistance Burden Research / 中国药房

OBJECTIVE:To investigate and analyze the situation of measurement method for antimicrobial resistance(AMR) burden research,in order to provide methodology literature support for conducting AMR burden research in China. METHODS:Retrieved from PubMed,ProQuest Health & Medical Complete,Springer datebase,related researches were summarized,and foreign calculation method of resistance burden of commonly used antimicrobial and matters of attention were analyzed. RESULTS& CONCLUSIONS:AMR burden is usually evaluated using indicators like the number of resistant incidents,deaths due to AMR, excess length of stay and economic burden of AMR. The issues needed to be considered during calculating the burden included the perspective,definition of the outcome indicator,controlling the length of stay before infection,selection of control group, adjustment for severity of illness,time point calculation,calculation of onset time of infection,definition of the cost and scale of the economic burden. Future studies needs to be focused on a social perspective to estimate the burden of AMR,so as to provide baseline data evidence for decision makers to further control the resistance.

"Investigation and Study on Patients'Satisfaction about""Sanming Medical Reform""" / 中国药房

OBJECTIVE:To provide the scientific evidence and reference for improving medical reform. METHODS:Based on background ofSanming Medical Reform,self-designed questionnaires were used to investigate the cognition and satisfaction of local patients. The results of investigation were analyzed statistically. RESULTS:A total of 275 paper questionnaires were sent out and all were collected;345 electronic questionnaires were sent out by Wechat and all collected. Among 620 questionnaires,372 valid questionnaires were collected with effective rate of 60.00%. More patients(31.45%)thought the cost of treatment decreased, and less (22.31%) thought the cost increased. The proportion of high-income people who thought cost reduced was significantly higher than the proportion of low-income people (P=0.018). 27.42% of patients believed shortage of drugs,and tertiary hospi-tals were more prone to drug shortage than other medical institutions(P=0.062). The patients'satisfaction with medical staff and healthcare reform were both high(86.56% and 79.03%),but the satisfaction of rural patients was lower than that of urban patients (P=0.051). Understanding of patients onSanming Medical Reformwas in low level. Only 20.70% of the patients fully under-stood or generally understood ofSanming Medical Reform. The patients who thought the skills of medical staff were improved (40.32%)were more than those who thought the skills of medical staff were reduced(5.91%). CONCLUSIONS:Most patients are satisfied withSanming Medical Reform,and agree the achievements;but some problems are not solved,such as the shortage of some drugs,lack of grass-roots medical personnel,not understand medical policy.

Study on Narcotics and Psychotropic Substances Control( Part Ⅴ):Comparative Study on Domestic and Foreign Control System of Narcotics and Psychotropic Substances / 中国药房

OBJECTIVE:To make proposals to improve narcotics and psychotropic substances(NPS)control in China. METH-ODS:NPS control system of international organizations,the United States,Britain and China were compared in terms of concept, classification,regulatory basis and agency,etc. The suggestions and reference were put forward. RESULTS & CONCLUSIONS:NPS of international organizations,the United States,Britain and China are drug types included in relevant categories,besides ana-leptics,precursor chemicals and other drugs are included in control catalogue by the United States and Britain. NPS are divided in-toⅠ-Ⅳcategories by international organizations,Ⅰ-Ⅴcategories by the United States,A,B,C categories and temporary catego-ry by Britain,and narcotics,first and second class psychotropic substances by China. NPS control basis of the United States,Brit-ain and China are Controlled Substances Act,Misuse of Drugs Act and Regulations on Narcotics and Psychotropic Drugs Control, respectively;major regulation organizations are Controlled Substances Enforcement Administration,Advisory Committee on Drug Abuse subordinated to Ministry of Interior,Special Drug Section under China Food and Drug Administration,respectively;there al-so are differences in the functions of control organization and cooperative units. Considering about the problems of NPS control in China,it is suggested to improve laws and regulations system,establish independent system,extend abuse surveillance network and encourage chronic non-cancer pain therapy.

Study on Narcotics and Psychotropic Substances Control( Part Ⅰ):Development and Status Quo of Inter-national Narcotics and Psychotropic Substances Control / 中国药房

OBJECTIVE:To study the development and status quo of international narcotics and psychotropic substances (NPS)control,and to provide evidence for NPS control in China. METHODS:The development and status quo of NPS control by international organization were summarized and studied through retrieving and collecting literatures,reports and policies about NPS from domestic and foreign databases,news reports and international website. RESULTS & CONCLUSIONS:International narcot-ics control dated back to opium trade with China in 19th century. International narcotics control system was established preliminarily by Shanghai conference and Haiya conference. The end of World War Ⅰ,the establishment of the League of Nations and the sign-ing of a number of international treaties promoted the development of internal control system. Through World War Ⅱ,the establish-ment of the United Nations and the change of international control organization,a number of international treaties were integrated into Single Convention on Narcotic Drugs in the early 1960s,which was used as the foundation of narcotics control system all round the world. In 1970s,the adoption of Convention on Psychotropic Substances meant psychotropic substances were included in the scope of internal control. In 1980s,the signing of United Nations Convention against Illicit Traffic in Narcotic Drugs and Psy-chotropic Substances marked the establishment of three conventions system of international NPS control. At present,internal NPS control is based on three conventions system and NPS list by Commission on Narcotic Drugs,International Narcotics Control Board and United Nations International Drug Control Program. The vast majority of countries are parties to that. International control orga-nizations and listed control have a great influence on NPS control all round the world.

Study on Narcotics and Psychotropic Substances Control( Part Ⅱ):Development and Status Quo of Con-trolled Substances Control in the United States / 中国药房

OBJECTIVE:To study the development and status quo of controlled substances control in the United States,and to provide evidence for narcotics and psychotropic substances (NPS) control in China. METHODS:The development and status quo of controlled substances control by the United States were summarized and studies through retrieving and collecting literatures,re-ports and policies about NPS from domestic and foreign databases,news reports and international website. RESULTS & CONCLU-SIONS:The United States'control for controlled substances dated back to Harrison Narcotics Tax Act in 1914,and the United States is the first nation to control narcotics addiction through the form of tax law after International Opium Convention is executed. Thereafter,the United States gradually extend the range by including cannabis,heroin and psychotropic substances into control range of Narcotics Drugs Import and Export Act,Heroin Act,Marijuana Tax Act,revising and developing comprehensive act Con-trolled Substances Act,and establishing comprehensive law enforcement agency Controlled Substances Enforcement Administration affiliated to Ministry of Justice by Nixon'sWar on Drugsplan.

Study on Narcotics and Psychotropic Substances Control( Part Ⅲ):Development and Status Quo of Con-trolled Drugs Control in Britain / 中国药房

OBJECTIVE:To study the development and status quo of controlled drugs control in Britain,and to provide evi-dence for narcotics and psychotropic substances(NPS)control in China. METHODS:The development and status quo of NPS con-trol by Britain were summarized and studied through retrieving and collecting literatures,reports and policies about NPS from do-mestic and foreign databases,news reports and international website. RESULTS & CONCLUSIONS:British control for controlled drugs dated back to Pharmacy Act in 1868,and Britain was the first country to control drugs by legislations. A unique British sys-tem of narcotics control was established and improved after issued Rolleston Report and two pieces of Brain Report in Britain. Final-ly,the British system of narcotics control was established,which combined public health prevention with judicial redress. At pres-ent,controlled drugs are classified and controlled by Advisory Committee on Drug Abuse,Serious Organised Crime Agency and National Drug Abuse Treatment Agency subordinated to Ministry of Interior,based on Misuse of Drugs Act.

Study on Narcotics and Psychotropic Substances Control( Part Ⅳ):Development and Status Quo of Nar-cotics and Psychotropic Substances Control in China / 中国药房

OBJECTIVE:To study the development and status quo of narcotics and psychotropic substances (NPS) in China since 1949,and to provide evidence for perfection of NPS control work in China. METHODS:The development and status quo of controlled substances control by China since 1949 were summarized and analyzed through retrieving and collecting literatures,re-ports and policies about NPS from domestic and foreign databases,news reports and related website. RESULTS & CONCLU-SIONS:Chinese narcotics and psychotropic substances control dated back to the release of Interim Regulations on Narcotics Con-trol in 1950 and Regulations on Narcotics Control,Drug Administration Law and other regulations have been issued. It had experi-enced the progress from no legal basis to having laws to follow and from executive-leading to legalization. Narcotics and psychotro-pic substances were gradually unified in systematic control,and the level of regulations rised from department rules to administra-tion regulation. At present,with Regulations on Narcotics and Psychotropic Drugs Control (2005) as regulatory basis and cata-logue of narcotics and psychotropic substances(2013)as object,China Food and Drug Administration are in charge of the national regulation,cooperating with health department,agricultural department,traffic department and other departments.

Analysis of accessibility of essential medicine in Beijing / 中国卫生政策研究

Objectives:To evaluate essential medicines accessibility from the availability, drug price level and affordability perspective in Beijing. Methods:Data was collected from a sample of a Beijing social security database on diabetes in 2013 and a field research on 4 primary healthcare institutions. The essential medicine equipping rate, medium price ratio ( MPR) and poverty-inducing effect were selected as accessibility indicators. Results:Among 21 sample drugs, the nitrendipine, magnesium sulfate, sodium nitroprusside, prazosin, phentolamine and glyburide e-quipping rates are less than 15%. The 9 sample drugs MPR varied from 1. 3 to 27. 4. The hypertension, hyper-lipemia and diabete poverty-inducing rate varied from 0. 44% to 0. 70% in urban areas, and varied from 1. 17% to 1. 88% in rural areas. Conclusion:Some essential medicines in Beijing are equipped with a very low rate, but have a high price level, and the poverty-inducing population is large. We recommend strengthening the monitoring of es-sential medicines accessibility and introducing appropriate supporting policies.

Establishment of Drug Safety Performance Evaluation Indicator System for Work Quality Evaluation of Drug Administration Department / 中国药房

OBJECTIVE:To establish drug safety performance indicator system in Beijing,and to provide reference for evaluat-ing work quality of administration department and drug market safety reasonably. METHODS:Through literature survey,expert brainstorming and maximum difference scaling,the indicators of drug safety performance evaluation system in Beijing were select-ed,and internet questionnaire survey was conducted among 20 regulators by using SSI Web software. The weight of each indicator was analyzed. RESULTS & CONCLUSIONS:4 factors of drug safety performance have been selected involving 27 indicators,ig. Results of drug sampling test(Oc)which reflect drug market safety directly;results of special drug sampling test(So)which mea-sure the quality of essential medicine;drug sampling operation standard (Na) which measure the completion of drug sampling by procedure or plan;rationality of drug sampling (Ra) which guarantee the rationality of sampling procedure and representativeness of sampled drugs. Finally,20 indicators are identified by experts. The weight of 4 factors are 21%,14%,40% and 25%,respec-tively. Established drug safety performance evaluation system can achieve quantitative check of drug supervision departments,and dispose several problems as rely on subjective factor greatly,lack of objective and uniform standard,only check the results. It pro-vides reference for the formulation of drug safety performance evaluation indicators in other provinces,cities and municipalities.

Analysis of provincial centralized bidding and procurement of drugs in China / 中国卫生政策研究

Objective:To improve the centralized bidding and procurement of drugs in China .Methods:By u-sing literature review , comparative analysis and field investigation , this study collected and analyzed implementation plans and regulations of the centralized bidding and procurement of drugs in 2015 .Results and Conclusions:Progress of centralized bidding procurement practice was mixed and there were differences in the scope of implementation , quality level classification , evaluation system of double envelope bidding , and other aspects among provinces .The government should give full play to the role of medical insurance department in drug procurement and group purcha -sing , develop a relatively comprehensive drug quality evaluation system , and speed up the evaluation of the consisten-cy of generic drugs .