ABSTRACT
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.
ABSTRACT
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.