RESUMO
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.
RESUMO
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.