RESUMO
OBJECTIVE：To evaluate the price and affordability of rare disease drugs in China and provide the suggestions for the improvement of rare disease drug affordability in order to provide reference for the relevant decision-making of government departments. METHODS ：According to the List of the First Batch of Rare Diseasesand Diagnosis and Treatment Guideline for Rare Diseases（2019 edition），rare disease drugs were selected. The median price ratio （MPR）was used to evaluate the drug price level ， and the ratio of the annual drug costs to the annual disposable income of urban or rural residents was used to evaluate the affordability，and the impact of price management policieson drug prices and affordability. RESULTS and CONCLUSIONS ：A total of 71 kinds of rare disease drugs were included ，and the median MPR of them was 0.83；among them ，the median MPR of the original drugs was 1.13，and the median MPR of the generic drugs was 0.37. The annual cost of 71 rare disease drugs was 0.001-178.43 times the average annual income of urban residents ，and 0.003-456.57 times the average annual income of rural residents. There were 21 and 28 drugs whose annual cost exceeded the annual income of urban and rural residents.After the implementation of national medical insurance negotiation or volume based procurement of 14 drugs，the median MPR of these drugs decreased from 1.71 to 0.46. For urban residents ，the number of unaffordable drugs had been reduced from 8 to 0；for rural residents，it had been reduced from 10 to 5. In summary ，the price level of orphan drugs in China was slightly lower than international reference price ，but the price level of original drugs was higher than the international reference price ，and the cost of some drugs far exceeded the residents ’ability to pay. It is suggested that the government should strengthen the price management of original drugs ，promote the substitution of high-quality generic drugs for original drugs ，and improve the payment system for high-value rare disease drugs.
RESUMO
Background: Aim of the study was to study percentage price variations among different brands of the commonly prescribed H2 receptor blockers.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2018 edition, Drug Today April to June 2018 Vol-1. The price ratio and the percentage price variation for individual drug brands was calculated. The price of 10 tablets/capsules were calculated. At last the price ratio and percentage price variation of various brands were compared.Results: Percentage variation in price for H2 receptor blockers marketed in India was found to be tablet cimetidine 200mg:81.89, tablet cimetidine 400mg:91.27, tablet ranitidine 150mg:295.64, tablet ranitidine 300mg:123.19, tablet famotidine 20mg:939.62, tablet famotidine 40mg:1110.09, tablet roxatidine 75mg:38.65, tablet roxatidine 150mg:21.85.Conclusions: H2 receptor blocker is the most common drug prescribed for prolonged period in case of gastritis, Gastro-Esophageal Reflux Disease (GERD), peptic ulcer. If a costly brand is prescribed, the patients have to pay more money unnecessarily for their treatment. The doctors prescribing these drugs should be aware of these variations in price to reduce the price of drug therapy.
RESUMO
OBJECTIVE： To provide evidence support for the economic benefits of generic drugs as substitutes for original drugs， and to provide suggestions for promoting the use of generic drugs. METHODS： Twelve kinds of drugs with both original and generic versions for treating hypertension and diabetes were selected from a tertiary public hospital in Jiangsu province. The proportion of usage quantity， the ratio of amount， price ratio were analyzed quarterly during 2017-2018. RESULTS： From the first quarter of 2017 to the fourth quarter of 2018， the ratio of quantity of original drugs increased from 24.53％ to 39.12％， while that of generic drugs decreased from 75.47％ to 60.88％； the ratio of amount of original drugs increased from 39.45％ to 61.47％， while that of generic drugs decreased from 60.55％ to 38.53％； the price ratio of generic drug to original drug decreased from 0.50 to 0.40. With the same efficacy， the cost of generic drugs replacing original drugs in 2018 could save 622，100 yuan， and the cost savings rate could be 47.65％. CONCLUSIONS： Drug expenditure could be reduced by substituting original drug with generics， but the useage quantity and amount ratio of generic drug in this hospital is gradually declining. So， in order to save drug experditure， it is necessary to speed up the process of conformity evaluation and clinical equivalence study of generic drugs， increase the education and publicity of generic prescriptions and rational use， so as to improve doctors’ and patients’ recognition of the quality and efficacy of generic drugs， cooperate with the centralized procurement policy to encourage the purchase and use of generic drugs.
RESUMO
OBJECTIVE:To provide reference for formulating drug price regulation policy and promoting reasonable drug price. METHODS:According to WHO and HAI drug price standard investigation,questionnaire survey(supplemented by field investigation)about sale price of 63 commonly used drugs with large consumption sum was conducted among 3 districts of different economic development levels in Hubei province. Median price ratio(MPR)was calculated statistically. Primary interview survey(supplemented by literature investigation)about drug distribution cost was conducted among managerial staff of pharmaceutical wholesale and retail enterprises,hospital pharmacy administrators. Suggestions were put forward to control distribution cost and standardizing drug price based on analysis and discussion. RESULTS:Totally 120 questionnaires were sent out,and 118 were effectively received,with effective recovery of 98.33%. Thirty managerial staff from drug wholesale and retail enterprises,hospital pharmacy department were interviewed for investigation of drug distribution cost. MPR of 63 drugs ranged 0.05-44.55 in different types of sample institutions. Among 67 specifications of 53 kinds of drugs,median retail price of 38 specifications(56.72%)was higher than international reference price in first-level sample medical institutions. Among 79 specifications of 63 kinds of drugs,median retail price of 57 specifications(72.15%)was higher than international reference price in second-level sample medical institutions. Among 80 specifications of 63 kinds of drugs,median retail price of 63 specifications(78.75%)was higher than international reference price in third-level sample medical institutions. Among 50 specifications of 37 kinds of drugs,median retail price of 42 specifications(84.00%)was higher than international reference price in sample pharmaceutical retail enterprises. In all sample institutions,maximum MPR of 13 specification were lower than 1;those of 12 specification ranged from 1 to <2;those of 23 specifications ranged from 2 to <5;15 specification ranged from 5 to <10;those of 17 specification were higher than 10. MPR of third-level medical institution samples were higher than those of second-level and first-level ones,and pharmaceutical retail enterprises(P<0.01). MPR of second-level medical institution samples and pharmaceutical retail enterprises were higher than those of first-level medical institutions(P<0.01). There was no statistical significance in the levels of MPR between second-level medical institutions and pharmaceutical retail enterprises(P>0.05). MPR of sample institutions in well-developed regions were higher than in medium-developed or less-developed regions(P<0.01). MPR of sample institutions in medium-developed regions were higher than in less-developed regions(P<0.01). MPR of original drugs were all higher than those of generic drugs in different types of sample institutions(P<0.01). There was no statistical significance in MPR of original drugs among different types of sample institutions(P>0.05). At the same time,MPR of generic drugs in third-level medical institution samples were higher than in second-level and first-level ones and pharmaceutical retail enterprises (P<0.05 or P<0.01). MPR of second-level medical institution samples and pharmaceutical retail enterprises were higher than in first-level ones(P<0.05). There was no statistical significance between second-level medical institution samples and pharmaceutical retail enterprises(P>0.05). Drug production and circulation cost,centralized bidding and purchasing price in Hubei province were higher than the national level. CONCLUSIONS:The drug price of Hubei province is in high level,especially that of three-level medical institutions is higher than other institutions;drug price of well-developed region is higher than those of medium-level and less-developed region;the price of original drugs are higher than those of generic drugs. The cost of pharmaceutical industry,drug circulation cost and the addition of drug price during application link eventually lead to the higher retailing price of drugs. Comprehensive policy measures need to be taken to control the cost of the whole process of drug distribution and to regulate the price of drugs.