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Measuring Access to Medicines: A Survey of Prices, Availability and Affordability in Shaanxi Province of China

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  • Minghuan Jiang
  • Shimin Yang
  • Kangkang Yan
  • Jun Liu
  • Jun Zhao
  • Yu Fang

Abstract

Objective: To measure the prices and availability of selected medicines in Shaanxi Province after the implementation of new healthcare reform in 2009. Methods: Data on the prices and availability of 47 medicines were collected from 50 public and 36 private sector medicine outlets in six regions of Shaanxi Province, Western China using a standardized methodology developed by the World Health Organization and Health Action International from September to October 2010. Medicine prices were compared with international reference prices to obtain a median price ratio. Affordability was measured as the number of days’ wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. Findings: The mean availabilities of originator brands and lowest-priced generics were 8.9% and 26.5% in the public sector, and 18.1% and 43.6% in the private sector, respectively. The public sector procured generics and originator brands at median price ratios of 0.75 and 8.49, respectively, while patients paid 0.97 and 10.16. Final patient prices for lowest-priced generics and originator brands in the private sector were about 1.53 and 8.36 times their international retail prices, respectively. Public sector vendors applied high markups of 30.4% to generics, and 19.6% to originator brands. In the private sector, originator brands cost 390.7% more, on average, than their generic equivalents. Generic medicines were priced 17.3% higher in the private sector than the public sector. The lowest-paid government worker would need 0.1 day’s wages to purchase captopril for lowest-priced generics from private sector, while 6.6 days’ wages for losartan. For originator brands, the costs rise to 1.2 days’ wages for salbutamol inhaler and 15.6 days’ wages for omeprazole. Conclusions: The prices, availability and affordability of medicines in China should be improved to ensure equitable access to basic medical treatments, especially for the poor. This requires multi-faceted interventions, as well as the review and refocusing of policies, regulations and educational interventions.

Suggested Citation

  • Minghuan Jiang & Shimin Yang & Kangkang Yan & Jun Liu & Jun Zhao & Yu Fang, 2013. "Measuring Access to Medicines: A Survey of Prices, Availability and Affordability in Shaanxi Province of China," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-8, August.
  • Handle: RePEc:plo:pone00:0070836
    DOI: 10.1371/journal.pone.0070836
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    References listed on IDEAS

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    1. Zaheer Ud Din Babar & Mohamed Izham Mohamed Ibrahim & Harpal Singh & Nadeem Irfan Bukahri & Andrew Creese, 2007. "Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia," PLOS Medicine, Public Library of Science, vol. 4(3), pages 1-10, March.
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    Cited by:

    1. Hao Zhang & Huimei Hu & Christina Wu & Hai Yu & Hengjin Dong, 2015. "Impact of China's Public Hospital Reform on Healthcare Expenditures and Utilization: A Case Study in ZJ Province," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-19, November.
    2. Krizzia Lambojon & Jie Chang & Amna Saeed & Khezar Hayat & Pengchao Li & Minghuan Jiang & Naveel Atif & Gebrehaweria Kassa Desalegn & Faiz Ullah Khan & Yu Fang, 2020. "Prices, Availability and Affordability of Medicines with Value-Added Tax Exemption: A Cross-Sectional Survey in the Philippines," IJERPH, MDPI, vol. 17(14), pages 1-15, July.
    3. Caijun Yang & Shuchen Hu & Yanbing Zhu & Wenwen Zhu & Zongjie Li & Yu Fang, 2019. "Evaluating access to oral anti-diabetic medicines: A cross-sectional survey of prices, availability and affordability in Shaanxi Province, Western China," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-13, October.
    4. Ahmadou M Jingi & Jean Jacques N Noubiap & Arnold Ewane Onana & Jobert Richie N Nansseu & Binhuan Wang & Samuel Kingue & André Pascal Kengne, 2014. "Access to Diagnostic Tests and Essential Medicines for Cardiovascular Diseases and Diabetes Care: Cost, Availability and Affordability in the West Region of Cameroon," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-8, November.
    5. Xiao Wang & Yu Fang & Shimin Yang & Minghuan Jiang & Kangkang Yan & Lina Wu & Bing Lv & Qian Shen, 2014. "Access to Paediatric Essential Medicines: A Survey of Prices, Availability, Affordability and Price Components in Shaanxi Province, China," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-7, March.

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