IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0201582.html
   My bibliography  Save this article

Making medicines more accessible in China: An empirical study investigating the early progress of essential medicine system

Author

Listed:
  • Yan Song
  • Ying Bian
  • Tianmin Zhen

Abstract

Objective: To assess changes in medicine availability and prices as well as subsequent affordability during the early years of the National Essential Medicine System (NEMS) reform in China. Methods: Data were obtained from four provinces through a field survey conducted in 2010–2011. Outcome measures were percentage availability, delivery efficiency, ratios of local prices to international reference prices (MPRs), and number of days’ household income needed to purchase medicines. Prices were adjusted for inflation/deflation and purchasing power parity. Results: Under NEMS, the median MPR for essential medicines decreased from 3.27 times to 1.59 times from 2009 to 2010. The median medicine expenditure under standard treatments in 2010 equaled 1.06 days household income at a low-income level and 0.25 days household income at a middle-income level. A 25.67% reduction was observed in the average number of medicines stocked by primary healthcare facilities in 2011 compared with 2009 and the availability of essential medicines was 66.83%. During 2009–2011, suppliers could respond to 98.24% of the purchasing orders raised by primary healthcare facilities, and 89.32% of the order amounts could be delivered. Conclusions: The market prices of essential medicines greatly decreased in China after the establishment of NEMS and showed improved affordability in the short term. However, current medicine prices remain high compared to international reference prices. Medicines were often unaffordable for economically backward residents. Future policies still need to target medicine availability as well as affordability.

Suggested Citation

  • Yan Song & Ying Bian & Tianmin Zhen, 2018. "Making medicines more accessible in China: An empirical study investigating the early progress of essential medicine system," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-13, August.
    • Handle: RePEc:plo:pone00:0201582
    DOI: 10.1371/journal.pone.0201582
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201582
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0201582&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0201582?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Zaheer-Ud-Din Babar & Charon Lessing & Cécile Mace & Karen Bissell, 2013. "The Availability, Pricing and Affordability of Three Essential Asthma Medicines in 52 Low- and Middle-Income Countries," PharmacoEconomics, Springer, vol. 31(11), pages 1063-1082, November.
    2. Karen Eggleston & Li Ling & Meng Qingyue & Magnus Lindelow & Adam Wagstaff, 2008. "Health service delivery in China: a literature review," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 149-165, February.
    3. Hu, Jia & Mossialos, Elias, 2016. "Pharmaceutical pricing and reimbursement in China: When the whole is less than the sum of its parts," Health Policy, Elsevier, vol. 120(5), pages 519-534.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Shi, Wunan & Wouters, Olivier J. & Liu, Gordon & Mossialos, Elias & Yang, Xiuyun, 2020. "Association between provincial income levels and drug prices in China over the period 2010–2017," Social Science & Medicine, Elsevier, vol. 263(C).
    2. Zuojun Dong & Qiucheng Tao & Bobo Yan & Guojun Sun, 2020. "Availability, prices and affordability of essential medicines in Zhejiang Province, China," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-11, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Currie, Janet & Lin, Wanchuan & Zhang, Wei, 2011. "Patient knowledge and antibiotic abuse: Evidence from an audit study in China," Journal of Health Economics, Elsevier, vol. 30(5), pages 933-949.
    2. Yamei Bai & Aaron Yao & Yulei Song & Guihua Xu, 2018. "Redesigning the patient classification system in China: A pilot study," Nursing & Health Sciences, John Wiley & Sons, vol. 20(2), pages 181-186, June.
    3. Pan, Jay & Qin, Xuezheng & Li, Qian & Messina, Joseph P. & Delamater, Paul L., 2015. "Does hospital competition improve health care delivery in China?," China Economic Review, Elsevier, vol. 33(C), pages 179-199.
    4. Cheung, Diana & Padieu, Ysaline, 2015. "Heterogeneity of the Effects of Health Insurance on Household Savings: Evidence from Rural China," World Development, Elsevier, vol. 66(C), pages 84-103.
    5. Shu Yan & Lizi Pan & Yan Lu & Juan Chen & Ting Zhang & Dongzi Xu & Zhaolian Ouyang, 2023. "Towards Sustainable Drug Supply in China: A Bibliometric Analysis of Drug Reform Policies," Sustainability, MDPI, vol. 15(13), pages 1-20, June.
    6. Shi, Wunan & Wouters, Olivier J. & Liu, Gordon & Mossialos, Elias & Yang, Xiuyun, 2020. "Association between provincial income levels and drug prices in China over the period 2010–2017," Social Science & Medicine, Elsevier, vol. 263(C).
    7. Rize Jing & Tingting Xu & Xiaozhen Lai & Elham Mahmoudi & Hai Fang, 2019. "Technical Efficiency of Public and Private Hospitals in Beijing, China: A Comparative Study," IJERPH, MDPI, vol. 17(1), pages 1-18, December.
    8. Qian Long & Weixi Jiang & Di Dong & Jiaying Chen & Li Xiang & Qiang Li & Fei Huang & Henry Lucas & Shenglan Tang, 2020. "A New Financing Model for Tuberculosis (TB) Care in China: Challenges of Policy Development and Lessons Learned from the Implementation," IJERPH, MDPI, vol. 17(4), pages 1-11, February.
    9. Li Zhang & Qian Zhang & Xinru Li & Weiya Shao & Jingyu Ma & Ruijie Zhang & Angdi Zhou & Jinghua Li, 2022. "The effect of patient perceived involvement on patient loyalty in primary care: The mediating role of patient satisfaction and the moderating role of the family doctor contract service," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(2), pages 734-754, March.
    10. Xuanyi Nie, 2023. "The ‘medical city’ and China’s entrepreneurial state: Spatial production under rising consumerism in healthcare," Urban Studies, Urban Studies Journal Limited, vol. 60(6), pages 1102-1122, May.
    11. Zhou, Wenhui & Wan, Qiang & Zhang, Ren-Qian, 2017. "Choosing among hospitals in the subsidized health insurance system of China: A sequential game approach," European Journal of Operational Research, Elsevier, vol. 257(2), pages 568-585.
    12. Tan, Jing & Liu, Tianyi & Xu, Hao, 2024. "The environmental and economic consequences of environmental centralization: Evidence from China's environmental vertical management reform," China Economic Review, Elsevier, vol. 84(C).
    13. repec:hal:wpspec:info:hdl:2441/6741 is not listed on IDEAS
    14. Tabea Bork-HÜffer & Frauke Kraas, 2015. "Health Care Disparities in Megaurban China: The Ambivalent Role of Unregistered Practitioners," Tijdschrift voor Economische en Sociale Geografie, Royal Dutch Geographical Society KNAG, vol. 106(3), pages 339-352, July.
    15. Yunyun Jiang & Haitao Zheng & Tianhao Zhao, 2019. "Socioeconomic Status and Morbidity Rate Inequality in China: Based on NHSS and CHARLS Data," IJERPH, MDPI, vol. 16(2), pages 1-19, January.
    16. Costa-Font, Joan & Cowell, Frank & Shi, Xuezhu, 2024. "Health inequality and health insurance coverage: The United States and China compared," Economics & Human Biology, Elsevier, vol. 52(C).
    17. Jianpei Wen & Hanyu Jiang & Jie Song, 2019. "A Stochastic Queueing Model for Capacity Allocation in the Hierarchical Healthcare Delivery System," Asia-Pacific Journal of Operational Research (APJOR), World Scientific Publishing Co. Pte. Ltd., vol. 36(01), pages 1-24, February.
    18. repec:hal:spmain:info:hdl:2441/6741 is not listed on IDEAS
    19. Long, Qian & Klemetti, Reija & Wang, Yang & Tao, Fangbiao & Yan, Hong & Hemminki, Elina, 2012. "High caesarean section rate in rural China: Is it related to health insurance (New Co-operative Medical Scheme)?," Social Science & Medicine, Elsevier, vol. 75(4), pages 733-737.
    20. Xinxin Peng & Xiaolei Tang & Yijun Chen & Jinghua Zhang, 2021. "Ranking the Healthcare Resource Factors for Public Satisfaction with Health System in China—Based on the Grey Relational Analysis Models," IJERPH, MDPI, vol. 18(3), pages 1-13, January.
    21. Currie, Janet & Lin, Wanchuan & Meng, Juanjuan, 2013. "Social networks and externalities from gift exchange: Evidence from a field experiment," Journal of Public Economics, Elsevier, vol. 107(C), pages 19-30.
    22. Chinyere Mbachu & Chinyere Okeke & Chinonso Obayi & Agnes Gatome-Munyua & Nkechi Olalere & Ikechi Ogbonna & Benjamin Uzochukwu & Obinna Onwujekwe, 2021. "Supporting strategic health purchasing: a case study of annual health budgets from general tax revenue and social health insurance in Abia state, Nigeria," Health Economics Review, Springer, vol. 11(1), pages 1-13, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0201582. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.