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dc.contributor.authorChen, Wen
dc.contributor.authorTang, Shenglan
dc.contributor.authorSun, Jing
dc.contributor.authorRoss-Degnan, Dennis
dc.contributor.authorWagner, Anita Katharina
dc.date.accessioned2010-12-08T17:24:01Z
dc.date.issued2010
dc.identifier.citationChen, Wen, Shenglan Tang, Jing Sun, Dennis Ross-Degnan, and Anita K. Wagner. 2010. Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces. BMC Health Services Research 10:211.en_US
dc.identifier.issn1472-6963en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:4621010
dc.description.abstractBackground: The current health care reform in China launched in 2009 tackles the problem of access to appropriate medicines for its 1.3 billion people by focusing on providing essential medicines to all. To provide evidence for the reform process, we investigated the manufacturing, purchasing, and prescribing of essential medicines in two provinces. Methods: We conducted surveys in 2007 of all manufacturers (n = 253) and of 59 purposively selected retail and 63 hospital pharmacies in Shandong and Gansu provinces to assess production and supply of products on the 2004 National Essential Medicines List (NEML), as well as factors underlying decision making about production and supply. We also reviewed prescriptions (n = 5456) in health facilities to calculate standard indicators of appropriate medicines use. Results: Overall, manufacturers in Shandong and Gansu produced only 62% and 50%, respectively, of the essential medicines they were licensed to produce. Of a randomly selected 10% of NEML products, retail pharmacies stocked up to 60% of Western products. Median availability in hospital pharmacies ranged from 19% to 69%. Manufacturer and retail pharmacy managers based decisions on medicines production and stocking on economic considerations, while hospital pharmacy managers cited clinical need. Between 64% and 86% of prescriptions contained an essential medicine. However, overprescribing of antibiotics (34%-77% of prescriptions) and injectables (22%-61%) for adult non-infectious outpatient consultations was common. Conclusions: We found that manufacturers, retail pharmacies, and hospital pharmacies paid limited attention to China's 2004 NEML in their decisions to manufacture, purchase, and stock essential medicines. We also found that prescribing of essential medicines was frequently inappropriate. These results should inform strategies to improve affordable access to essential medicines under the current health care reform.en_US
dc.language.isoen_USen_US
dc.publisherBioMed Centralen_US
dc.relation.isversionofdoi:10.1186/1472-6963-10-211en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915989/pdf/en_US
dash.licenseLAA
dc.titleAvailability and Use of Essential Medicines in China: Manufacturing, Supply, and Prescribing in Shandong and Gansu Provincesen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalBMC Health Services Researchen_US
dash.depositing.authorRoss-Degnan, Dennis
dc.date.available2010-12-08T17:24:01Z
dash.affiliation.otherHMS^Population Medicineen_US
dc.identifier.doi10.1186/1472-6963-10-211*
dash.contributor.affiliatedChen, Wen
dash.contributor.affiliatedWagner, Anita
dash.contributor.affiliatedRoss-Degnan, Dennis


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