Availability of essential medicines, progress and regional distribution in China: a systematic review and meta-analysis

Frontiers in Public Health

Public Health

Imti Choonara¹  Bingchen Lang²  Kun Zou²  Linan Zeng²  Xiao Cheng²  Hailong Li²  Lingli Zhang³  Zheng Liu⁴  Miao Zhang⁵  Zhe Chen⁵  Dan Liu⁵  Yuqing Shi⁵  Xiuli Wang⁶  Yongmu Jiang⁷  Shaoyang Zhao⁷  Yong Tang⁷ 

[1] Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Derby, United Kingdom;Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China;Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China;National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products and Correlation, Chengdu, China;Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China;Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China;Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China;National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products and Correlation, Chengdu, China;Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China;Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China;Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China;Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China;National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products and Correlation, Chengdu, China;Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China;West China School of Medicine, Sichuan University, Chengdu, China;Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China;Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China;National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products and Correlation, Chengdu, China;Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China;West China School of Pharmacy, Sichuan University, Chengdu, China;Healthcare Evaluation and Organizational Analysis (HEOA) Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China;School of Economics, Sichuan University, Chengdu, China;

关键词: essential medicines;    availability;    China;    regional distribution;    systematic review;   

DOI  :  10.3389/fpubh.2023.1149838

 received in 2023-01-23, accepted in 2023-04-06,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundEssential medicines are the backbone of healthcare and meet the priority healthcare needs of the population. However, approximately one-third of the global population does not have access to essential medicines. Although China formulated essential medicine policies in 2009, the progress of availability of essential medicines and regional variations remains unknown. Therefore, this study was conducted to evaluate the availability of essential medicines, their progress, and regional distribution in China in the last decade.MethodsWe searched eight databases from their inception to February 2022, relevant websites, and reference lists of included studies. Two reviewers selected studies, extracted data, and evaluated the risk of bias independently. Meta-analyses were performed to quantify the availability of essential medicines, their progress, and regional distribution.ResultsOverall 36 cross-sectional studies conducted from 2009 to 2019 were included, with regional data for 14 provinces. The availability of essential medicines in 2015–2019 [28.1%, 95% confidence interval (CI): 26.4–29.9%] was similar to that in 2009–2014 (29.4%, 95% CI: 27.5–31.3%); lower in the Western region (19.8%, 95% CI: 18.1–21.5%) than Eastern (33.8%, 95% CI: 31.6–36.1%) and Central region (34.5%, 95% CI: 30.6–38.5%); very low for 8 Anatomical Therapeutic Chemical (ATC) categories (57.1%), and low for 5 categories (35.7%) among all ATC groups.ConclusionThe availability of essential medicines in China is low compared with the World Health Organization goal, has not changed much in the last decade, is unequal across regions, and lacks data for half of provinces. For policy-making, the monitoring system of the availability of essential medicines is to be strengthened to enable long-term surveillance, especially in provinces where the data has been missing. Meanwhile, Joint efforts from all stakeholders are warranted to improve the availability of essential medicines in China toward the universal health coverage target.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=315267, identifier: PROSPERO CRD42022315267.

【 授权许可】

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Copyright © 2023 Zhang, Zou, Liu, Liu, Wang, Shi, Chen, Cheng, Lang, Li, Zeng, Tang, Zhao, Jiang, Choonara and Zhang.