Objective. To explore the safety of the essential medicines recorded in China’s list through the comparison of the list of essential medicines of China and the World Health Organization (WHO), as well as the analysis of the basic situation and characteristics of adverse drug reactions (ADRs) on the two essential medicines recorded in China’s and WHO lists in order to provide a reference for the improvement of China’s list. Methods. A retrospective descriptive study was conducted, based on the database in Jiangsu Province ADR Monitoring Center from 2013 to 2015. A total of 266869 cases reports were collected within this period, comparing the differences between the two essential medicines recorded in China’s and WHO lists, considering number of ADRs, type of report, and modes of administration. Compare the differences between the two groups of drugs in the presence of new, severe, and new severe adverse events using chi square test. Results. Comparing the two essential medicines list, they have the same 117 species. When comparing ADRs in the two groups, most are antimicrobial, electrolytes, and acid-base balance drugs, regulate water, and are higher in China. In addition, with respect to the number of ADR types in the two groups, there is statistical significance (p<0.001) (total number is 68603 and 47515, new types are 12601 and 7262, the severe are 2714 and 7566, and the new severe are 820 and 716). Conclusion. Compared to the WHO list of essential drugs, China’s list is still to be improved.

Objectives This study aimed to investigate the availability, price, and affordability of nationally negotiated innovative anticancer medicines in China. Design Retrospective observational study based on data from a nationwide medical database. Data sources/setting Quarterly data about the use of innovative anticancer medicines from 2020 to 2022 were collected from the Chinese Medicine Economic Information Network. This study covered 895 public general hospitals in 30 provincial administrative regions in China. Of the total hospitals, 299 (33.41%) were secondary and 596 (66.59%) were tertiary. Main outcome measures The adjusted WHO and Health Action International methodology was used to calculate the availability and affordability of 33 nationally negotiated innovative anticancer medicines in the investigated hospitals. Price is expressed as the defined daily dose cost. Results On average, the total availability of 33 innovative anticancer medicines increased annually from 2020 to 2022. The median availability of all investigated medicines in tertiary hospitals from 2020 to 2022 was 24.04%, 33.60% and 37.61%, respectively, while the indicators in secondary hospitals were 4.90%, 12.54% and 16.48%, respectively. The adjusted prices of the medicines newly put in Medicare (in March 2021) decreased noticeably, with the decline rate ranging from 39.98% to 82.45% in 2021 compared with those in 2020. Most generic brands were priced much lower than the originator brands. The affordability of anticancer medicines has improved year by year from 2020 to 2022. In comparison, rural residents had lower affordability than urban residents. Conclusions The overall accessibility of 33 nationally negotiated innovative anticancer medicines improved from 2020 to 2022. However, the overall availability of most anticancer medicines in China remained at a low level (less than 50%). Further efforts should be made to sufficiently and equally benefit patients with cancer.

The maintenance medicines for chronic obstructive pulmonary disease (COPD) include inhaled corticosteroids (ICS), long-acting muscarinic antagonists (LAMA) and long-acting β2-agonists (LABA). Budesonide/glycopyrronium/formoterol (BUD/GLY/FOR) and fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) are two representative drugs for prefixed ICS/LAMA/LABA association in a single inhaler and have shown comparable efficacy and safety with other ICS/LAMA/LABA open combination therapies in patients with moderate-to-very severe COPD. This study aimed to investigate the availability, price, affordability, and utilisation of single-inhaler triple medicines for COPD in China. Quarterly data about the use of BUD/GLY/FOR and FF/UMEC/VI from 2020 to 2022 were collected from the Chinese Medicine Economic Information Network. We used the adjusted World Health Organization and Health Action International methodology to calculate the availability and affordability of the two investigated medicines in 596 tertiary general hospitals and 299 secondary general hospitals in 31 provincial administrative regions in China. The availability and consumption of BUD/GLY/FOR were significantly higher than those of FF/UMEC/VI during the study period. At the end of 2022, the availability of BUD/GLY/FOR and FF/UMEC/VI in tertiary general hospitals was 69.80% and 52.01% respectively, while in secondary general hospitals, it was 52.51% and 28.76% respectively. Both medications were equally affordable at 1.3 days of the minimum wage after reimbursement in 2022. In the first quarter of 2021, with the inclusion of both drugs in the Medicare catalog, their DDDc decreased significantly, which was accompanied by notable improvements in their availability, affordability and consumption. The overall accessibility and consumption of BUD/GLY/FOR and FF/UMEC/VI were improved in China from 2020 to 2022. The implementation of the national drug price negotiation policy reduces the cost of drugs in China and plays an important role in improving the availability of the investigated drugs.

To optimize the medication administered to children with influenza, we evaluated the effectiveness of peramivir in hospitalized children with influenza A/H3N2 and influenza B/Victoria. A retrospective study was conducted from October 2019 to March 2020 in children aged 29 days to 18 years with influenza A/H3N2 or B/Victoria. A total of 97 patients were enrolled and treated with intravenous infusion of peramivir. The duration of influenza virus nucleic acid positivity in the influenza A/H3N2 group (3 days) was shorter than that in the influenza B/Victoria group (4 days) (P = 0.008). The remission time of fever symptoms in the influenza A/H3N2 group was 14 h, which was significantly shorter than that in the influenza B/Victoria group (26 h) (P = 0.042). In the 6-18 years age group, the median duration of virus nucleic acid positivity for children with influenza B/Victoria (4 days) was longer than that for children with influenza A/H3N2 (2 days) (P = 0.005). The incidence of adverse drug reactions (ADRs) with peramivir in the influenza A/H3N2 group and the influenza B/Victoria group was 2.04% (n = 1/49) and 4.17% (n = 2/48), respectively (P = 0.617). A difference in the effectiveness of peramivir against different subtypes of influenza was observed. Compared to those infected with influenza B/Victoria, the children infected with influenza A/H3N2 experienced a significantly shorter duration of influenza virus nucleic acid positivity and remission time of fever symptoms.

Objective: To analyze and predict the dynamic influence trends and degrees caused by various factors that may affect the expansion of the hospital pharmacist team in China. Methods: Time series data including the number of hospital visits in all hospitals in China, the total number of pharmacists, per capita health expenditure, and per capita GDP from 2002 to 2022 were collected at the national level. A vector autoregressive (VAR) model was constructed, and methods such as the Granger causality test, impulse response analysis, and variance decomposition were employed to explore the influence process and direction of various influencing factors on the number of pharmacists in China. Results: The Augmented Dickey-Fuller (ADF) test indicates the first-order difference series of the time series is stationary (P< 0.05). The model stability test shows the modulus of all specific root reciprocals falls within the unit circle, indicating model stability and credible results. The cointegration test reveals a cointegration relationship among the number of hospital visits, per capita health expenditure, per capita GDP, and the number of pharmacists (P< 0.05). The Granger causality test indicates a unidirectional Granger causality relationship between the number of hospital visits, per capita health expenditure, and the number of pharmacists. The impulse response function indicates that the number of pharmacists shows an upward trend after being impacted by one unit of the number of hospital visits and per capita GDP, while the positive impact of per capita health expenditure on the number of pharmacists turns into a negative impact in the third stage. Variance decomposition shows that the contribution rate of the number of hospital visits to the number of pharmacists is 12%, the contribution rate of per capita health expenditure to the number of pharmacists is 57%, and the contribution rate of per capita GDP to the number of pharmacists is 80%. Conclusion: The number of hospital visits, per capita health expenditures, and per capita GDP all positively contribute to the development of the pharmacist workforce. Per capita health expenditures lead to an increase in the number of pharmacists in the short term. Among the selected indicators, the primary drivers of pharmacist workforce development are per capita health expenditures and per capita GDP. Hospital visits have a relatively minor contribution to the growth in the number of pharmacists.

Background: China is characterized by significant regional disparities in economic development levels. Accordingly, both the regional implementation effectiveness of the national centralized drug procurement (NCDP) policy and relevant influencing factors urgently require investigation, with the aim of providing evidence to optimize the policy’s implementation. Methods: The first to fifth batches of NCDP drugs were investigated on the basis of the adjusted standard survey methodology suggested by the World Health Organization/Health Action International. This study has assessed NCDP drug availability across over 900 secondary and tertiary public general hospitals in regions with varying levels of economic development in terms of both the procurement rate and the availability rate. Results: The availability of these five batches of NCDP drugs in regions with different economic development levels generally followed the pattern that their availability in developed regions is higher than that in moderately developed regions which is also higher than that in less developed regions. A significant difference was observed in the availability of different batches of NCDP drugs (P < 0.05). In developed regions, the average availability rate of each batch was relatively high (from 53.34% to 70.42%), and their procurement rates exceeded 50%. In moderately developed regions, all batches except the fourth exhibited relatively high average availability rates (from 50.08% to 65.14%), and their procurement rates all exceeded 50%. In less developed regions, only two batches (the first batch of “4 + 7” expansion and the second batch) exhibited relatively high average availability rates, and their procurement rates exceeded 50%. The availability of all types of NCDP drugs was also higher in more developed regions. Conclusion: The implementation of five batches of NCDP drugs has gained initial achievements, but differences persist among regions with varying economic development levels. Accordingly, relevant national departments should optimize the policy implementation mechanism, strengthen the construction of supply chains, and change the inertia of medical behaviour in these regions, aiming to promote the coordinated development of different regions, increase the availability of NCDP drugs and allow people to enjoy policy benefits.