对上海青浦区基本药物目录中抗高血压药物可负担性的实证研究

目的 评估基本药物制度下上海青浦区口服抗高血压药物的可负担性，为促进社区慢性病基本药物价格合理性提供实证依据。方法 采用WHO/HAI标准化法和贫化法对该地区口服抗高血压药物的可负担性进行评价。结果 用WHO/HAI标准化法评价结果显示，医疗保险患者对原研药和仿制药的可负担性都较好，而自费患者对原研药的可负担性较差。贫化法结果显示，使用同一通用名的5种原研药和仿制药的致贫人口数量差距较小。厄贝沙坦原研药的可负担性高于仿制药。结论 医疗保险对提高基本药物可负担性作用明显，同时要对一些具有明确循证学证据和使用人群广泛的药物给予合理的定价，以提高治疗高血压药物的可负担性。

Empirical research on the affordability of the antihypertensive drugs in the basic drug list from Qingpu District

Objective To evaluate the affordability of oral antihypertensive drugs in Qingpu District within the basic medication system and provide a substantial evidence for rationalizing the price of essential drugs to treat chronic diseases in communities. Methods WHO/HAI standardized method and dilution method were used to evaluate the affordability of the oral antihypertensive drugs in that area. Results The results of WHO/HAI standardized method showed that patients with health insurance had better affordability for brand name and generic medications. The uninsured patients had lower affordability for brand name medications. The results of dilution method showed that 5 medications available both in brand and generic forms had a smaller gap in the poverty population. The affordability of the brand name drug, Irbesartan, is higher than its generics. Conclusion Health insurance plays an important role in improving the affordability for essential drugs. Reasonable pricing should be given to the commonly used medications with clear evidence based data to improve the affordability of antihypertensive drugs.