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1、华中科技大学硕士学位论文foundinbothsectors,andmoreinthehospitals.Themedianavailabilityofinnovatorbrandwas28%and39%inhospitalsandretailpharmacies,while39%and50%forgenerics.(2)ThemedianMPRsofprocurementpricesforLPGs(80%oftheMSHreferenceprice)hadindicatedefficientprocurement,beinga
2、tamiddlelevelbetweenShandongandShanghaibuthigherthantherationalprocurementpriceinIndia.Incontrast,theprocurementpriceofinnovatorbrandwasmuchhigherthanShandongandShanghai.Forretailpricesinhospitals,themedianMPRsofinnovatorbrandsandgenericswere12.1and1.1timestheinterna
3、tionalreferenceprices,respectively.Eventhoughthehospitalsreceivedagoodprocurementprices,themarkupsbetweenprocurementandretailpriceswerehigh(medianmarkupsrateofinnovatorbrandsandgenerics:20.5%and32.5%,respectively).Therefore,thehospitalsstillattainedalotofprofitsfroms
4、ellingmedicinesandthebenefitsoflowprocurementpriceswerenottransferredtothepatients.(3)ThemedianMPRsofretailpriceforinnovatorbrandinhospitalswereonlyhalfoftheoneinprivateretailpharmacies.(4)Theaffordabilitywaschieflydeterminedbytheavailabilityandprice.Forthelow-income
5、population,eventheexpenditureofessentialmedicinesfortreatmentswasunaffordable,namelythecommondiseaseswouldcausepoverty.Forthesocialaverageincomepopulation,theaffordabilitywasmuchoptimistic.(5)Theaveragenumberofdrugsperprescriptionwas2.6,higherthan2,whichindicatedthat
6、theprescriberswereinclinedtoofferexcessivemedicines.ThepercentageusageofessentialmedicinesbelongedtoWHOEssentialMedicineList(2007),NationalEssentialMedicineList(2004,China)andNewRuralCooperativeMedicalSystemEssentialMedicineList(SecondEdition)were44.3%、77.5%and71.8%,
7、respectively,whichshowedthepatternsofpreparationswasfarfromtherecommendationbyWHO.Therefore,theirrationaluseofmedicineswouldraisemoreobstaclestoaccesstoessentialmedicines.4华中科技大学硕士学位论文Suggestions(1)ThemodifiedWHO/HAImethodologycouldbeincludedintonationalevaluationsys
8、temforessentialmedicinepolicy.(2)Somemeasures,suchascentralizeddistributionandregulatingtheprescriptionofhospitals,shouldbeusedtoen
