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Access to medicines for children in China
Zhe Chen1,2,3,4,5, Siyu Li1,2,3,4,6, Imti Choonara7
1Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China.
Insights
Access to essential pediatric medicines in China remains a challenge, with availability ranging from 1.6% to 46.5%. While generics are more available and affordable than original brands, continuous policy improvements are needed for better accessibility.
Area of Science:
- Pediatric pharmacology
- Health economics
- Pharmaceutical policy
Background:
- Access to essential medicines for children is a significant global challenge, especially in low- and middle-income countries.
- In China, the availability of essential pediatric medicines varies widely, from 1.6% to 46.5%.
Purpose of the Study:
- To evaluate the availability and affordability of essential medicines for children in China.
- To analyze the impact of pharmaceutical policies on pediatric medicine accessibility.
Main Methods:
- Analysis of medicine availability and pricing data in Chinese public hospitals.
- Comparison of generics versus original brands and different dosage forms.
- Review of national policies implemented since 2011.
Main Results:
- Generic medicines showed higher availability (27.3%-46.5%) and lower prices (0.52-4.28 times international reference prices) compared to original brands (1.6%-33.0%, 2.59-11.38 times).
- Tablets/capsules were more affordable than injections, and common anti-infectives and antipyretics were relatively affordable.
- Six key pediatric medicines, including amoxicillin/clavulanic acid and various antibiotics, were found to be unaffordable.
Conclusions:
- While Chinese policies since 2011 have partially improved pediatric medicine accessibility, significant challenges remain.
- Generics offer a more affordable and accessible option, but specific essential medicines require further attention to ensure affordability.
Abstract:
Access to essential medicines for children is a big challenge, particularly in low-income and middle-income countries. In China, the average availability of essential medicines for children is 1.6%-46.5%. The availability of generics was generally higher than original brands in public hospitals and the prices of generics were relatively lower and more reasonable (generics: availability, 27.3%-46.5%, prices, 0.52-4.28 times the international reference prices; original brands: 1.6%-33.0%, 2.59-11.38 times the international reference prices). In terms of affordability of medicines for children, generics were more affordable than original brands and tablets/capsules were more affordable than injections. Most commonly used anti-infective medicines (such as amoxicillin capsule, azithromycin tablet, cefuroxime tablet) and antipyretics (such as ibuprofen suspension) were relatively affordable. Six commonly used medicines in paediatrics, including amoxicillin/clavulanic acid, beclomethasone, cefazolin, ceftazidime, ceftriaxone, cyclosporine were unaffordable. Since August 2011, China has successively issued several policies to ensure the accessibility of medicines for children, covering research and development, production, procurement and prices of medicines. The accessibility of medicines for children has been partially improved, but still needs continuous improvement.
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