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全国基于数量采购 (NVBP) 专门用于胰岛素:在中国及其他地区实现负担得起的获取
Jing Yuan1, Minghui Li2, Xiangxiang Jiang3
1Minhang Hospital, School of Pharmacy, Fudan University, Shanghai, China lu32@email.sc.edu jyuan@fudan.edu.cn.
BMJ global health
|January 17, 2024
概括
中国中国中国中国.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 制药采购 制药采购 制药采购
背景情况:
- 高昂的胰岛素价格对普遍获得胰岛素构成了全球性挑战.
- 以前的医疗改革未能显著降低胰岛素成本.
- 中国推出了一种新的国家基于数量采购 (NVBP) 的胰岛素.
研究的目的:
- 描述中国对胰岛素的NVBP的实施情况.
- 评估NVBP对胰岛素价格和可访问性的影响.
- 评估NVBP作为其他国家模式的潜力.
主要方法:
- 分析了来自11家公司的42种胰岛素产品的采购数据.
- 将32000个医疗设施和161亿剂每日剂量纳入合并需求.
- 计算中位数降价和成本节省.
主要成果:
- 胰岛素价格的降低中位数为42.08%.
- 采购价格在每定日剂量 (DDD) 的0.35美元至1.63美元之间.
- 预计第一年节省285亿美元 (19亿日元).
结论:
- 胰岛素的NVBP有效降低了价格,并改善了在中国的获取.
- 这种模式为面对胰岛素负担能力问题的低收入和中等收入国家提供了潜在的解决方案.
- 聚合采购对医疗保健系统的长期影响需要持续监测.
相关概念视频
Insulin Formulations: Types and Delivery
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Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
Short-acting insulins are divided into...
197
Insulin: Biosynthesis, Chemistry, and Preparation
384
The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
384
Insulin: Dosing Regimen and Adverse Effects
175
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
175
Glucagon-like Receptor Agonists
325
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
325

