在COVID-19大流行之前和期间的药物短缺问题
Katherine Callaway Kim1,2, Scott D Rothenberger1, Mina Tadrous3,4
1Department of Medicine, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
JAMA network open
|April 5, 2024
概括
药品供应链问题显著增加了药品短缺的风险,特别是在COVID-19大流行早期. 这凸显了需要制定政策来保障药物可用性,并优先考虑基本药物.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 制药政策 制药政策
- 药物供应链管理 药物供应链管理
背景情况:
- 药物短缺对患者安全构成重大威胁,也是医疗保健中持续存在的问题.
- 由于COVID-19大流行扰乱了制药生产,引发了对其对药物供应链稳定性及其造成的短缺影响的质疑.
研究的目的:
- 量化供应链问题报告与药物短缺之间的关联.
- 为了确定这种关联在COVID-19大流行期间与大流行前时期相比是否有所不同.
主要方法:
- 一项纵向,横截面研究分析了2017-2021年美国药房购买数据.
- 来自FDA和ASHP的供应链问题报告与药物短缺有关,定义为6个月内购买单位减少>33%.
- 随机效应物流回归模型评估了短缺的几率,相互作用术语检查了流行病效应和药物特征.
主要成果:
- 供应链问题报告与药物短缺的可能性增加了3.7倍 (13.7%与4.1%相比).
- 在疫情初期 (2020年2月至4月),有供应链问题的药物出现短缺的可能性增加了4.9倍.
- 短缺风险因配方,基本药物地位和品牌与仿制药的地位而异,亲肠道和非基本药物风险更高.
结论:
- 供应链中断显著提高了药物短缺的风险,在COVID-19大流行开始时观察到明显增加.
- 特定的药物类别,包括肠道配方药和非必要药物,更容易受到短缺的影响.
- 政策干预对于提高美国药物供应链对未来干扰的弹性和优先考虑有风险的药物至关重要.
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