美国和加拿大的药物短缺差异
Mina Tadrous1, Katherine Callaway Kim2,3, Inmaculada Hernandez4
1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
JAMA
|October 31, 2024
概括
药物供应链问题在加拿大比在美国造成短缺的可能性更小. 国际合作可以提高药物可用性和供应链性.
科学领域:
- 公共卫生
- 卫生政策
- 药物经济学
背景情况:
- 药物短缺是一个重大的公共卫生挑战,由COVID-19大流行加剧.
- 美国和加拿大的监管机构要求报告药物供应链问题.
- 这些报告对两国实际药物短缺的比较影响尚不清楚.
研究的目的:
- 为了比较美国和加拿大的供应链问题所导致的药物短缺频率.
- 确定影响供应链中断和药物短缺之间的因素.
主要方法:
- 一项纵向,横截面的研究分析了2017年至2021年间加拿大和美国的与毒品有关的供应链问题报告.
- 用IQVIA数据评估,药物短缺被定义为每月药物单位购买量下降≥33%.
- 分析的因素包括国家,流行时间,基本药物状态,制造来源和药物特征.
主要成果:
- 在美国49.0%的病例中,报告的供应链问题与药物短缺有关,而在加拿大为34.0% (调整后的危险比率[HR],0.53).
- 在加拿大,这种较低的风险在COVID-19大流行之前 (调整HR,0.47) 和之后 (调整HR,0.31) 持续存在.
- 单一来源的药物有两倍的短缺风险 (调整后的HR,2.58) 而加拿大三级药物有近一半的风险 (调整后的HR,0.56).
结论:
- 与美国相比,加拿大的药物供应链问题很少导致药物短缺.
- 调查结果强调需要国际合作来缓解药物短缺并增强供应链的弹性.
- 政策干预可以通过对影响药物可用性的监管和市场因素进行比较分析.
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