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 RESEARCH ARTICLE
Year : 2015  |  Volume : 47  |  Issue : 5  |  Page : 535-539

Short-term differences in drug prices after implementation of the national essential medicines system: A case study in rural Jiangxi Province, China


1 Collaborative Innovation Center of Health Risks Governance, School of Public Health, Fudan University, Shanghai; Department of Preventive Medicine, Health Development and Policy Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
2 Department of Preventive Medicine, Health Development and Policy Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
3 Department of Circulation Supervision for Medicine and Cosmetics, Jiangxi's Department of Food and Drug Supervision and Administration, Nanchang, China
4 Collaborative Innovation Center of Health Risks Governance, School of Public Health, Fudan University, Shanghai, China

Correspondence Address:
Prof. Mo Hao
Collaborative Innovation Center of Health Risks Governance, School of Public Health, Fudan University, Shanghai
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7613.165192

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Objectives: China's 2009 national essential medicine system (NEMS) was designed to reduce prices through a zero-markup policy and a centralized bidding system. To analyze NEMS's short-term impact on drug prices, we estimated the retail and wholesale prices before and after the reform at health institutions in rural Jiangxi Province. Materials and Methods: We undertook two cross-sectional surveys of prices of 39 medicines in November 2008 and May 2010, calculated inflation adjusted prices, and used the Wilcoxon signed-rank and rank-sum tests to examine price changes at different health institutions. Results: Retail prices at pilot (P < 0.01) and nonpilot (P < 0.01) township health centers decreased significantly, whereas the declines at retail pharmacies (P = 0.57) and village clinics (P = 0.29) were insignificant. The decline at pilot township health centers was the largest, compared with other kinds of health institutions (P < 0.01). Retail prices of essential and non-essential medicines declined significantly at pilot facilities (P < 0.05); price drops for non-essential medicines occurred only at pilot facilities (P < 0.05). No significant decline of wholesale prices were found at pilot (P = 0.86) and nonpilot units (P = 0.18), retail pharmacies (P = 0.18), and village clinics (P = 0.20). The wholesale prices changes at pilot units before and after the reform were higher than at nonpilot public units (P < 0.05), retail pharmacies (P < 0.05), and village clinics (P < 0.05). Conclusion: While the NEMS zero-markup policy significantly reduced retail prices at pilot health institutions, the centralized bidding system was insufficient to lower wholesale prices. A drug price management system should be constructed to control medicine prices and a long-term price information system is needed to monitor price changes.






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