A Generic Drug Policy as Cornerstone to Essential Medicines in China
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Compared with developed economies,
health expenditure in China is not particularly high on a
per capita basis or as a share of Gross Domestic Product
(GDP). Similarly, pharmaceutical expenditure in comparative
perspective is not particularly high on a per capita basis
or as a percentage of GDP. China's exceptionally high
rate of pharmaceutical expenditure has important
implications for the future of a health care system that not
only serves a rapidly aging population, but encourages
overuse of drugs in ways that are both financially and
medically inefficient. Pharmaceutical reform is therefore a
high priority for China's health policymakers. Several
factors are discussed for reforming this system based on
lessons from recent reforms. The section following this
introduction briefly reviews the expansion of basic medical
insurance coverage in the 2000s and several structural
features of the pharmaceutical sector in China. The related
concepts of an essential medicines policy, an essential drug
list, and a generic drug policy are briefly described in
first section. The second section of the paper looks at
several hurdles that are built into the path of essential
medicines reform. The third section considers some lessons
for pharmaceutical reform based on China's recent
learning from regional experimentation and piloting
initiatives. The fourth section considers several relevant
lessons derived from reform experiences in other countries.
The fifth section looks at the path forward-success factors
for implementing an essential medicines program based on
low-cost generic drugs.
Palabras clave
ACCESS TO HEALTH CARE, ACCESS TO INFORMATION, ACTIVE INGREDIENTS, AGING, ANTIBIOTICS, BENCHMARKS, BIDDING, BIOEQUIVALENCE, CANCER, CAPACITY BUILDING, CAPITATION, CAPITATION BASIS, CENTER FOR HEALTH, CERTIFICATION, CHRONIC CONDITIONS, CHRONIC DISEASES, CITIZEN, CITIZENS, CLINICAL GUIDELINES, CLINICAL PRACTICE, COMMUNITY HEALTH, CONSUMER EDUCATION, COOPERATIVE MEDICAL INSURANCE, DECISION MAKING, DEVELOPING COUNTRIES, DIABETES, DIAGNOSIS, DIFFERENTIAL PRICING, DISSEMINATION, DISTRIBUTION SYSTEMS, DOCTORS, DOSAGES, DRUG ADMINISTRATION, DRUG INDUSTRY, DRUG LIST, DRUG MARKETS, DRUG POLICIES, DRUG PRICES, DRUG UTILIZATION, DRUGS, ECONOMIC IMPLICATIONS, ECONOMIC PROGRESS, EQUAL ACCESS, EQUITABLE ACCESS, ESSENTIAL DRUGS, ESSENTIAL MEDICINES, FAMILIES, FEES FOR SERVICES, FINANCIAL COMMITMENT, FORECASTS, FRAUD, GENERIC DRUGS, GMP, GOOD MANUFACTURING PRACTICES, GOVERNMENT AGENCIES, GROSS DOMESTIC PRODUCT, HEALTH AUTHORITIES, HEALTH CARE, HEALTH CARE COVERAGE, HEALTH CARE SYSTEM, HEALTH CENTERS, HEALTH COVERAGE, HEALTH ECONOMICS, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH IMPACT, HEALTH INSTITUTIONS, HEALTH INSURANCE, HEALTH MAINTENANCE ORGANIZATIONS, HEALTH OUTCOMES, HEALTH POLICY, HEALTH PROFESSIONALS, HEALTH PROVIDERS, HEALTH REFORM, HEALTH REFORMS, HEALTH RISKS, HEALTH SECTOR, HEALTH SECTOR REFORM, HEALTH SERVICE, HEALTH SERVICES, HEALTH STATUS, HEALTH STRATEGIES, HEALTH SYSTEM, HEALTHCARE, HEPATITIS B, HIV/AIDS, HOSPITAL, HOSPITAL PHARMACIES, HOSPITALS, HUMAN RESOURCES, HYPERTENSION, ILLNESSES, INCOME, INFECTIOUS DISEASES, INSURANCE COVERAGE, INSURANCE SCHEMES, INSURERS, INTERFERON, INTERMEDIARIES, INTERVENTION, IRRATIONAL USE, LACK OF INFORMATION, LARGE NUMBERS OF PEOPLE, LARGE POPULATIONS, LIVING STANDARDS, MANAGEMENT SYSTEMS, MARKETING, MEDICAL CARE, MEDICAL CONDITIONS, MEDICAL EDUCATION, MEDICAL INSURANCE, MEDICAL SERVICES, MEDICAL STAFF, MEDICAL SYSTEMS, MEDICAL TECHNOLOGIES, MEDICATION, MEDICINE, MEDICINES, MIGRANT, MINISTRY OF HEALTH, MORTALITY, NATIONAL DEVELOPMENT, NATIONAL DRUG, NATIONAL HEALTH SYSTEM, NATIONAL LEVEL, NATIONAL LEVELS, NDP, NURSES, NUTRITION, PACKAGING, PATIENT, PATIENT EDUCATION, PATIENTS, PERSONAL RELATIONSHIPS, PHARMACEUTICAL, PHARMACEUTICAL DISTRIBUTION, PHARMACEUTICAL EXPENDITURE, PHARMACEUTICAL INDUSTRY, PHARMACEUTICAL MANUFACTURERS, PHARMACEUTICAL POLICY, PHARMACEUTICAL PRICES, PHARMACEUTICAL REFORM, PHARMACEUTICAL SECTOR, PHARMACEUTICAL SUPPLIERS, PHARMACEUTICAL SUPPLY, PHARMACEUTICALS, PHARMACISTS, PHARMACY, PHYSICIAN, PHYSICIANS, POOLED PROCUREMENT, POOR FAMILIES, PRESCRIPTIONS, PRIMARY CARE, PRIVATE HEALTH INSURANCE, PROGRESS, PROVIDER PAYMENT, PUBLIC EDUCATION, PUBLIC HEALTH, PUBLIC HEALTH INSURANCE, PUBLIC HOSPITALS, PURCHASING, PURCHASING POWER, QUALITY ASSURANCE, QUALITY OF CARE, QUALITY OF SERVICES, RATES OF GROWTH, RATIONAL DRUG USE, RATIONAL USE OF DRUGS, REFORM EFFORT, REGULATORY AUTHORITIES, REMEDIES, RESPECT, RETAIL PHARMACIES, RURAL AREAS, RURAL POPULATION, RURAL RESIDENTS, SERVICE CONTRACTS, SERVICE PROVIDER, SERVICE PROVIDERS, SOCIAL HEALTH INSURANCE, SOCIAL SECURITY, SOCIAL WELFARE, STATE PLANNING, THERAPIES, TRADITIONAL MEDICINES, TREATMENT GUIDELINES, TREATMENTS, URBAN AREAS, URBAN ENVIRONMENTS, URBAN POPULATIONS, USER FEES, WASTE, WORKERS, WORLD HEALTH ORGANIZATION