BEIJING, April 7 (Xinhua) -- The Chinese government
Tuesday announced it will institute an essential medicine system within three
years to drive down prescription costs and quell public complaints of limited
accessibility of medicines.
The system includes a list of essential medicines
that would be produced and distributed under government control and supervision,
according to an action plan (2009-2011) on China's health-care reform.
The list will be issued this year, according to the
It did not say how many drugs would be included in
the list, but sources with the Ministry of Health said the list could be
compiled on the basis of 300 to 400 drugs recommended by the World Health
Essential medicines are those that satisfy priority
health-care needs, according to the definition of the World Health Organization.
"Essential medicines do not mean cheap medicines,"
Liu Xinming, director general of the department of policy and regulations of the
Ministry of Health, told Xinhua.
They were selected with due regard to disease
prevalence, evidence on efficacy and safety, and comparative cost-effectiveness,
The WHO model Lists of Essential Medicines has been
updated every two years since 1977. The current version, the 15th list, dates
from March 2007.
The action plan states essential medicines should be
used at all public health facilities at grassroots levels from 2009. They should
also be available at all retail drugstores and medical institutions.
In China, drugs are also sold at hospitals.
Prices of the essential drugs will be under
government control. The central government will set reference prices, based on
which, provincial governments set the purchase prices of the drugs in their
Public medical and health facilities at the
grassroots levels should sell the drugs at the purchase prices, according to the
Drug pricing in China currently falls with the
jurisdiction of several departments, including the National Development and
Reform Commission (NDRC) and the State Food and Drug Administration.
In the 1980s, China launched market-oriented reforms.
Public hospitals were encouraged to make their own incomes with the aim of
mobilizing medical workers and improving hospital efficiency.
Less government funding resulted in deficits for
public health institutions, which forced hospitals to generate their own revenue
by aggressively selling drugs.
To stem the tide of rising public complaints about
high medical costs, the NDRC has capped the cost of hundreds of drugs over the
However, critics argue the price cuts have not been
the cure since drug manufacturers often change the name and packaging of their
drugs to escape price controls.
Some hospitals and clinics have also turned a blind
eye to government price caps and refuse to prescribe lower priced alternative
To ensure the quality of the drugs and prevent
corruption in drug purchasing and distribution, the plan also said all essential
medicines used in public medical and health institutions can only be purchased
from enterprises selected through public tender.
Drug safety regulators should regularly conduct
quality inspections of drugs on the list and open the results to the public, the
"A system that ensures transparent bidding, reasonable pricing, standard drug use is key to addressing public complaints of limited accessibility of medical services," Liu said.
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