Pharmacoeconomics in Healthcare Decision Making in China
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Pharmacoeconomics in Healthcare Decision Making in China Hai-tao Li,1 Ai-xia Ma,1 Hong-chao Li1 and Shi-xue Li2 1 School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, People’s Republic of China 2 School of Public Health, Shandong University, Ji’nan, Shandong, People’s Republic of China
Abstract
The use of pharmacoeconomic analyses has grown dramatically in the past decade as the cost of healthcare throughout the industrialized world has required increased scrutiny of health outcomes. Pharmacoeconomic analysis, however, has not been fully utilized in public health policy decision making in China. China is currently using a hybrid approach to regulate the healthcare market as the country moves from a planned to a market economy. There are problems in China’s current healthcare system, such as the high price and low quality of drugs, as well as inappropriate prescribing by healthcare professionals. Pharmacoeconomics is a useful tool to evaluate the cost effectiveness of drugs that can help solve some of these problems, for example through the application of a national Essential Medicines List, hospital formularies and clinical guidelines. Pharmacoeconomic methodologies have already been discussed by experts in China; however, in practice, these have not yet been used to guide decision making. Many obstacles exist. Importantly, there are only a small number of experts in the field and there are no standardized teaching materials or training courses for pharmacoeconomics in the country. In spite of these barriers, the Chinese government is actively promoting the utilization of pharmacoeconomic evaluation because of limited health resources relative to the huge healthcare market. Therefore, there exists a possibility for pharmacoeconomics to assist in rational decision making in the healthcare sector in China.
Chinese healthcare regulation is rapidly changing. As the country moves from a planned to a market economy, the Chinese government has utilized a hybrid approach where both old and new institutions are being used to regulate the emerging healthcare market.[1] This approach is consistent with the incremental reform strategy adopted by the party state.[1] The most dramatic result of this introduction of the market forces was the disappearance of universal access to free basic healthcare. This change has led to two major problems: (i) a greater inequity in access to services between the rich (or insured people) and the poor; and (ii) a substantial inefficiency in the use of the scant resources available because of an anomalous pricing structure.[2] The system requires healthcare professionals and hospitals to generate most of their own income,[3] while the government has tried to guarantee access to healthcare through use of price caps and profit margin regulation.[4] Central directives ensure that the cost of basic medical care (cost of consultation and bed charges) is kept low. However, charges f
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