Insulin prices, availability and affordability: a cross-sectional survey of pharmacies in Hubei Province, China
Abstract Background Poor access to affordable insulin results in serious and needless complications and premature deaths for those with diabetes who need this essential medicine. To help address this issue, we assessed insulin availability, prices, affordability and price components in Hubei Provinc...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-017-2553-0 |
| _version_ | 1819162736604479488 |
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| author | Chenxi Liu Xinping Zhang Chaojie Liu Margaret Ewen Zinan Zhang Guoqin Liu |
| author_facet | Chenxi Liu Xinping Zhang Chaojie Liu Margaret Ewen Zinan Zhang Guoqin Liu |
| author_sort | Chenxi Liu |
| collection | DOAJ |
| description | Abstract Background Poor access to affordable insulin results in serious and needless complications and premature deaths for those with diabetes who need this essential medicine. To help address this issue, we assessed insulin availability, prices, affordability and price components in Hubei Province as China has the heaviest burden of diabetes globally. Methods In 2016, insulin availability and price data was collected in the capital and five other cities. A total of 30 public sector outlets (hospitals and primary care institutions) and 30 private pharmacies were sampled, using an adaptation of the World Health Organization/Health Action International methodology, Data was collected for all human and analogue insulins in stock, then analyzed by type (prandial, basal or pre-mixed) and duration of action. Prices were expressed as Median Price Ratios (MPRs) to Australian PBS prices. Price components were tracked for five insulin products in two cities.. Affordability was assessed as the number of days’ wages of the lowest paid unskilled government worker needed to purchase 10 ml 100 IU/ml (approximately 30 days’ supply). Results Mean availability was highest in public hospitals for prandial (70%), basal (80%) and pre-mixed insulin (90%). In primary care institutions and private pharmacies mean availability ranged from 10% to 33%. Median prices of all insulin types were higher that Australian PBS prices in all three sectors for human and analogue insulins (ranging from1.36–2.59 times). Patients have to pay 4 to 16 days’ wages to purchase a month’s treatment depending on the insulin type and sector. The largest component of the patient price was the manufacturers’ selling price (60%). Taxes in the form of import duties and VAT are applied in some sectors. Conclusions The availability of insulin in primary care institutions and private retail pharmacies was very low in Hubei. Only public hospitals had good insulin availability. Insulin prices were high in all sectors making this life-saving medicine unaffordable, especially for those on low incomes. Governments should consider using its bargaining power to reduce prices, abolish taxes on essential medicines such as insulin, and develop strategies for more equitable access to insulin. |
| first_indexed | 2024-12-22T17:32:59Z |
| format | Article |
| id | doaj.art-b743b2c89a86499db6413163c0429911 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-22T17:32:59Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-b743b2c89a86499db6413163c04299112022-12-21T18:18:34ZengBMCBMC Health Services Research1472-69632017-08-011711910.1186/s12913-017-2553-0Insulin prices, availability and affordability: a cross-sectional survey of pharmacies in Hubei Province, ChinaChenxi Liu0Xinping Zhang1Chaojie Liu2Margaret Ewen3Zinan Zhang4Guoqin Liu5School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and TechnologySchool of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and TechnologyChina Health Program, La Trobe UniversityHealth Action InternationalSchool of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and TechnologySchool of Management, Zunyi Medical UniversityAbstract Background Poor access to affordable insulin results in serious and needless complications and premature deaths for those with diabetes who need this essential medicine. To help address this issue, we assessed insulin availability, prices, affordability and price components in Hubei Province as China has the heaviest burden of diabetes globally. Methods In 2016, insulin availability and price data was collected in the capital and five other cities. A total of 30 public sector outlets (hospitals and primary care institutions) and 30 private pharmacies were sampled, using an adaptation of the World Health Organization/Health Action International methodology, Data was collected for all human and analogue insulins in stock, then analyzed by type (prandial, basal or pre-mixed) and duration of action. Prices were expressed as Median Price Ratios (MPRs) to Australian PBS prices. Price components were tracked for five insulin products in two cities.. Affordability was assessed as the number of days’ wages of the lowest paid unskilled government worker needed to purchase 10 ml 100 IU/ml (approximately 30 days’ supply). Results Mean availability was highest in public hospitals for prandial (70%), basal (80%) and pre-mixed insulin (90%). In primary care institutions and private pharmacies mean availability ranged from 10% to 33%. Median prices of all insulin types were higher that Australian PBS prices in all three sectors for human and analogue insulins (ranging from1.36–2.59 times). Patients have to pay 4 to 16 days’ wages to purchase a month’s treatment depending on the insulin type and sector. The largest component of the patient price was the manufacturers’ selling price (60%). Taxes in the form of import duties and VAT are applied in some sectors. Conclusions The availability of insulin in primary care institutions and private retail pharmacies was very low in Hubei. Only public hospitals had good insulin availability. Insulin prices were high in all sectors making this life-saving medicine unaffordable, especially for those on low incomes. Governments should consider using its bargaining power to reduce prices, abolish taxes on essential medicines such as insulin, and develop strategies for more equitable access to insulin.http://link.springer.com/article/10.1186/s12913-017-2553-0AccessAvailabilityAffordabilityPrice componentInsulinDiabetes |
| spellingShingle | Chenxi Liu Xinping Zhang Chaojie Liu Margaret Ewen Zinan Zhang Guoqin Liu Insulin prices, availability and affordability: a cross-sectional survey of pharmacies in Hubei Province, China BMC Health Services Research Access Availability Affordability Price component Insulin Diabetes |
| title | Insulin prices, availability and affordability: a cross-sectional survey of pharmacies in Hubei Province, China |
| title_full | Insulin prices, availability and affordability: a cross-sectional survey of pharmacies in Hubei Province, China |
| title_fullStr | Insulin prices, availability and affordability: a cross-sectional survey of pharmacies in Hubei Province, China |
| title_full_unstemmed | Insulin prices, availability and affordability: a cross-sectional survey of pharmacies in Hubei Province, China |
| title_short | Insulin prices, availability and affordability: a cross-sectional survey of pharmacies in Hubei Province, China |
| title_sort | insulin prices availability and affordability a cross sectional survey of pharmacies in hubei province china |
| topic | Access Availability Affordability Price component Insulin Diabetes |
| url | http://link.springer.com/article/10.1186/s12913-017-2553-0 |
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