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Objective To investigate access to essential anticancer medicines for children throughout China.
Methods We obtained cross-sectional drug use data for 2021 from 55 tertiary children's hospitals in seven geographical regions (one third of public children's hospitals in mainland China). Affordability was assessed by comparing the single-day copayment for each medicine with the same generic name and route of administration (i.e. product) or for a treatment course with daily disposable income per capita in each region. The median availability and affordability of all 33 anticancer medicines in the 2021 WHO Model list of essential medicines for children were calculated and compared by region and medicine type.
Findings Although all medicines had been approved in China, 14 (42.4%) were available in under 50% of hospitals and six (18.2%) products had a median single-day copayment exceeding daily disposable income. Median availability was higher among the 19 medicines with approval for paediatric indications than among the 14 without (80.0% versus 48.2%, respectively; P<0.001). Overall, 42.4% (14/33) of medicines had both good availability and affordability; the lowest proportion was in north-west China (30.3%, 10/33). A Chinese resident needed to work for 5.3 days to afford 4 weeks' induction therapy for acute lymphoblastic leukaemia, the most common childhood cancer.
Conclusion Access to essential anticancer medicines for children remained suboptimal in China and varied across regions. Fewer than half the medicines studied had both good availability and affordability. Actions are warranted to address potential shortages and decrease the financial burden on families.
Résumé
Objectif Étudier l'accès aux médicaments anticancéreux essentiels pour les enfants dans l'ensemble de la Chine.
Méthodes Nous avons obtenu des données transversales sur l'utilisation des médicaments en 2021 auprès de 55 hôpitaux pédiatriques tertiaires dans sept régions géographiques (un tiers des hôpitaux pédiatriques publics en Chine continentale). L'accessibilité financière a été évaluée en comparant d'une part le ticket modérateur d'une journée pour chaque médicament ayant le même nom générique et la même voie d'administration (c'est-à-dire un produit) ou pour une série de traitements et d'autre part le revenu disponible quotidien par habitant dans chaque région. La disponibilité médiane et l'accessibilité financière des 33 médicaments anticancéreux figurant sur la Liste modèle de l'OMS des médicaments essentiels destinés à l'enfant ont été calculées et comparées par région et par type...