International Journal of Clinical Pharmacy

, Volume 37, Issue 1, pp 12–17 | Cite as

Medicine prices, availability, and affordability in the Shaanxi Province in China: implications for the future

  • Minghuan Jiang
  • Zhongliang Zhou
  • Lina Wu
  • Qian Shen
  • Bing Lv
  • Xiao Wang
  • Shimin Yang
  • Yu FangEmail author
Short Research Report


Background In 2009, China implemented the National Essential Medicines System (NEMS) to improve access to high-quality low-cost essential medicines. Objective To measure the prices, availability and affordability of medicines in China following the implementation of the NEMS. Setting 120 public hospitals and 120 private pharmacies in ten cities in Shaanxi Province, Western China. Method The standardized methodology developed by the World Health Organization and Health Action International was used to collect data on prices and availability of 49 medicines. Main outcome measures Median price ratio; availability as a percentage; cost of course of treatment in days’ wages of the lowest-paid government workers. Results In the public hospitals, originator brands (OBs) were procured at 8.89 times the international reference price, more than seven times higher than the lowest-priced generics (LPGs). Patients paid 11.83 and 1.69 times the international reference prices for OBs and generics respectively. A similar result was observed in the private pharmacies. The mean availabilities of OBs and LPGs were 7.1 and 20.0 % in the public hospitals, and 12.6 and 29.2 % in the private pharmacies. Treatment with OBs is therefore largely unaffordable, but the affordability of the LPGs is generally good. Conclusion High prices and low availability of survey medicines were observed. The affordability of generics, but not OBs, is reasonable. Effective measures should be taken to reduce medicine prices and improve availability and affordability in Shaanxi Province.


Affordability Availability China Essential medicine Pharmacoepidemiology Prices WHO/HAI methodology 



We would like to thank Mrs. Margaret Ewen from Health Action International for providing technical support for the survey design and other assistance. We appreciate the cooperation and participation of the pharmacists and other staff at the medicine outlets where data was collected. M. Jiang and Z. Zhou should jointly be regarded as first author.


This survey was conducted with financial support from the National Natural Science Funds (No.: 71473192/G0308; No.: 71103141/G0308), the Fundamental Research Funds for the Central Universities (No.: sk2014041) and the Shaanxi Provincial Foundation of Philosophy and Social Science (No.: 10E066).

Conflicts of interest



  1. 1.
    Hogerzeil HV. Essential medicines and human rights: what can they learn from each other? Bull World Health Organ. 2006;84(5):371–5.PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    WHO. The world medicines situation 2011-access to essential medicines as part of the right to health. Geneva: World Health Organization; 2011.Google Scholar
  3. 3.
    WHO. WHO medicines strategy countries at the core 2004–2007. Geneva: World Health Organization; 2008.Google Scholar
  4. 4.
    National Health and Family Planning Commission of the People’s Republic of China. China Health Statistical Yearbook 2012. 2013. Accessed 3 Nov 2013.
  5. 5.
    The Shaanxi Provincial Government. The suggestions for implementing National Essential Medicine System. 2009. Accessed 19 Nov 2011.
  6. 6.
    Jiang MH, Yang SM, Yan KK, Liu J, Zhao J, Fang Y. Measuring access to medicines: a survey of prices, availability and affordability in Shaanxi Province of China. PLoS One. 2013;8(8):e70836.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    World Health Organization, Health Action International. Measuring medicine prices, availability, affordability and price components 2nd ed. 2008. Accessed 13 Jun 2010.
  8. 8.
    Li H, Guan XD, Xu LP, Liu Y, Han X, Shi LW. Empirical research of price difference and market share between brand-name drugs and generics in one province in China. Chin J New Drugs. 2012;21(24):2853–6.Google Scholar
  9. 9.
    National Development and Reform Commission. The notice of further adjustment of prices of medicines and medical care. Accessed 20 Nov 2013.
  10. 10.
    Singal GL. Medicine prices and availability in the state of Harayana, India. Accessed 12 Sept 2014.
  11. 11.
    Kotwani A. Medicine prices in the state of Rajasthan, India. Accessed 12 Sept 2014.
  12. 12.
    Zeng WJ. A price and use comparison of generic versus originator cardiovascular medicines: a hospital study in Chongqing, China. BMC Health Serv Res. 2013;13(10):390–7.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Yip WC, Hsiao WC, Chen W, Hu SL, Ma J, et al. Early appraisal of China’s huge and complex health-care reforms. Lancet. 2012;379:833–42.PubMedCrossRefGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Minghuan Jiang
    • 1
  • Zhongliang Zhou
    • 2
  • Lina Wu
    • 1
  • Qian Shen
    • 1
  • Bing Lv
    • 1
  • Xiao Wang
    • 1
  • Shimin Yang
    • 1
  • Yu Fang
    • 1
    Email author
  1. 1.Department of Pharmacy Administration, School of Pharmacy, Health Science CenterXi’an Jiaotong UniversityXi’anPeople’s Republic of China
  2. 2.Institute for Health Management and Policy, School of Public Policy and AdministrationXi’an Jiaotong UniversityXi’anPeople’s Republic of China

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