The impact of National Centralised Drug Procurement policy on the use of policy-related original and generic drugs in China.

AIMS: To evaluate the effects of the first round of National Centralised Drug Procurement pilot (so-called '4+7' policy) on the use of policy-related original and generic drugs. METHODS: This study used drug purchasing order data from the Centralised Drug Procurement Survey in Shenzhen 2019, covering 24 months from January 2018 to December 2019. '4+7' policy-related drugs were selected as study samples, including 25 drugs in the '4+7' procurement list and 69 alternative drugs that have an alternative relationship with '4+7' List drugs in clinical use. '4+7' List drugs were then divided into bid-winning and bid-non-winning products according to the bidding results. Included drugs were sorted into original and generic drugs. Purchase volume, expenditures, and daily costs were selected as outcome variables, and were measured using Defined Daily Doses (DDDs), Chinese Yuan (CNY), and Defined Daily Drug cost (DDDc). A single-group Interrupted Time Series analysis was adopted to quantify policy effect. RESULTS: After policy intervention, the overall policy-related original drugs significantly decreased by 0.39 CNY (95% CI: -0.62 to -0.17, p < 0.01) in DDDc, 5949.36 thousand DDDs (95% CI: -8276.67 to -3622.05, p < 0.001) in volume, and 31,575.08 thousand CNY (95% CI: -41,812.68 to -21,337.49, p < 0.001) in expenditures. The volume proportion of generic drugs increased from 78.6% to 91.0%, and the expenditure proportion of increased from 30.9% to 49.8%. CONCLUSION: '4+7' policy promoted the substitution use of domestic generics against original branded drugs and played positive effects on drug price cut and medication burden reduction. The proportion of original branded drugs and generics that passed generic consistency evaluation significantly increased after policy intervention, indicating the improvement of the overall quality level of drug use in China.

Trends and Associated Factors of Dietary Knowledge among Chinese Older Residents: Results from the China Health and Nutrition Survey 2004-2015.

Promoting a healthy diet of the elderly is an important task in the current "Healthy China Action". This study aimed to describe the changing trends of the dietary knowledge elderly Chinese during 2004-2015 and to examine the associated factors of dietary knowledge. Elderly people aged ≥60 years were included as study subjects from the China Health and Nutrition Survey 2004-2015. A total of 15,607 samples were involved in the analysis. The correct rate of dietary knowledge items followed upward trends over time, except for two items regarding physical activity intensity (Question 11, Cochran-Armitage χ2 = 20.05, p < 0.001) and healthy weight (Question 12, Cochran-Armitage χ2 = 43.93, p < 0.001). Four of the twelve dietary knowledge items consistently followed the lowest correct rate between 2006 and 2015, regarding physical activity intensity (Question 11, 24.5%-25.8%), staple food consumption (Question 5, 36.6%-41.5%), animal product consumption (Question 6, 45.8%-59.5%), and fatty meat and animal fat consumption (Question 7, 63.6%-64.9%). Participants who had a lower educational level or lived in rural areas or western regions, did not know about the Chinese Food Pagoda (CFP) or Dietary Guidelines for Chinese Residents (DGCR), and did not proactively look for nutrition knowledge were less likely to have adequate dietary knowledge literacy. Targeted interventions should be developed to promote dietary knowledge level of the elderly.

Do Older Adults with Parent(s) Alive Experience Higher Psychological Pain and Suicidal Ideation? A Cross-Sectional Study in China.

Elderly mental health promotion is an important task in the current "Healthy China Action". This study aims to (a) clarify the psychological pain and suicidal ideation of the Chinese elderly with different parental states, (b) examine the associated factors of psychological pain and suicidal ideation, and (c) examine the relationship between psychological pain and suicidal ideation. A sample of 4622 adults aged 60 years and older were included in this study, from the China's Health-related Quality of Life Survey for Older Adults 2018. Participants with both parents alive demonstrated the heaviest psychological pain, and those with one parent alive observed significantly lowest psychological pain and suicidal ideation. Participants who were single, divorced, or widowed, live in rural areas, had higher education level, had lower family income, suffered from two or more chronic diseases, and had no self-care ability were more likely to experience psychological pain and suicidal ideation. In addition, higher psychological pain significantly associated with the occurrence of suicidal ideation. In China, much more attention should be paid to the mental health condition of the elderly, especially for those with both parents alive. Moreover, the associated factors above should be considered to develop targeted health interventions.