Exploratory study on the impact of medical insurance system reform on the accessibility of chronic Disease Drugs in Hospitals——Based on Front-line Clinical and Pharmacy Work Practices

OBJECTIVE To explore the influence of policies of health security system reform on the accessibility of drugs for chronic diseases in recent years. METHODS Fifteen clinical and pharmacy front-line workers were selected as the research objects in August 2022. The semi-structured outline was used to conduct one-to-one in-depth interviews, and the data were analyzed based on the thematic framework method. RESULYS The reform of health insurance payment method improved the availability and accessibility of low-priced drugs, but had the opposite effect on high-priced drugs. Centralized drug procurement had a bidirectional impact on the affordability of drugs for patients with chronic diseases:the change of medication habits reduced the acceptability of some patients, and the limited choice of drugs by doctors and patients reduced the availability and accessibility of original drugs for patients. National drug negotiations had improved the affordability of drugs for patients with chronic diseases and the availability of expensive drugs. The development of "internet plus medical insurance service" had improved the accessibility of drugs, but the coverage was still small and the application was not widely. CONCLUSION The reform of medical insurance system has multiple effects on the accessibility of drugs for chronic diseases. Relevant policy makers should consider the impact of medical insurance policy on the accessibility of drugs to protect the rights and interests of patients with chronic diseases.