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Contents Introduction

Access to drugs is crucial for achieving Sustainable Development Goal 3 of the United Nations, which aims to promote good health and well-being for all. Improving access to drugs requires addressing availability, affordability, and adoption. Availability refers to the physical presence of medicines in healthcare facilities or in the market, which is influenced by production capacity, quality control, regulatory approval processes, procurement and tendering processes. Affordability, on the other hand, refers to the ability of individuals and health systems to acquire and pay for drugs. High drug prices, intellectual property protection, market competition, government policies, and drug development expenses can create significant barriers to affordability. Finally, adoption is the utilization of drugs by healthcare providers and patients, which is influenced by clinical decision-making, prescribing practices, and patient preferences. Even if drugs are available and affordable, they may not be adopted if healthcare providers and patients do not perceive them as safe and effective.

While addressing all three elements is important for improving access to drugs, it can be challenging and may require trade-offs between different interests, especially when resources and budgets are limited. For example, reducing drug prices to enhance affordability may lead to lower revenues for drug manufacturers, which could deter them from investing in research and development. This, in turn, could affect the availability of innovative medicines in the long run, particularly for neglected diseases or conditions that disproportionately affect marginalized populations.

To help policymakers anticipate the long-term implications of drug pricing and availability, rigorous economic evaluation of existing policies is crucial. However, the lack of data remains a significant obstacle to this evaluation, highlighting the need for further research in this area. This report provides a historical overview of the Chinese pharmaceutical market and the evolution of drug policies that have affected accessibility. It also provides a summary of recent initiatives to improve drug availability and their results based on existing evidence. The overview and additional preliminary descriptive analyses are part of the overall drug access research program, and they are expected to provide the basis for a quantitative evaluation of policy effects in future studies.