Basic drug expansion helps upgrade the treatment of fundus diseases
2023-07-06
In the "14th Five Year Plan for National Eye Health (2021-2025)", fundus diseases are listed as new key diseases. With in-depth research, continuous technological innovation, intraocular injection of anti Vascular endothelial growth factor (VEGF) drugs and other new drugs, the treatment of fundus diseases has entered a new era. However, in the current National Essential medicines Catalogue, the shortage of ophthalmic drugs is currently more prominent. In this regard, many experts in ophthalmology and medicine field called for the urgent expansion of the Essential medicines directory to help more patients with fundus diseases to obtain better quality of life. Ophthalmic basic drugs should be "old out and new in, and the total amount should be increased", a member of the National Committee of the Chinese People's Political Consultative Conference Wang Ningli, professor of ophthalmology at Beijing Tongren Hospital affiliated to Capital Medical University, "In the adjustment of the National Essential medicines Catalogue, there are two problems that need to be carefully grasped: one is how to eliminate clinically unnecessary and outdated drugs, the other is how to select clinically necessary drugs, and at the same time, to increase the total amount of Essential medicines for ophthalmology." With the economic development and social environment evolution, The spectrum of ophthalmic diseases has also undergone significant changes. Infectious eye diseases are no longer the main challenge faced by ophthalmic clinical practice, and age-related eye diseases have become the focus of clinical diagnosis and treatment. As the aging population gradually accelerates, there will be more and more age related eye diseases. At the same time, as the incidence rate of hypertension, diabetes, Atherosclerosis and other diseases increases year by year, it also brings challenges to the diagnosis and treatment of ophthalmic diseases. The incidence of eye complications in diabetes patients is about 20%. Ocular ischemia, Central retinal artery occlusion, vein occlusion, fundus hemorrhage and other diseases caused by hypertension can not be ignored. We call for strengthening the science popularization of eye diseases, enhancing public health awareness, and including eye diseases in screening. Regular fundus photography can detect 80% to 90% of diseases early, and 80% to 90% of them can be prevented and controlled early. Early prevention can benefit early, while early control can prevent blindness and disability. With the change of clinical diagnosis and treatment, Essential medicines should be adjusted accordingly. Essential medicines should have three characteristics: the most important, the most basic and indispensable. In addition, it is necessary to balance major health concerns. In the current National Essential medicines Catalogue, many drugs have faded out of clinical use. Taking anti infective drugs as an example, Chloramphenicol eye drops have long been used clinically and can be completely replaced by other drugs. Rifampicin for ophthalmic use was mainly used for trachoma treatment before, but it has been rarely used because blinding trachoma has been eliminated in China. For example, in the treatment of glaucoma, pilocarpine is currently only a temporary medication or used in the treatment of pupil contraction, but it is no longer a conventional medication for glaucoma treatment. Timolol is now the second and third line drug for glaucoma treatment, and Prostaglandin derivatives have become the first line drug. It can be seen that the National Essential medicines Catalogue is different from the clinical practice of ophthalmology. Of course, there is a time issue, but adjustments are imperative. In addition, there are two principles for the selection of Essential medicines, one is that the reserves and supply should be sufficient, and the other is that there should be no risk. Then, there is only one anti VEGF drug in the National Essential medicines Catalogue, which cannot meet the requirements of this principle. The purpose of Essential medicines is to ensure supply
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