本文系统回顾了国际基本药物制度的发展经验，总结认为提高基本药物“可及性、可负担性和质量安全”是最重要的政策目标和努力方向。在回顾中国基本药物制度进展的基础上，重点分析了当前在基层可及性不足、个人负担仍偏高以及使用率不高等突出问题。文章提出，在现有国家基本药物目录内，进一步遴选出一个小范围的“福利性基础用药目录”，以免费或象征性收费方式向全民提供，并与财政保障、医保支付、基层医疗体系建设和医共体改革等协同推进，以促进健康公平、提升卫生投入整体效率。

This policy brief systematically reviews international experience with essential drugs system and finds that improving accessibility, affordability, and quality and safety of essential medicines constitutes the core policy objectives and priority areas for action. Drawing on an assessment of progress in China’s essential drugs system, the brief highlights several persistent challenges, including inadequate availability at the primary healthcare level, continued high out-of-pocket payments, and suboptimal utilization of essential drugs. The brief proposes that, within the existing national essential drugs system, a smaller subset of “public-benefit essential drugs” be further identified and made available to the entire population free of charge or at nominal cost. This approach should be implemented in close coordination with strengthened public financing, health insurance payment arrangements, primary healthcare system strengthening, and reforms of integrated health service delivery networks, with the aim of advancing health equity and improving the overall efficiency of health investment.