OBJECTIVE： To provide reference for improving the efficiency of medicine supply in primary health care institutions. METHODS： By stratified random sampling， 6 counties of Dabie Mountains in Anhui province were selected as sample areas. Medicine purchase data of 143 primary health care institutions in 2015 were collected from Anhui provincial centralized purchase platform. Those data were analyzed in respects of purchase and distribution of National Essential Medicine， medicines of Anhui Province Essential Medicine List and cheap medicines. By stratified random sampling， 12 primary health care institutions were selected for on-site interview. The reasons for medicine distribution and insufficient distribution were investigated. RESULTS： The rate of medicine distribution in the sample areas was 82.27％， and the rate of essential medicine distribution was more than 80％. Ratio of purchase amount for national essential medicines and medicines of Anhui Province Essential Medicine List were all up to standard in different types of primary health care institutions. The rate of cheap medicine distribution was in low level（only 80％）. The distribution rate had great difference in the primary health care institutions and different areas； the highest rate of medicine distribution reached 99.86％， and the lowest was only 46.18％. The results of on-site investigation showed that main reasons for insufficient distribution were the divided area distribution model had a certain influence on the market competitiveness of the distribution enterprises， and distribution enterprises strength had huge differences. CONCLUSIONS： The primary health care institutions have high awareness of National Essential Medicine System in Dabie Mountains of Anhui Province； purchase rate and overall distribution rate of essential medicine are also high. There are great differences in distribution efficiency among different areas and health care institutions， and some health care institutions cannot distribute medicine in time with full capacity. It is suggested to conduct “two-receipt system” of medicine distribution， perfect medicine distribution enterprise supervision system， establish medicine circulation information platform and lead cheap medicine supply guarantee by government， etc. Those measures can guarantee the accessibility and selectivity of the masses to essential medicines in grass-roots areas.