基于药物利用分析药品集中带量采购政策对我院心血管系统用药的影响  

Analysis of the Influence of Drug Centralized Procurement Program on the Utilization of Cardiovascular Drugs in a Tertiary Hospital

作　　者：魏安华 陈顺达 李娟[1] 贡雪芃 WEI Anhua;CHEN Shunda;LI Juan;GONG Xuepeng(Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430030,China.)

机构地区：[1]华中科技大学同济医学院附属同济医院,湖北武汉430033

出　　处：《药品评价》2022年第9期513-516,共4页Drug Evaluation

基　　金：国家自然科学基金青年项目(81803841)。

摘　　要：目的:分析药品集中带量采购(简称药品集采)政策对心血管系统药物的利用评价指标的影响,探讨仿制药替代策略所带来的经济效益,并为进一步政策完善提供参考。方法:选取2018年1月至2021年10月华中科技大学同济医学院附属同济医院(简称我院)药品集采目录中涉及心血管系统的品种,以及相应同通用名的非中选品种的销售金额、销售数量、用药频度(DDDs)、限定日费用(DDC)等进行动态统计分析。结果:我院集采中选药品涉及心血管系统治疗用药共25个品规,药价降幅高达71.33%,未中选药品价格下降4.68%,整体而言,心血管疾病患者日治疗费用下降41.23%。同时我院集采中选药品DDDs值增加11.56%,DDC下降59.17%,呈现药品“降价”不“减量”现象。通过进一步分析,我院临床用药选择倾向与药品本身药理特性、指南推荐等因素密切相关,受药品集采政策影响相对较小,而大多数集采药品DDDs呈现的先降后升的变化趋势,可能与政策执行初期临床医生对集采药品存在不信任等因素有关。结论:药品集采政策的实施对于降低心血管疾病患者的治疗费用有显著意义,而药物利用评价有利于分析临床用药倾向和发掘问题。Objective:To analyze the impact of the drug centralized procurement program on the utilization of cardiovascular drugs,and to confirm the economic effectiveness of generic drug substitution strategy,which provide a reference for the improvement of medical related policy.Methods:A dynamic analysis of the cardiovascular drugs on sales amount,consumption volumes,DDDs and DDC from January 2018 to October 2021 was performed in Tongji Hospital affiliated to Tongji Medical College.Results:There were a total of 25 drugs involved in the centralized procurement in hospital for the treatment of cardiovascular diseases,and the unit price of drugs dropped significantly,up to 71.33%.And the prices of the drugs that were not selected also decreased by 4.68%.Thus,the overall defined daily cost for the treatment of cardiovascular diseases decreased by 41.23%.Meanwhile,the DDDs value of selected drugs in the centralized procurement increased by 11.56%,but DDC decreased by 59.17%during the four years,which shown the phenomenon of"price reduction"but not"quantity reduction".The further analysis showed that the clinical drug selection was closely related to the pharmacological characteristics of drugs and the recommendations of guideline,was not the policy of the drug centralized procurement program.The DDDs values of most selected drugs were decreased in first,and then increased,which may reflect that there was inadequate trust of the clinician in the beginning of policy implementation in Tongji Hospital affiliated to Tongji Medical College.Conclusion:The implementation of the drug centralized procurement program has significant benefits in reducing the treatment costs to patients with cardiovascular disease,and the drug utilization research is conducive to analyzing the tendency of clinical drug selection and finding problems related to policy implementation.

关 键 词：集中采购 费用 药物 药物利用评价 心血管药物 药品集中带量采购 用药频度 限定日费用 

分 类 号：R95[医药卫生—药学]