药品集中带量采购政策实施后某医院抗精神病药物的使用情况分析  

Analysis of the use of antipsychotics in a hospital after the implementation of the centralized bulk-buying policy for drugs

作　　者：贾晓妮[1] 叶根洋 陈建波[2] 李欢 支丽娟 田玉梅[3] 成昱霖[2] 张晓红[2] JIA Xiaoni;YE Genyang;CHEN Jianbo;LI Huan;ZHI Lijuan;TIAN Yumei;CHENG Yulin;ZHANG Xiaohong(Central Laboratory,Xi'an Mental Health Center,Xi'an,Shaanxi 710100,China;Department of Pharmacy,Xi'an Mental Health Center,Xi'an,Shaanxi 710100,China;Department of Psychiatric Rehabilitation,Xi'an Mental Health Center,Xi'an,Shaanxi 710100,China;Wuya College of Innovation,Shenyang Pharmaceutical University,Shenyang,Liaoning 110016,China)

机构地区：[1]西安市精神卫生中心中心实验室,陕西西安710100 [2]西安市精神卫生中心药剂科,陕西西安710100 [3]西安市精神卫生中心精神康复科,陕西西安710100 [4]沈阳药科大学无涯创新学院,辽宁沈阳110016

出　　处：《安徽医药》2023年第9期1890-1895,共6页Anhui Medical and Pharmaceutical Journal

基　　金：陕西省自然科学基础研究计划项目(2022JQ-861);西安市科技计划项目(21YXYJ0077,21YXYJ0078)。

摘　　要：目的探讨药品集中带量采购政策实施后,在西安市某医院的实施效果以及对该院抗精神病药物使用情况的影响。方法收集西安市精神卫生中心医院信息系统(HIS)中带量采购执行前(2018年3月25日至2019年3月24日)、带量采购执行后(2019年3月25日至2020年3月24日、2020年3月25日至2021年3月24日)销量排名前十的抗精神病药物的用量及销售金额,并按照世界卫生组织官网提供的药物限定日剂量(DDD)值,分别计算各药品在上述3个时间段内的用药频度(DDDs)、日均费用(DDC)从而分析药品集中带量采购政策的实施对该院抗精神病药物使用情况的影响。结果该院的抗精神病药物主要有18个品种、39个品规,该研究收集销量排名前十的品种,包含25个品规。其中奥氮平片(欧兰宁)及利培酮(索乐)降价幅度、DDDs变化均较大,降价幅度分别为58.22%、29.41%;对于DDDs,奥氮平(欧兰宁)降低了44.35%,利培酮片(索乐)降低9.74%;对于DDC,入围带量采购品规的DDC逐渐降低,其中奥氮平片(欧兰宁)和利培酮片(索乐)变化最为明显,奥氮平片(欧兰宁)在带量采购实施前及带量采购后1年、2年的DDC分别为15.05元、9.63元、6.23元,利培酮片(索乐)在带量采购后1年、2年分别为0.84元、0.53元。结论药品的DDDs与DDC的变化幅度逐步向量价挂钩方向发展,但尚有部分药品未体现出线性关系,药品带量采购政策的实施取得了一定成效,多数病人的药品费用逐渐降低,但其中仍存在一定的问题,需要继续完善。Objective To explore the implementation effect of a centralized drug bulk-buying policy at a hospital in Xi'an and its impact on the use of antipsychotics in the hospital.Methods To collect the consumption and sales amount of the top ten antipsychotics in the Hospital Information System(HIS)of Xi'an Mental Health Center before the implementation of bulk-buying(March 25,2018-March 24,2019)and after the implementation of bulk-buying(March 25,2019-March 24,2020,March 25,2020-March 24,2021).According to the drug defined daily dose(DDD)values provided by the official website of the World Health Organization,the frequency(DDDs)and average daily cost(DDC)of each drug were calculated in the above three time periods to analyze the impact of the implementation of the centralized drug bulk-buying policy of medicines on the use of antipsychotics in the hospital.Results There were mainly 18 varieties and 39 grades of antipsychotics in the hospital,and the study collected the top 10 varieties in terms of sales volume,containing 25 grades.Among them,olanzapine tablets(Oulanning)and risperidone(Suole)had greater price reductions and changes in DDDs,with price reductions of 58.22%and 29.41%,respectively;for DDDs,olanzapine tablets(Oulanning)were reduced by 44.35%,and risperidone(Suole)was reduced by 9.74%;as for DDC,the DDC of the shortlisted bulk-buying products gradually decreased,among which the changes of olanzapine tablets(Oulanning)and risperidone tablets(Suole)were the most obvious,and the DDC of olanzapine tablets(Oulanning)were RMB 15.05 yuan,RMB 9.63 yuan,and RMB 6.23 yuan before the implementation of bulk-buying and in one year and two years after the implementation of bulk-buying,and the DDC of risperidone tablets(Suole)was 0.84 yuan,0.53 yuan,and 0.53 yuan,respectively,in one year and two years after bulk-buying.Conclusions The change range of DDDs and DDC of drugs has gradually developed in the direction of vector-price linkage,but there are still some drugs that do not yet reflect a linear relationship.The implemen

关 键 词：集体采购 抗精神病药 费用 药物 带量采购政策 用药情况 

分 类 号：R95[医药卫生—药学]