集中带量采购政策相关的口服抗菌药物使用量及费用的中断时间序列分析  

Changes in the Use and Cost of Oral Antimicrobials Related to Centralized Volume-based Procurement Policy: An Interrupted Time-series Analysis

作　　者：过佳月 陈大宇 张海霞[1,3] GUO Jiayue;CHEN Dayu;ZHANG Haixia(Department of Pharmacy,China Pharmaceutical University Nanjing Drum Tower Hospital,Nanjing 210008,China;School of Basic Medicine and Clinical Pharmacy,China Pharmaceutical University,Nanjing 210009,China;Nanjing Medical Center for Clinical Pharmaceutical,Nanjing 210008,China)

机构地区：[1]中国药科大学南京鼓楼医院药学部,南京210008 [2]中国药科大学基础医学与临床药学学院,南京210009 [3]南京临床药学中心,南京210008

出　　处：《药学与临床研究》2023年第4期374-379,共6页Pharmaceutical and Clinical Research

基　　金：江苏省药学会恒瑞医院药学基金科研项目(H202106)。

摘　　要：目的:探究集中带量采购(集采)政策对医疗机构口服抗菌药物使用变化的影响,为医疗机构口服抗菌药物的管理提供参考。方法:采用中断时间序列方法,将2020年1月设为新冠疫情带来的第一个干预时间点,2020年5月设为集采政策带来的第二个干预时间点,分析2019年5月~2021年4月本院前三批口服抗菌药物集采品种及其替代药物月度使用量、费用的变化。结果:集采政策实施后,所有纳入的口服抗菌药物总体使用量较集采政策前同比减少9.16%,但中断时间序列分析结果显示,集采政策后整体呈上升趋势。集采与非集采口服抗菌药物的使用量在集采政策后均显著上升,总费用则显著下降,符合集采政策减轻患者用药负担的目标。其中集采口服抗菌药物总费用下降极为显著,较集采政策前同比下降了78.42%,模型分析显示集采药物的费用在大幅下降的基础上持续平缓下降;而非集采药物的总费用在政策实行后增加了27.55%,呈显著上升趋势。结论:集采政策促使医疗机构药品价格下降,有助于减轻患者用药负担;而显著增加对口服集采抗菌药物使用量。医疗机构对抗菌药物合理使用需要进一步加强。Objective:To explore the changes in the use and cost of centralized volume-based procurement policy-related oral antibiotics and to provide references for the management of antibiotics in medical institutions.Methods:Using the interrupted time series analysis,January 2020 was set as the first point of intervention brought about by the lockdown,May 2020 was set as the second intervention time point,and the changes in the monthly usage and cost of centralized volume-based procurement policy-related oral antibiotics were collected and analyzed in a tertiary hospital from May 2019 to April 2021.Results:After the implementation of the centralized drug volume-based procurement policy,the overall usage of antibiotics involved decreased by 9.16%compared with that before the policy,but the results of the interrupted time series analysis showed an overall upward trend after the implementation of the policy.Both the use of centralized and non-centralized procurement antibiotics showed a significant upward trend after the implementation of the policy.And the total cost of the included drugs showed a significant downward trend,which was in line with the objective of the policy to reduce cost burden of drugs.Among them,the total cost of centralized procured drugs dropped significantly,decreasing by 78.42%after the policy was implemented,while that of non-centralized procured drugs increased by 27.55%,showing a significant upward trend.Conclusion:The policy can reduce the cost of drugs in medical institutions,which reduces the burden of medication for patients,and is associated with the significant increases in volume of policy-related antibiotics.More efforts are needed in the appropriate use of antibiotics in medical institutions.

关 键 词：集中带量采购政策 口服抗菌药物 中断时间序列分析 使用量 费用 

分 类 号：R95[医药卫生—药学]