集中带量采购对公立医疗机构约定采购周期及续约期药品采购的影响  

Impact of National Centralized Volume-Based Drug Procurement on the Agreed Procurement Cycle and Renewal Period Daily Cost in Public Medical Institutions

作　　者：文小桐 刘雨欣 段凤然 王越 赵秋玲[1,2] 吴雨欣 罗佳 毛宗福[1,2] WEN Xiao-tong;LIU Yu-xin;DUAN Feng-ran(School of Public Health,Wuhan University,Wuhan,430071,China;Global Health Institute,Wuhan University,Wuhan,430071,China;不详)

机构地区：[1]武汉大学健康学院,武汉430071 [2]武汉大学全球健康研究中心,武汉430071 [3]武汉大学董辅礽经济社会发展研究院,武汉430065

出　　处：《中国卫生经济》2023年第6期8-12,共5页Chinese Health Economics

基　　金：国家卫生健康委统计信息中心委托项目(09202004、250000193)。

摘　　要：目的:分析集中带量采购对公立医疗机构约定采购周期及续约期药品采购的影响,以期为政策协同提供科学依据。方法:基于两干预点间断时间序列模型,分析2018年1月—2020年12月7个试点城市公立医疗机构药品采购量、采购金额及日均费用的变化特征。结果:集中带量采购品种中原研药、未过评仿制药试点期采购量及其占比水平变化均为下降(P<0.05)。集中带量采购品种中原研药(β_(2)=-0.58,P=0.043)、过评仿制药(β_(2)=-3.18,P<0.001)、未过评仿制药(β_(2)=5.83,P<0.001)试点期日均费用水平变化均具有统计学意义。可替代品种中过评仿制药在试点期政策干预后采购量(β_(3)=19.69,P=0.025)及采购量占比均呈上升趋势,但在续约期政策干预后采购量及采购量占比均呈下降趋势。抗感染药、抗肿瘤药及免疫用药试点期采购量水平变化均具有统计学意义(P<0.05)。结论:加强药品使用监测和合理用药管理,制定并完善挂网采购审核、价格监测、医保支付标准调整等相关配套措施。period daily cost in public medical institutions,so as to provide scientific evidence for Policy synergy.Methods:Based on the Interrupted time-series analysis(ITSA)with two intervention points,the change of purchase volume,expenditure and daily cost of policy-related drug in the public medical institutions from 7 pilot cities during January 2018 and July 2020 were analyzed.Results:The changes in procurement volume and its share of the level of the pilot period for the original drugs and the generic drugs did not pass the CEQE among the centralized volume-based drug procurement are all decreased(P<0.05).The change in the level of the daily cost were statistically significant among original drugs(β_(2)=-0.58,P=0.043),generic which passed the CEQE(β_(2)=-3.18,P<0.001)and generic which did not pass the CEQE(β_(2)=5.83,P<0.001)in the pilot period.The procurement amount(β_(3)=19.69,P=0.025)and the proportion of generic which passed the CEQE during the pilot period were all increased,while the procurement amount and the proportion after the intervention were all decreased.Different ATC classified drugs of selected drugs showed that the levels of anti-infective drugs,anti-tumor and immune drugs increased significantly(P<0.05).Conclusion:It needed to strengthened clinical drug use monitoring and management,design and improve the supporting measures such as price monitoring,adjustment of medical insurance payment standards.

关 键 词：药品集中带量采购 间断时间序列分析 日均费用 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R19-0