艾滋病抗病毒治疗药物使用情况分析——以B市为例  

Utilization of antiretroviral drugs for aids treatment:a case study of City B

作　　者：朱正 韩润之 张佳伟 杨莉[1] ZHU Zheng;HAN Runzhi;ZHANG Jiawei;YANG Li(School of Public Health,Peking University,Beijing 100191)

机构地区：[1]北京大学公共卫生学院,北京100191

出　　处：《中国艾滋病性病》2025年第3期273-277,共5页Chinese Journal of Aids & STD

基　　金：国家自然科学基金项目(72174010,71673004)。

摘　　要：目的 本研究以B市为例,对HIV/AIDS患者的cART药物的使用情况进行分析,探讨cART药物使用情况变迁。方法 采用WHO推荐的限定日剂量(DDD)分析方法,分别对B市2016-2021年门诊患者艾滋病国家免费药物、医保谈判药物、自费药物的日均费用(DDC)、用药频度(DDDs)、药物支出进行描述性分析。结果 国家免费药物拉米夫定、富马酸替诺福韦二吡呋酯片的DDC仅有0.30元,恩曲他滨替诺福韦片在集采政策后,2021年DDC降为22.00元;在DDDs方面,医保谈判药物从0.08万DDD增长到58.19万DDD,自费药物从0.30万DDD增长到5.94万DDD。药物支出方面,国家免费药物2020-2021年从1 291.01万元降至1 143.57万元,医保谈判药物2016-2021年从5.33万元增长到2 497.08万元,自费药物2016-2021年从20.28万元增长到227.59万元。2021年,国家免费药物的药物支出占比29.56%、医保谈判药物为64.55%、自费药物为5.88%。结论 B市的国家免费药物的DDC普遍低于医保谈判药物与自费药物,保障了众多患者的基本治疗需求;从用药频度来看,B市的国家免费药物总DDDs先升后降,医保谈判药物和自费药物的总DDDs逐年升高,患者对药物的选择更加多元化,药物可及性大幅提高。Objective This study aimed to analyze the utilization of combination antiretroviral therapy(cART) drugs in HIV/AIDS patients in City B as an example and to explore the changes in cART drug usage over time. Methods Following the World Health Organization(WHO) recommended Defined Daily Dose(DDD) methodology, this study conducted a descriptive analysis of the daily drug cost(DDC), drug utilization frequency(DDDs), and total drug expenditure for nationally free, insurance-covered, and self-funded drugs among HIV/AIDS outpatients in City B from 2016 to 2021. Results The DDC of national free drugs, such as lamivudine and tenofovir disoproxil fumarate tablets,was as low as 0.30 yuan, while the DDC of emtricitabine/tenofovir tablets dropped to 22.00 yuan after the implementation of the centralized procurement policy in 2021. In terms of DDDs, the utilization of insurance-covered drugs increased from 800 to 581 900 DDDs, and self-funded drugs increased from 3 000 to 59 400 DDDs. Regarding total drug expenditure, nationally free drugs decreased from 12.910 1 million yuan in 2020 to 11.435 7 million yuan in 2021, while insurance-covered drugs surged from 53 300 yuan in 2016 to 24.970 8 million yuan in 2021, and self-funded drugs rose from 202 800 yuan to 2.275 9 million yuan over the same period. In 2021, nationally free drugs accounted for 29.56% of the total expenditure, insurance-covered drugs for 64.55%, and self-funded drugs for 5.88%. Conclusions The DDC of nationally available free drugs in City B was generally lower than that of insurance-covered and self-funded drugs,ensuring the basic treatment needs of patients. From the perspective of drug utilization frequency, the total DDDs of nationally free drugs in City B initially increased and then declined, whereas the total DDDs of insurance-covered and selffunded drugs steadily increased. This reflects greater diversity in drug choices and a significant improvement in drug accessibility for patients.

关 键 词：艾滋病 医保谈判 抗病毒治疗 药物使用 

分 类 号：R512.91[医药卫生—内科学]