集采背景下医疗机构抗高血压药物使用现状及分析  

Analysis of the current status of antihypertensive drug use in medical institutions under centralized procurement

作　　者：曾慧琳 邓艾平[1] 赖永继 周迎迎 ZENG Huilin;DENG Aiping;LAI Yongji;ZHOU Yingying(Department of Pharmacy,the Central Hospital of Wuhan,Tongji Medical College of Huazhong University of Science&Technology,Hubei Wuhan 430014,China;Department of Pharmacy,Suzhou Hospital of Traditional Chinese Medicine,Jiangsu Suzhou 215000,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院药学部,湖北武汉430014 [2]苏州市中医医院药学部,江苏苏州215000

出　　处：《中国医院药学杂志》2025年第7期820-826,共7页Chinese Journal of Hospital Pharmacy

基　　金：中国光华科技基金会项目(编号:院横2022-096)。

摘　　要：目的:分析研究集采背景下医疗机构抗高血压药物使用现状,为相关的政策制定完善及药事管理优化提供重要的参考依据。方法:以武汉市中心医院为样本,采用药物经济学方法对药品集中带量采购政策执行前后抗高血压药的价格、用药频度(defined daily doses,DDDs)、使用金额、限定日费用(defined daily cost,DDC)、实际节省费用等指标研究分析。结果:带量采购执行后,抗高血压药物整体单片价格降幅29.70%,中选药品降幅62.58%,非中选药品降幅17.49%,可替代药品降幅6.18%,其他药品降幅40.33%。借助信息化手段管理带量采购药品,执行后第4年,抗高血压药物整体DDDs增长16.74%,使用金额下降52.08%,DDC下降58.95%,呈“量升价降”的关系。其中,中选药品整体DDDs增长930.19%,使用金额仅增长60.85%;非中选药品整体DDDs下降72.26%,使用金额下降75.89%;可替代药品整体DDDs下降33.11%,使用金额下降37.64%,但其中阿利沙坦酯片、盐酸阿罗洛尔片及甲磺酸多沙唑嗪缓释片等DDDs增长明显;其他药品整体DDDs增长527.84%,使用金额增长478.08%。抗高血压药执行集采后2020年至2023年实际节省费用共计2693.10万元,总体费用节省率为35.44%,集采涉及药品实际节省费用共计1930.08万元,可替代药品费用增加8.51万,其他药品实际节省费用共计771.53万元。结论:药品集中带量采购的执行实施,从根源上解决了“药价虚高”的难题,中选药基本取代非中选药品,明显降低了药品费用,切实减轻了患者的药费负担。建议进一步加强可替代和其他药品监控,不断推进并扩大集中带量采购范围。OBJECTIVE To analyze the current status of antihypertensive drugs used in medical institutions within the context of centralized procurement,thus providing valuable insights into policy development and the optimization of pharmaceutical management.METHODS A sample was taken from The Central Hospital of Wuhan.Pharmacoeconomic methods were adopted to examine various indicators before and after the implementation of the centralized procurement policy,including drug prices,defined daily doses(DDDs),expenditures,defined daily cost(DDC),and actual savings.RESULTS Following the implementation of quantity-based centralized procurement,the overall price per unit of antihypertensive drugs decreased by 29.70%.Specifically,there was a price reduction of 62.58%,17.49%,6.18%,and 40.33% in the selected drugs,nonselected drugs,alternative drugs and other drugs,respectively.After four years of implementing quantity-based centralized procurement via an informatization management,there were 16.74%increase in the overall DDDs for antihypertensive medications,52.08%decrease in the expenditures,and 58.95% decrease in the DDC,indicating a trend where volume increased while price decreased.Notably,DDDs for selected drugs surged by 930.19%,with expenditures rising only by 60.85%.Conversely,DDDs for non-selected drugs plummeted by 72.26%alongside a 75.89%drop in expenditures.DDDs for alternative drugs decreased by 33.11%with a corresponding decline in expenditures of 37.64%.Certain medications,such as Aliskiren tablets,Arotinolol hydrochloride tablets,and Doxazosin mesylate sustained-release tablets,showed significant increases in DDDs.Meanwhile,other drugs experienced a DDD increase of 527.84% with expenditures rising by 478.08%.From 2020 to 2023,the actual savings from antihypertensive drug procurement amounted to ¥26.931 million,resulting in an overall cost-saving rate of 35.44%.The actual savings for involved drugs totaled ¥19.301 million,while expenditures on alternative drugs increased by ¥85100,and savings from other drugs reach

关 键 词：带量采购 抗高血压药 药事管理 节省费用 

分 类 号：R952[医药卫生—药学]