摘要
目的评估国家组织药品集中采购和使用试点改革政策执行过程中采取不同改进措施对达成带量采购任务目标的影响和效果。方法调取本单位2019年3月26日~10月31日以及2018年同期门诊用药、处方量及费用数据,利用Excel对数据进行统计分析。结果本单位历经观察期、停单个品种期、ARB类降压药品类管理期以及大类降压药品类管理期四个阶段的探索改进,停用其他厄贝沙坦时,厄贝沙坦总体的日均使用总量从629片/d减少到474片/d,而ARB(血管紧张素受体拮抗剂)同类药替米沙坦和缬沙坦日均使用量却分别增加了19片/d,7片/d,日均处方数下降1.71张,难以如期完成任务;在进行大类降压药品类管理中标品厄贝沙坦的日均完成进度最快达0.62%/d,可提前4个月完成,且单张处方金额环比降幅最大9.64元,日均处方量增加2.53张。结论国家组织药品带量采购和使用政策执行过程中广泛存在"花洒效应",据此进行品类管理可合理加快完成进度的同时增加日均处方数,降低单张处方金额从而提高患者药品可及性,降低经济负担。
Objective Evaluate the effect of different improvement measures adopted by our hospital in the implementation of the pilot of volume based purchase policy.Methods Data of outpatient drug use,prescription amount and cost were collected from March 26 th,2019 to October 31 st,2019 and the same period in 2018.Statistical analysis was conducted with Excel.Results The unit has gone through four stages of exploration and improvement,namely,observation period,withdrawal of single variety period,category management period of ARB class antihypertensive drugs and category management period of all antihypertensive drugs.When stopping using other irbesartan,the total daily use in irbesartan declined from 629 tablets per day to 474 tablets per day.However,the daily use of similar ARB drugs telmisartan and valsartan increased by 19 tablets/day and 7 tablets/day,respectively,with an average daily decrease of 1.71 prescriptions and can’t complete the task on time;.In category management period of all antihypertensive drugs,the daily completion progress of the winning-drug irbesartan reached 0.62%per day at the fastest speed.It can be completed 4 months in advance,and the amount of a single prescription decreases by the maximum 9.64 yuan month-on-month,and the average daily prescription volume increases by 2.53.Conclusion Shower effect is widely found in the implementation process of pilot of volume based purchase policy.Based on which,category management can reasonably speed up the progress,increase the number of daily prescriptions and reduce the money of single prescriptions,so as to improve drug accessibility and reduce the economic burden for patients.
作者
李超群
王静
黄艳丽
曾庆秋
马希丹
叶静雪
罗晓露
LI Chao-qun;WANG Jing;HUANG Yan-li(Community Health Service Center,South Railway Station,Wuhou District,Chengdu 610041,China;Center for Pharmaceutical Policy and Pharmacoeconomics,West China School of Pharmacy,Sichuan University,Chengdu,610041 China;Department of Science and Information,Wuhou District Health and Planning Bureau,Chengdu 610041,China)
出处
《中国处方药》
2020年第7期9-12,共4页
Journal of China Prescription Drug
关键词
集中带量采购
品类管理
厄贝沙坦
花洒效应
降压药
Volume based purchase
Category management
Irbesartan
Shower effect
Antihypertensive drugs
