摘要
目的 对比国家药品集采政策执行前、后的口服降糖药用药数据,分析和探讨国家药品集采政策对县级医院口服降糖药使用的影响,为相关用药目录的调整提供参考。方法 检索医院HIS系统,筛选目标药物,确定其限定日剂量(DDD)值,采用Microsoft Excel 2019导出集采前、后口服降糖药的用药数据,进行分类整理,统计对比用药频度(DDDs)、限定日费用(DDC)、排序比(B/A)、仿制药替代率和药费节省率等评价指标。结果 共纳入15个品种的口服降糖药,涉及23个品规,集采目录内的品种、品规,分别占比为66.67%,57.89%;总体上共节省药费565 407.11元,合计药费节省率为32.01%;进口原研药降价后的价格仍高出集采目录内的国产仿制药72.84%~3555.56%;国产仿制品规占比由40.00%增至58.82%,DDDs占比由69.85%增至72.92%;双胍类、磺脲类、α-糖苷酶抑制剂和格列奈类的B/A值增幅范围为37.50%~566.67%;二肽基肽酶4抑制剂(DPP-4i)和钠-葡萄糖协同转运蛋白2抑制剂(SGLT-2i)的DDDs增加值占DDDs增加总额的67.55%,其药费增长额度占未实现药费节省药物的药费增长总额的80.58%,DDDs占比分别增加了8.95%和3.02%。结论集采后,通过主动优化用药结构,优先配备了政策目录内药品,降低了县级医院的药品运营成本,减轻了基层患者的用药负担,国产仿制药实现了“价低量增”,形成了“老药”基础降糖,“新药”兼顾心肾的用药思路,从而为县级医院口服降糖药的目录调整和使用提供一定参考。
Objective To compare the drug use data of oral antidiabetic drugs before and after the implementation of National Policy for Pooled Procurement of Medicines,and analyze and discuss the influence of the policy on the usage of oral antidiabetic drugs in county-level hospital and to provide reference for the adjustment of relevant medicine catalogue.Methods The hospital's HIS system was searched to screen out target drugs,determine their defined daily dose(DDD) value,and use Microsoft Excel 2019 to export the drug use data of the oral antidiabetic drugs before and after the implementation of policy.The evaluation indicators such as drug use frequency(DDDs),limited daily cost(DDC),ranking ratio(B/A),generic drug substitution rate,and drug cost saving rate were used.Results 15 varieties of oral antidiabetic drugs were included,involving 23 drug specifications,and the varieties and specifications listed in the pooled procurement catalog accounted for 66.67 % and 57.89 %,respectively.In general,a total of 565 407.11Yuan of drug costs were saved,and the total drug cost saving rate was 32.01 %.The price of original drugs was 72.84 %-3555.56 % higher than that of the generic drugs involved in the pooled procurement catalog.The proportion of generic specifications increased from 40.00 % to 58.82 %,and the proportion of DDDs increased from 69.85 %to 72.92 %.The B/A value of biguanides,sulfonylureas,α-glycosidase inhibitors and glinides increased from 37.50 %to 566.67 %.The added value of DDDs of dipeptidyl peptidase-4 inhibitor(DPP-4i) and sodium-glucose linked transporter 2 inhibitor(SGLT-2i) accounted for 67.55 % of the total increase of DDDs,and the increase of drug cost accounts for 80.58 % of the total increase of unrealized drug cost savings.For DPP-4i and SGLT-2i,the proportion of DDDs increased by 8.95 % and 3.02 %,respectively.Conclusion After the implementation of the policy,by active optimization of the drug use structure and giving priority to drugs involved in the pooled procurement catalog,the drug operation cost of county-level hospital is reduced,and the drug burden of the basic unit patients is reduced.Generic drugs have achieved “low price and increased usage”,and the medication idea that based on use of “old drugs” for reducing blood glucose and “new drugs” for giving attention to heart and kidney has been formed.This achievement can provide reference for the catalog adjustment and use of oral antidiabetic drugs in county-level hospital.
作者
李岩
李凤
王安翠
孙晶
化晓凯
LI Yan;LI Feng;WANG An-cui;SUN Jing;HUA Xiao-kai(Xintai Hospital of Traditional Chinese Medicine,Xintai Branch of Qingdao University Medical Group,Taian 271200,China;The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)
出处
《食品与药品》
CAS
2024年第4期359-366,共8页
Food and Drug
基金
山东省医药卫生科技计划项目(编号:202213040609)
山东省药品临床综合评价项目(编号:2021YZ003)。
关键词
口服降糖药
县级医院
国家药品集采
药品使用数据
回顾性分析
oral antidiabetic drug
county-level hospital
National Policy of Pooled Procurement of Medicines
drug use data
retrospective analysis
