带量采购政策下他汀类药物在上海某院的应用情况分析-中国药房

带量采购政策下他汀类药物在上海某院的应用情况分析

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篇名：	带量采购政策下他汀类药物在上海某院的应用情况分析
TITLE：	Analysis of Statins Use in a Shanghai Hospital under the Policy of Drug Quantity Purchasing
摘要：	目的：探讨上海市第三批带量、国家“4+7”带量采购政策在上海某医院的实施效果及对该院他汀类药物使用情况的影响。方法：收集该院信息系统中上海市第三批带量采购执行前（2018年2月10日－8月31日）、上海市第三批带量采购执行后（2018年9月1日－2019年3月19日）“、4+7”带量采购执行后（2019年3月20日－10月9日）的他汀类药物消耗用量（片）及销售金额，并按《新编药物学》及相关药品说明书推荐的药物限定日剂量（DDD）分别计算各他汀类药物在上述3个时间段内的用药频度（DDDs）、日均费用（DDC），从而分析上海市第三批带量采购及国家“4+7”带量采购政策的实施对该院他汀类药物应用情况的影响并预测各品规在该院的市场份额走势。结果与结论：上海市第三批带量采购执行前，该院在院的他汀类药物有5个品种、8个品规；实施带量采购后，调整为5个品种、9个品规。辛伐他汀片的用量总体较小，其销售金额在实施带量采购后也持续下降。瑞舒伐他汀钙片在实施带量采购前的用量占比达49.49％，排名第1位；在执行上海市第三批带量采购后，其用量占比降至30％以下，销售金额占比由37.82％降低至18.77％；执行国家“4+7”带量采购后，销售金额占比继续下降至17.38％。阿托伐他汀钙片的用量占比在执行上海市第三批带量后明显上升，由原来的41.55％上升至54.09％，在执行国家“4+7”带量采购后略有下降，但其用量占比仍高达53.06％，排名第1位；在带量采购前后其用药金额占比均排名第1位，均保持在50％左右，分别为52.87％、61.18％、46.50％，与执行上海市第三批带量前相比，其仿制药品规用量上升了40.32％，但金额下降了78.18％。普伐他汀钠片与匹伐他汀钙片无带量采购中选品种，用量占比虽持续上升，但总体占比较小。他汀类药物在中选带量采购目录后价格下降明显。预计辛伐他汀在该院的市场份额将继续缩减，阿托伐他汀则可能会继续扩大，而瑞舒伐他汀受限于不良反应较多其可扩大的空间有限，普伐他汀占比不大但仍有患者需求，匹伐他汀因是新药其在该院的应用尚需更多的临床数据支持。
ABSTRACT：	OBJECTIVE：To investigate the effects of the third batc h of Shanghai drug quantity purchasing and national “4+7” drug quantity purchasing in a Shanghai hospital and its impact on the use of statins. METHODS ：Consumption amount （tablets） and sum of statins were collected from information system of this hospital before （Feb. 10th-Aug. 31th，2018）and after （Sept. 1th，2018-Mar. 19th，2019）the implementation of the third batch of Shanghai drug quantity purchasing ，after the implementation of national “4+7”drug quantity purchasing （Mar. 20th-Oct. 9th，2019）. The defined drug frequency （DDDs）and average defined daily cost （DDC） of above 3 periods were calculated according to drug defined daily dose （DDD） recommended by New Pharmacology and related drug instructions ，so as to analyzethe influence of the third batch of Shanghaidrug quantity purchasing and national “4+7”drug quantity purchasing on the use of statins in this hospital and predict the market share trend of each specification in this hospital. RESULTS & CONCLUSIONS ：Before the implementation of the third batch of Shanghaidrug quantity purchasing，there were 5 varieties and 8 specifications of statins in this hospital ；after the implementation of quantity purchasing ，it was adjusted to 5 varieties and 9 specifications. The amount of Simvastatin tablets was small in general ，and its consumption sum also continued to decline after the implementation of quantity purchasing. The amount of Rosuvastatin calcium tablets accounted for 49.49％ before the implementation of quantity purchasing ，ranking the first ；after the implementation of 3 batches of Shanghai drug quantity purchasing ， the amount proportion decreased to Δ 基金项目：上海市科学技术委员会科研计划项目（No.19ZR1450- 600） below 30％，and consumption sum proportion decreased from ＊本科。研究方向：医药市场研究与分析。电话：021- 37.82％ to 18.77％；after the implementation of national “4+ 54237308。E-mail：2123398711@qq.com 7”drug quantity purchasing ，the consumption sum proportion # 通信作者：副主任药师，博士。研究方向：临床药学。电话： continued to decline to 17.38％ .The amount of Atorvastatin 021-65690520。E-mail：Hongjun.chen@tongji.edu.cn calcium tablets increased significantly after the implementation 中国药房 2021年第32卷第2期 China Pharmacy 2021Vol. 32 No. 2 ·247· of the thi rd batch of Shanghaidrug quantity purchasing ，from 41.55％ to 54.09％，and decreased slightly after the implementation of the national “4+7”drug quantity purchasing ，but the amount proportion was still as high as 53.06％，ranking the first ；before and after the implementation of quantity purchasing ，the proportions of its consumption sum were ranked the first ，which remained at about 50％，being 52.87％，61.18％ and 46.50％，respectively. Compared with the amount before the implementation of the third batch of Shanghaidrug quantity purchasing ，the amount of its generic drugs increased by 40.32％，but the consumption sum decreased by 78.18％. Any one type of Pravastatin sodium tablets and Pitavastatin calcium tablets was not selected ；the proportion of them was increased continuously ，but the overall proportion was relatively small. The price of statins decreased significantly after included in quantity purchasinglist. It is expected that the market share of simvastatin in thise hospital will continue to shrink ，and that of atorvastatin may continue to expand. Due to more adverse reactions ，rosuvastatin has limited room to expand ，and pravastatin accounts for a small proportion ，but there is still a demand for patients. Because pitavastatin is a new drug ，its application in this hospital needs more clinical data support.
期刊：	2021年第32卷第02期
作者：	张弦，陈红君
AUTHORS：	ZHANG Xian，CHEN Hongjun
关键字：	带量采购；上海市第三批带量采购；国家“4+7”带量采购；他汀类药物；辛伐他汀；瑞舒伐他汀；阿托伐他汀；匹伐他汀；普
KEYWORDS：	Drug quantity purchasing ；Third batch of Shanghai drug quantity purchasing ；National“4 + 7”drug quantity
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