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广西医疗机构落实国家药品集中带量采购政策的效果分析
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| 篇名： | 广西医疗机构落实国家药品集中带量采购政策的效果分析 |
| TITLE： | Analysis of the effects of national centralized drug volume-based procurement policy in public medical institutions of the Guangxi Zhuang Autonomous Region |
| 摘要： | 目的 探讨国家药品集中带量采购政策（后文简称“国家集采政策”）在广西壮族自治区的实施效果，为医疗机构后续开展集采药品相关工作提供参考。方法选取广西壮族自治区医疗机构国家集采政策实施前后的药品采购数据，以政策目标、利益相关方关注的问题等为导向，引入并研究6个二级指标（如可获得性、可负担性、药品安全性等）、18个三级指标（如约定采购量完成率、负担水平、药占比等）。采用描述性统计方法对国家集采政策实施前后（2019年和2020年）的数据进行差异性、变化趋势等分析。结果在可获得性方面：广西壮族自治区医疗机构参与度为92.55%，疾病覆盖率为40.16%，整体约定采购量完成率中值为287.82%，总体配送率为97.20%。在可负担性方面：2019－2022年药品价格总体的降幅为74.80%，人均住院药品费用、门诊药占比、住院药占比降幅依次为17.61%、10.22%、20.10%，除慢性病、抗肿瘤用药外，药品可负担水平均低于1。对医药的影响：2022年药品不良反应事件占比为66.00%，相比执行国家集采政策前增幅为1.29%，广西壮族自治区通过一致性评价的药品共12个品规，前8名的制药企业的市场集中度小于20.00%。对医疗医保的影响：直至2022年基本实现仿制药替代原研药，同类非中选药品使用比约为9.12%，未提出二次换药的人数占63.39%；药品费用支出减少共24.59亿元。结论国家集采政策在广西壮族自治区取得了显著的效果，但同时还需重点关注扩大专科病种用药覆盖面、中选药品的临床综合评价、优化待分配量选择方案等问题。 |
| ABSTRACT： | OBJECTIVE To investigate the implementation effects of the national centralized drug volume-based procurement policy （abbreviated as “national centralized procurement policy”） in Guangxi Zhuang Autonomous Region prefecture， and to provide a reference for the future centralized drug procurement work of the medical institution. METHODS Drug procurement data before and after policy implementation were included in the study. The six secondary indicators （such as availability， affordability， and drug safety） and eighteen third-level indicators （such as completion rate of agreed purchase volume， affordability level， drug revenue proportion） were introduced， guided by the policy objectives and issues of concern to policy beneficiaries. Descriptive statistics was adopted to analyze the data before and after policy implementation （in 2019 and 2020） in terms of differences and change trends. RESULTS In terms of accessibility， the participation rate of medical institutions in Guangxi Zhuang Autonomous Region was 92.55%， the proportion of diseases involved and median completed procurement rate were 40.16%， and 287.82% respectively， and the total centralized delivery rate was 97.20%. In terms of affordability， the total reduction amplitude in drug price was 74.80% from 2019 to 2022； the charge for medicine per capita in hospitalization， the proportion of medicine used for outpatient service and hospitalization， decreased by 17.61%， 10.22%， and 20.10% in order； the burden levels on medical fares for patients were all below 1 in addition to chronic diseases， and anti-tumor drugs. In terms of the impact on medicine， the ratio of adverse drug reaction event cases in 2022 was 66.00%， an increase of 1.29% compared to the previous； since the implementation of the policy， 12 drugs from local pharmaceutical enterprises from Guangxi Zhuang Autonomous Region had passed the consistency evaluation， and the market concentration rate of the top 8 pharmaceutical companies was less than 20.00%. In terms of the impact on healthcare and medical insurance， the public medical institutions achieved generic substitution for originator drugs mostly until 2022； about 9.12% of drugs that were non- centrally purchased in the same category were used； 63.39% of people under investigation did not show a need for a second dressing change； drug expenditure decreased by 2.459 billion yuan. CONCLUSIONS The national centralized procurement policy achieves a significant effect in Guangxi Zhuang Autonomous Region. On the other hand， attention should be paid to these suggestions as follows: expanding the category of drugs used in clinic， conducting clinically comprehensive evaluation of selected drugs， and improving reasonable allocation strategy， etc. |
| 期刊： | 2024年第35卷第05期 |
| 作者： | 曾铮；巫柳岑；黄振光；何文莉；宓郑成；谢祥威；苏思多；梁桂诚；廖遥灵；张宏亮 |
| AUTHORS： | ZENG Zheng，WU Liucen，HUANG Zhenguang， HE Wenli，MI Zhengcheng，XIE Xiangwei，SU Siduo，LIANG Guicheng，LIAO Yaoling，ZHANG Hongliang |
| 关键字： | 国家药品集中带量采购政策；广西壮族自治区；实施效果；可获得性；可负担性；药品安全性；制药企业影响力 |
| KEYWORDS： | national centralized drug volume-based procurement policy； Guangxi Zhuang Autonomous Region； implementation |
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