浙江省11家医院2013-2017年抗抑郁药使用分析
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篇名: 浙江省11家医院2013-2017年抗抑郁药使用分析
TITLE:
摘要: 目的:了解浙江省抗抑郁药的使用情况,为促进临床合理用药提供参考。方法:采用世界卫生组织推荐的限定日剂量(DDD)分析法,对浙江省11家医院2013-2017年抗抑郁药的销售金额、主要品种、用药频度(DDDs)和日均费用(DDC)及排序比(B/A值,即为某药品销售金额排序/某药品DDDs排序,该值<1说明药品价格较高,反之说明药品价格较低)等进行统计分析。结果:浙江省11家医院2013-2017年抗抑郁药销售金额逐年上升,由2013年的323.52万元上升至2017年的456.91万元,但抗抑郁药占所有药物销售金额的比例较稳定,约在0.47%~0.50%之间;氟西汀、度洛西汀、奥氮平以及文拉法辛的销售金额较高,占比维持在前5位,艾司西酞普兰的销售金额占比涨幅较大(占比由2013年的第8位上升至2017年的第1位);5年内,氟西汀、帕罗西汀以及舍曲林的DDDs基本均位列前3,奥氮平、喹硫平以及度洛西汀的DDC位列前3;总体上B/A值<1的药物包括度洛西汀、奥氮平、文拉法辛以及喹硫平等,B/A值>1的药物有帕罗西汀和舍曲林。结论:浙江省11家医院抗抑郁药的临床使用结构较为合理,选择性5-羟色胺(5-HT)再摄取抑制剂和选择性5-HT和去甲肾上腺素(NE)再摄取抑制剂两类药物占据主导地位;新型抗抑郁药艾司西酞普兰体现出较好的临床前景。
ABSTRACT: OBJECTIVE: To investigate the application of antidepressants in Zhejiang province and to provide reference for rational drug use in clinic. METHODS: WHO-recommended defined daily dose (DDD) method was used to statistically analyze consumption sum, main types, defined daily dose system (DDDs), daily drug cost (DDC) and ranking ratio (B/A value, i.e. consumption sum rank/DDDs rank, B/A<1 means the price of drugs was higher, whereas the price of drugs was lower) of antidepressant drugs in 11 hospitals from Zhejiang province during 2013-2017. RESULTS: The consumption sum of antidepressants was increased year by year in 11 hospitals from Zhejiang during 2013-2017, and increased from 3 235 200 yuan in 2013 to 4 569 100 yuan in 2017; the proportion of consumption sum of antidepressants in total consumption sum of all drugs kept stable, ranging from 0.47% to 0.50%. The top 5 drugs by consumption sum were fluoxetine, duloxetine, olanzapine and venlafaxine; consumption sum of escitalopram accounted for a larger increase (proportion ration increased from 8th place in 2013 to first place in 2017). Within 5 years, DDDs of fluoxetine, paroxetine and sertraline took up the first 3 place; DDC of olanzapine, quetiapine and duloxetine took up the first 3 place; the drugs with B/A value<1 included duloxetine, olanzapine, venlafaxine and quetiapine, etc; the drugs with B/A value>1 were paroxetine and sertraline. CONCLUSIONS: The use of antidepressant drugs in 11 hospitals from Zhejiang province is rational in structure; selective 5-hydroxytryptamine (5-HT) reuptake inhibitors (SSRI), selective 5-HT and noradrenaline reuptake inhibitor (SNRI) take up the predominant place. New antidepressant drug escitalopram shows a good clinical prospect.
期刊: 2019年第30卷第5期
作者: 王丽,吴凡
AUTHORS: WANG Li,WU Fan
关键字: 抗抑郁药;销售金额;用药频度;日均费用;用药分析;浙江省
KEYWORDS: Antidepressants; Consumption sum; Defined daily dose system; Daily drug cost; Analysis of drug use; Zhejiang province
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