摘要
目的:分析郑州市第二人民医院(简称我院)集中带量采购(简称集采)和国家医保目录准入谈判(简称国谈)政策执行前后注射用质子泵抑制剂临床使用结构的改变,探讨集采和国谈政策执行过程中出现的潜在用药问题,为促进临床合理用药和优化政策执行提供参考。方法:从医院药品使用数据库中提取2019—2024年注射用质子泵抑制剂的使用数据,分析并比较注射用质子泵抑制剂的用药频度(DDDs)和使用量占比、限定日费用(DDDc)和使用金额占比等指标变化情况。结果:在集采和国谈政策作用下,我院注射用质子泵抑制剂使用结构发生较大改变,未中选品种逐步退出医院目录,2023年后,我院注射用质子泵抑制剂仅剩中选品种、临采品种和国谈品种。中选品种中,[集采]注射用奥美拉唑B DDDs和使用量占比逐年增加,但占较小比例;[集采]注射用兰索拉唑2022—2023年DDDs呈上升趋势,但因临床选用倾向性小,2024年已基本不再使用;[集采]注射用泮托拉唑DDDs和使用量占比呈增加趋势,2024年,DDDs和使用量占比居全院第一。国谈品种注射用艾普拉唑2020—2023年DDDs呈逐年递增趋势,经医院管控后,DDDs和使用量占比有所下降,但仍占较大比例。结论:集采和国谈政策降低了注射用质子泵抑制剂的价格,减轻了患者的用药负担,增加了药品的可及性,节约了大量医保资金,然而也衍生了一些不合理的用药问题,只有加强用药监管,才能保证合理用药,促进利好政策行稳致远。
Objective:To analyze the changes in the clinical use structure of proton pump inhibitors for injection before and after the implementation of the"national-centralized drug procurement"and"national medical insurance negotiation"policies in Zhengzhou Second People's Hospital,and to explore the potential drug use problems in the process of implementation of the"national-centralized drug procurement"and"national medical insurance negotiation"policies,so as to provide reference for promoting rational clinical use of drugs and optimizing policy implementation.Methods:The usage data of injectable proton pump inhibitors from 2019 to 2024 were extracted from the hospital drug usage database,the variations in key indicators,including the defined daily dose(DDDs)and its usage proportion,as well as the defined daily cost(DDDc)and the proportion of usage amount,specifically for injectable proton pump inhibitors were analyzed and compared.Results:Under the influence of the"national-centralized drug procurement"and"national medical insurance negotiation"policies,the use structure of injectable proton pump inhibitors in our hospital has undergone major changes,and unselected drugs have gradually been withdrawn from the hospital catalog.After 2023,the use of injectable proton pump inhibitors in our hospital were only selected drugs,temporary harvest varieties and"national medical insurance negotiation"varieties left.Among the selected drugs,[national-centralized drug procurement]Omeprazole B for injection DDDs and the proportion of usage are increasing year by year,but they account for a smaller proportion;[national-centralized drug procurement]Lansoprazole for Injection DDDs will be on the rise from 2022 to 2023,but due to the small tendency for clinical use,they will basically no longer be used in 2024;[national-centralized drug procurement]the proportion of DDDs and usage of pantoprazole for injection is increasing.In 2024,the proportion of DDDs and usage of pantoprazole ranks first in the hospital.The DDDs of the"national medical insurance negotiation"variety of iprazole for injection showed an increasing trend year by year from 2020 to 2023.After hospital control,the proportion of DDDs and usage has declined,but still accounts for a large proportion.Conclusion:The"national-centralized drug procurement"and"national medical insurance negotiation"policies have lowered the price of injectable PPIs,reduced patients'medication burden,increased the accessibility of drugs,and saved a large amount of medical insurance funds.However,they have also derived some potential medication behaviors,only by strengthening the supervision of drug use can we ensure the rational use of drugs and promote the stable and long-term implementation of favorable policies.
作者
贾雪松
王娟
汪梦园
张英杰
Jia Xuesong;Wang Juan;Wang Mengyuan;Zhang Yingjie(Zhengzhou Second People's Hospital,Zhengzhou 450006,China)
出处
《中国药事》
2025年第6期717-724,共8页
Chinese Pharmaceutical Affairs
关键词
国家医保目录准入谈判
集中带量采购
质子泵抑制剂
用药频度
限定日费用
national medical insurance negotiation
national-centralized drug procurement
proton pump inhibitors
defined daily doses
defined daily dose cost
