Effects of the national centralized drug procurement policy on drug availability and the structure of hospital drug use

LIN Limin; PENG Xiaoqing; TANG Rong; LIU Guodong; LIU Hong; YIN Jiayu

doi:10.6039/j.issn.1001-0408.2023.24.03

您当前的位置：

首页 >

文章列表页 >

Effects of the national centralized drug procurement policy on drug availability and the structure of hospital drug use

更新时间：2023-12-22

- Effects of the national centralized drug procurement policy on drug availability and the structure of hospital drug use
- ZHONGGUO YAOFANG Vol. 34, Issue 24, Pages: 2968-2974(2023)
- 作者机构：
  
  1.华南理工大学医学院，广州　510006
  2.华南理工大学附属第二医院药剂科，广州　510180
  3.广东药科大学附属第一医院药学部，广州　510080
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.24.03
  CLC： R95
- Published：30 December 2023，
  
  Received：10 May 2023，
  
  Revised：28 November 2023，
扫描看全文
林丽敏,彭晓青,唐榕等.国家药品集中采购政策对药品经济可及与医院用药结构的影响 ^Δ[J].中国药房,2023,34(24):2968-2974.

LIN Limin,PENG Xiaoqing,TANG Rong,et al.Effects of the national centralized drug procurement policy on drug availability and the structure of hospital drug use[J].ZHONGGUO YAOFANG,2023,34(24):2968-2974.
林丽敏,彭晓青,唐榕等.国家药品集中采购政策对药品经济可及与医院用药结构的影响 ^Δ[J].中国药房,2023,34(24):2968-2974. DOI： 10.6039/j.issn.1001-0408.2023.24.03.

LIN Limin,PENG Xiaoqing,TANG Rong,et al.Effects of the national centralized drug procurement policy on drug availability and the structure of hospital drug use[J].ZHONGGUO YAOFANG,2023,34(24):2968-2974. DOI： 10.6039/j.issn.1001-0408.2023.24.03.

摘要

目的

分析国家药品集中采购政策对公立医院药品经济可及与用药结构的影响。

方法

以降糖类、调脂类、抗肝炎病毒类（简称“抗病毒类”）药品和治疗精神病和抑郁症的精神类（简称“精神类”）药品为研究对象，采用间断时间序列模型，定量评估国家药品集采政策实施前后目标药品在全国样本医院中药品使用量、药品使用金额、日均费用等的变化情况，以及目标药品在某大型三级甲等医院中人均用药频度、门诊处方金额和医保结余留用金额的变化情况。

结果

集采实施后，全国样本医院的4类中选药品的使用量均增加（降糖类药品除外其余3类的

＜0.01）、日均费用均显著下降（

＜0.01），集采相关药品使用金额均显著下降（

＜0.001）；非中选药品的使用量（调脂类药品除外）均有明显的下降趋势（

＜0.05），日均费用均明显降低（精神类药品除外其余3类的

＜0.05）；抗病毒类药品除外的其他可替代药品的使用量（

＜0.01）、日均费用（仅精神类药品的

＜0.01）均明显增加。不同的药品的用药结构受到集采政策影响不同，降糖类所受影响较为明显，集采后可替代药品的使用比例有所增加。单家医院门诊处方金额在集采后均显著降低，其中使用调脂类与抗病毒类集采相关药品患者支付费用降幅均大于0.60；目标中选药品可结余医保金额约125.25万元。

结论

集采政策有效缓解了患者药品支出负担，同时也带动了仿制药对于原研药的替换和可替代药品使用的增长等用药结构的变化。

Abstract

OBJECTIVE

To analyze the effects of the national centralized drug procurement （NCDP） policy on drug availability and the structure of drug use in public hospitals.

METHODS

Using hypoglycemic， lipid-lowering， antiviral drugs， and psychiatric drugs for the treatment of mental illness and depression as objects， the interrupted time series model was used to quantitatively evaluate the changes in consumption sum of drugs， consumption amount and daily cost of the target drugs in national sample hospitals as well as the changes in per capita medication frequency， outpatient prescription amount， and medical insurance surplus of target drugs in a third grade class A hospital before and after the implementation of NCDP policy.

RESULTS

After the implementation of the NCDP policy， the volume for the four bid-winning drugs increased significantly （

＜0.01 for the remaining three categories except for hypoglycemic drugs）， but DDDc （

＜0.01） and the amount of related drugs （

＜0.001） decreased significantly. The volume for the non-winning drugs （except for lipid-lowering drugs） decreased significantly （

＜0.05）， and DDDc also decreased significantly （

＜0.05 for other 3 categories except for psychiatric drugs）； the volume （

＜0.01） and DDDc （

＜0.01 only for psychiatric drugs） for alternative drugs all increased except for antiviral drugs. The structure of drug use for different drugs was affected differently by the NCDP policy， and that of hypoglycemic drugs was affected obviously； the proportion of alternative drugs increased after centralized procurement. The outpatient prescription amount of each hospital significantly decreased after centralized procurement， and the decrease in the cost paid by the patients using lipid-lowering and antiviral drugs related to centralized procurement was greater than 0.60； the remaining medical insurance amount for bid-winning drugs was approximately 1.252 5 million yuan.

CONCLUSIONS

NCDP policy effectively alleviates the burden of medical expenditure and also drives the structure changes of drug use such as the substitution of generic drugs for original drugs， the growth of the volume of alternative drugs.

关键词

国家药品集中采购政策用药结构间断时间序列药品可及性

Keywords

the structure of drug useinterrupted time series modeldrug availability

references

姜姗，葛卫红，穆耕林，等. 国家组织药品集中带量采购在某公立医院的实施效果分析[J]. 中国医院管理，2022，42（7）：70-73.

JIANG S，GE W H，MU G L，et al. Analysis of the implementation effect of the national volume-based procurement in a public hospital[J]. Chin Hosp Manag，2022，42（7）：70-73.

张弦，陈红君. 带量采购政策下他汀类药物在上海某院的应用情况分析[J]. 中国药房，2021，32（2）：247-253.

ZHANG X，CHEN H J. Analysis of statins use in a Shanghai hospital under the policy of drug quantity purchasing[J]. China Pharm，2021，32（2）：247-253.

李春秀，杨志勇，刘翌，等. “4+7”带量采购政策下成都大学附属医院调血脂药使用情况分析[J]. 现代药物与临床，2022，37（1）：179-186.

LI C X，YANG Z Y，LIU Y，et al. Utilization analysis of “4+7” procurement with target quantity on using of lipid-regulating drugs in the Affiliated Hospital of Chengdu University[J]. Drugs Clin，2022，37（1）：179-186.

朱星月，林腾飞，米源，等. 间断时间序列模型及其在卫生政策干预效果评价中的应用[J]. 中国药事，2018，32（11）：1531-1540.

ZHU X Y，LIN T F，MI Y，et al. Interrupted time series model and its application in effect evaluation of health policy intervention[J]. Chin Pharm Aff，2018，32（11）：1531-1540.

GBD Viewpoint Collaborators. Five insights from the global burden of disease study 2019[J]. Lancet，2020，396（10258）：1135-1159.

张方，郭莹，李九翔. 药物经济学应用与案例[M]. 北京：化学工业出版社，2018：118-119.

ZHANG F，GUO Y，LI J X. The application and cases of pharmacoeconomics application and cases of pharmacoe-conomics[M]. Beijing：Chemical Industry Press，2018：118-119.

YANG Y，TONG R W，YIN S C，et al. The impact of “4 + 7” volume-based drug procurement on the volume，expenditures，and daily costs of antihypertensive drugs in Shenzhen，China：an interrupted time series analysis[J]. BMC Health Serv Res，2021，21（1）：1275.

谢金平，王斌，陈缪丰，等. 常州市第二批国家药品集中采购政策实施效果研究：基于双组间断时间序列分析[J]. 中国卫生政策研究，2022，15（5）：59-66.

XIE J P，WANG B，CHEN M F，et al. Study on the implementation effects of the second batch of national drug centralized procurement policy in Changzhou City：based on two groups interrupted time-series analysis model[J]. Chin J Health Policy，2022，15（5）：59-66.

张晗希，韩孟杰，周郁，等. 应用中断时间序列分析我国 “四免一关怀” 政策实施前后对艾滋病相关病死率的影响[J]. 中华流行病学杂志，2020，41（3）：406-411.

ZHANG H X，HAN M J，ZHOU Y，et al. Interrupted time series analysis for influence on HIV related fatality of implementation of “Four Free Services One Care” policy in China[J]. Chin J Epidemiol，2020，41（3）：406-411.

HUANG A Q，WANG X X，TAO Y，et al. Healthcare professionals’ knowledge，attitude and practice towards National Centralized Drug Procurement policy in central China：a cross-sectional study[J]. Front Pharmacol，2022，13：996824.

郑聃. 药品带量采购政策患者满意度及其影响因素分析[J]. 中国医药导刊，2022，24（6）：623-628.

ZHENG D. Analysis on patients’ satisfaction with volume-based drug procurement and its influence factors[J]. Chin J Med Guide，2022，24（6）：623-628.

岳小林，付娜，赵艳玲，等. 国家集中带量采购中选药品疗效与安全性的真实世界研究[J]. 临床药物治疗杂志，2022，20（6）：43-48.

YUE X L，FU N，ZHAO Y L，et al. Efficacy and safety evaluation of selected drugs in the national volume-based procurement：a real-world study[J]. Clin Med J，2022，20（6）：43-48.

郑聃. 带量采购政策下上海市某二甲综合医院降压药使用结构分析[J]. 中国医院药学杂志，2022，42（15）：1557-1562.

ZHENG D. Structure analysis of anti-hypertensive drugs used in a general hospital of level Ⅱ in Shanghai under the volume-based procurement[J]. Chin J Hosp Pharm，2022，42（15）：1557-1562.

王永杰，许红，俞亚静，等. 药品集中带量采购背景下芜湖市第一人民医院ARB类降压药使用情况分析[J]. 中国药事，2022，36（3）：355-362.

WANG Y J，XU H，YU Y J，et al. Analysis on the use of ARB anti-hypertensive drugs in Wuhu No.1 People’s hospital under the background of centralized drug procurement[J]. Chin Pharm Aff，2022，36（3）：355-362.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Analysis on the linkage of 415 generic medicines passing consistency evaluation and essential medicine list ， medical insurance list and centralized procurement list from the perspective of medicine accessibility

Related Author

ZHANG Huan

XU Nuo

XU Gan

LIU Liping

Related Institution

No data

Address：8/F,129 Daping Main Street,Yuzhong District,Chongqing 400042,P.R.China
Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号公网安备50010302001817
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰