北京市场喹诺酮类抗菌药销售和利用现状

The Status of Quinolone Antibacterial Utilization and Marketing in Beijing

描述并分析北京市2001～2006年来喹诺酮类药物、加替沙星和左氧氟沙星的医院市场销售趋势,以及加替沙星和左氧氟沙星在不同级别医院的利用情况,为管理层的相关政策提供数据支持。方法:通过收集资料、现场问卷调查和访谈,进行定量和定性调查,运用卫生经济学研究方法进行描述性统计分析。结果:①2005年北京市二级以上医院喹诺酮类抗菌药、左氧氟沙星和加替沙星的销售金额分别为27251.90万元、22478.28万元和1425.69万元;左氧氟沙星和加替沙星使用人次分别为166.75万人次和4.71万人次。②喹诺酮类药物在2001年后的增长势头明显放缓乃至下降;尽管左氧氟沙星一直排在各类喹诺酮类抗菌药的首位,但销量却在逐年下降;而加替沙星的走势却自从2003年上市以来,正以每年228.13%的速度抢占着北京市场。③2005年北京市二级以上医院两类药物次均治疗费用分别为:加替沙星302.70元,左氧氟沙星134.80元。结论:截止到2005年,药品招标和连续降价等直接影响医院用药的调控政策,在现行医院运营的体制下,并未起到促进医疗机构使用价廉物美药品的作用。制药企业和医院很快就找到了价格相对较高的左氧氟沙星的替代品——加替沙星,而这并非因临床应用存在问题而找到的替代品种。这不能不说明了在抗生素临床利用方面,政府有关部门的宏观调控政策和监管尚需进一步完善。

Objective： This study is to preliminarily describe the level and tendency of Gatifloxacin, Levofloxacin and Quinolone antibacterial sales in hospitals of Beijing from 2001 to 2006, and analyze the utilization of Gatifloxacin and Levofloxacin in different level hospitals in order to give the suggestions to decision makers on the relative decision. Methods： The data for Quinolone antibacterial Utilization and Marketing were collected through the subject interview and questionnaire survey and analyzed by the method of health economics. Results ： （1） The sales amount of Gatifloxacin, Levofloxacin and Quinolone antibacterial were 14256.9 thousand RMB, 224782. 8 thousand RMB, and 272519. 0 thousand RMB respectively in the Secondgrade hospitals and above in Beijing in 2005. In the meantime, the person times using Gatifloxacin and Levofloxacin were 47.1 thousand and 1667.5 thousand respectively. （2） After 2001, the sales amount of Quinolone antibacterial began to decline annually. And so did Levofloxacin though it had been ranking first among Quinolone drugs. However the average annual growth rate of the sales sum of Gatifloxacin had been as high as 228. 13% since 2003. （3） Treatment expenses of Gatifloxacin and Levofloxacin were 302.70RMB per capita and 134. 80RMB per capita respectively in the Second-grade hospitals and above in Beijing in 2005. Conclusion： Up to 2005, the policy influencing hospital behavior on using drugs, such as decreasing drug price and inviting public bidding on drug price, had not yet had effect on promoting hospitals to select the drug with lower price and higher effectiveness. The medicine enterprises and hospitals replaced cheaper Levofloxacin with Gatifloxacin as soon as they could, which not because Levofloxacin had lower clinical effectiveness than that of Gatifloxacin. These results demonstrated that macro policy adjustment needs further enhancement.