某省级精神卫生中心2002—2011年抗精神病药物用药频度分析

The Frequency of the Use of Antipsychotics in A Provincial Mental Health Center From 2002 to 2011

目的了解某省级精神卫生中心2002—2011年抗精神病药物的使用情况,为精神科药物使用政策的制定提供客观依据。方法收集河北省精神卫生中心2002、2006、2011年度的药品出库记录,以限定日剂量(DDD)为指标,运用药物经济学用药频度(DDDs)分析方法,并结合药品总销售金额,对精神科药物使用情况进行分析。结果该机构抗精神病药物选择范围逐渐增加,2011年较2002年抗精神病药物品种增加了33.33%(4/12),非典型抗精神病药物所占品种数由2002年的25.00%(3/12)上升至2011年的56.25%(9/16)。抗精神病药物的销售金额及DDDs呈现上升趋势,复合增长率分别达26.71%和4.51%。非典型抗精神病药物的销售金额(30.39%)和DDDs(15.71%)稳步增长,其构成比也相应增加,而典型抗精神病药物销售金额(-12.68%)及DDDs(-13.95%)呈负增长态势。2011年DDDs排名前5位的均为非典型抗精神病药物,分别是喹硫平、奥氮平、利培酮、氯氮平、阿立哌唑。非典型抗精神病药物价格日趋合理,除氯氮平外其余药品总销售金额排序与DDDs排序的比值(B/A)整体呈上升趋势,至2011年利培酮和喹硫平B/A≥1。结论该机构使用的主要抗精神病药物已经由传统的典型抗精神病药物转向以喹硫平、奥氮平、利培酮为主的非典型抗精神病药物。根据药物使用趋势,建议卫生行政部门适时调整医保药物政策。

Objective To investigate the status quo of the usage of antipsychotics in a provincial mental health center from 2002 to 2011. Methods The drug outbound records of the setting in Mental Health Center of Hebei Province in 2002, 2006 and 2011 were collected. By taking defined daily dose（ DDD）as an indicator,using pharmacoeconomic DDDs analysis method and considering the total drug sale amount,we conducted analysis on the usage of psychotropic drugs. Results The range of choice of antipsychotics in the setting was increasing. Compared with 2002,the categories of antipsychotic drugs 33. 33% in 2011. The number of the categories of atypical antipsychotics was 25. 00% （3 / 12） in 2002,and the number increased to 56. 25% （9 / 16） in 2011. The sales amount and DDDs of antipsychotics were increasing,and the compound growth rates were 26. 71% and 4. 51% respectively. The sales amount （ 30. 39% ） and DDDs （ 15. 71% ） of atypical antipsychotics increased stably,and their constituent ratios also increased,while the sales amount（ - 12. 68% ）and DDDs （ - 13. 95% ）of atypical antipsychotics were decreasing. The first five atypical antipsychotics with the highest DDDs were quetiapine,olanzapine,risperidone,clozapine and ariprazole. The price of atypical antipsychotics is being rationalized,and the level of B/ A of all antipsychotics was increasing except clozapine,with risperidone and quetiapine B/ A ≥1 in 2011. Conclusion Major antipsychotic drugs used by the setting has been changed from traditional typical antipsychotics into atypical antipsychotics such as quetiapine,olanzapine and risperidone. According to the tendency of drug use,we suggest that health administrative departments timely adjust the policies of medical insurance drugs.