西安地区11家三级医院2013-2015年辅助用药使用分析

Analysis of the Utilization of Adjuvant Drugs in 11 Tertiary Hospitals of Xi'an Area during 2013-2015

目的:为促进临床合理用药及卫生行政部门制定用药政策提供依据。方法:对西安地区11家三级医院2013-2015年销售金额排名前20位的药品中辅助用药的总销售金额及构成比、单品种销售金额、用药频度(DDDs)、日均费用(DDC)等数据及不良反应情况进行统计分析。结果:西安地区11家三级医院2013-2015年辅助用药的总销售金额及构成比均呈上升趋势,3年间辅助用药销售金额构成比分别为8.43%、10.25%、12.20%。共有13种辅助用药至少1年进入3家以上医院药品总销售金额排名前20位;其中,小牛血清去蛋白注射液、前列地尔注射液和丹红注射液销售金额各年度均稳居前4位,注射用丹参多酚酸盐2014-2015年进入前3位;前列地尔注射液、血栓通注射和脾氨肽口服冻干粉各年度DDDs均居前3位;脾多肽注射液、注射用益气复脉和脑苷肌肽注射液DDC居前3位,分别为885.24、372.34和349.37元。辅助用药不良反应发生率逐年升高,由2013年的9.13%上升至2015年的13.49%。结论:辅助用药已成为西安地区医院临床用药的重要组成部分,其销售金额、用量增长较快。临床需要加强对辅助用药的管控,密切关注其安全性问题,控制医疗费用不合理增长。

OBJECTIVE：To provide reference for promoting rational drug use and formulating medication policy by health administrative department. METHODS：The utilization of top 20 adjuvant drugs in the list of consumption sum in 11 tertiary hospitals from Xi＇an area during 2013-2015 was analyzed statistically in respects of total consumption sum and constituent ratio,the consumption sum of single type,DDDs,DDC,ADR,etc. RESULTS：The total consumption sum and the proportion of adjuvant drugs in 11 tertiary hospitals from Xi＇an area increased year by year from 2013 to 2015,accounting for 8.43%,10.25% and12.20%,respectively. 13 kinds of adjuvant drugs were included in top 20 in the list of total consumption sum from more than 3hospitals. Deproteinised calf blood serum injection,Alprostadil injection and Danhong injection took up the first 4 places in the list of consumption sum,and Salvianolate for injection took up the first 3 place during 2014-2015. Alprostadil injection,Xueshuantong injection and Spleen peptide oral lyophilized powder took up the first 3 places in the list of DDDs. Spleen polypeptides injection,Yiqi fumai for injection and Cattle encephalon glycoside and ignotin injection took up the first 3 places in the list of DDC,and their DDC were 885.24,372.34 and 349.37 yuan. The incidence of adjuvant drugs-induced ADR increased year by year,increasing from 9.13% of 2013 to 13.49% of 2015. CONCLUSIONS：At present,adjuvant drugs become the important part of clinical drug use in Xi＇an area. The consumption sum and amount is increasing rapidly. Great importance should be attached to the rational use and safety of adjuvant drugs so as to control the unreasonable increase of drug expenses.