基于药品采购数据库的上海市各级医疗机构降糖药物利用情况分析

Analysis on the Utilization Situation of Antidiabetic Drugs in Different Medical Institutions of Shanghai Based on Drug Purchasing Database

目的:分析上海市降糖药物利用情况,并对各级医疗机构用药合理性进行评价。方法:对上海市医疗机构药品招标数据库中2013年11月—2014年10月一年期降糖药的采购金额、单价和剂量等进行统计,采用世界卫生组织(WHO)推荐的用药频度(DDDs)和日均费用(DDDc)方法。结果:分析药物构成发现,上海市各级医疗机构降糖药用药频率最高的为磺脲类药物(53.84%),其次为胰岛素和二甲双胍类降糖药。分析采购金额发现,一级、二级和三级医疗机构的降糖药采购金额分别为5.73亿元、3.22亿元和3.39亿元。将DDDs值按通用名排序后发现,上海市降糖药用药频率最高的药品为格列齐特、格列美脲和重组人胰岛素等。各级医疗机构降糖药采购的平均一致性为68.69%。结论:上海市糖尿病患者主要在社区配药,日治疗费用较为合理。糖尿病用药构成基本合理,降糖药以磺脲类、胰岛素和二甲双胍类为主,磺脲类占主导地位。一、二级医疗机构用药更为接近。

Objective： To analyze the current situation of drug use of patients with diabetes in Shanghai, and evaluate the drug use rationality among all levels of medical institutions. Methods： Using the indicators of defined daily doses（DDDs） and defined daily consumption（DDDc） recommended by the World Health Organization（WHO）, it conducted statistical analysis on the amount, price, dose of the antidiabetie drugs purchased from November 2013 to October 2014 in the Pharmaceutical Bidding Datahase of Shanghai. Results： The research on the top drug composition showed that the DDDs in different medical institutions of Shanghai was sulfonylureas（53.84%）, followed by insulin and metformin. The analysis of the purchase amount shows that, the art, nun, of antidiabetic drugs purchased by the primary, secondary and tertiary medical institutions were 573 million, 322 million and 339 million respectively. Additionally, it sorted the DDDs by generic name and found the most frequently used antidiabetic drugs were gliclazide, glimepiride and recombinant human insulin, etc. The average level of medical institutions consistency tor antidiabetic drug was 68.69%. Conclusion： Patients with diabetes primarily purchased the drug prescribed in the community health centers in Shanghai, DDDc was rational. Sulfonylureas, insulin and metformin were the most frequently used antidiabetic drugs, while sulfonylureas was used more frequently. It was closed in the primary and secondary medical institutions.