2013―2015年我国医保患者口服降糖药用药分析

Analysis of oral hypoglycemic agents during 2013―2015

目的:分析全国31省(自治区、直辖市)城镇基本医疗保险门诊患者口服降糖药的实际使用情况,为糖尿病患者临床用药提供参考。方法:分别按年度、区域、医疗机构级别等对全国医疗机构进行抽样,提取2013―2015年间城镇基本医疗保险门诊患者口服降糖药使用相关数据进行统计、分析。结果:共使用口服降糖药28种,总用药人次逐年上升,总销售金额波动较大。α-糖苷酶抑制剂、磺酰脲类、格列奈类及双胍类4种类型口服降糖药的合计用药人次及销售金额均占到九成左右,其中阿卡波糖、二甲双胍和瑞格列奈3个品种的用药人次和销售金额较多。不同级别医疗机构用药人次及销售金额排名前10药品品种差异甚微。结论:不同年度、区域、医疗机构级别口服降糖药的使用情况总体一致,α-糖苷酶抑制剂、磺酰脲类及双胍类为主要口服降糖药,各品种口服降糖药的使用情况可能与是否进入医保目录、是否为指南推荐药品,以及药品的疗效、安全性、价格、使用方便性等相关。

Objective： To analyze the actual use of oral hypoglycemic agents in the outpatient department of basic medical insurance in 31 provinces（autonomous regions and municipalities directly under the central government）, provide reference for clinical medication of diabetic patients. Methods： The data of oral hypoglycemic agents use in outpatients of urban basic medical insurance during 2013―2015 were extracted and analyzed. Sampling of medical institutions was carried out according to the years, regions and medical institutions. Results： 28 kinds of oral hypoglycemic agents were used in the whole country, the total number of users increased year by year while the total amount of sales was larger fluctuant. Both the number of drug users and the amount of drug sales of four types of oral hypoglycemic agents included alpha glucosidase inhibitors, sulfonylureas, glinide and biguanides accounted for about 90% of the total, benefited more from acarbose, metformin and repaglinide. There were little differences in the number of users and the amount of drug sales among the top 10 drug varieties in different levels of medical institutions. Conclusion： The use of oral hypoglycemic agents were generally same in different years, regions and medical institutions. Alpha glucosidase inhibitors, sulfonylurea and metformin were the main oral hypoglycemic agents. The use of drugs may be related to whether they were in the medicare directory or recommended by guidelines, as well as drug efficacy, safety, price and ease of use.