中国医院糖尿病治疗基本药物使用情况分析

The utility of essential medicines of diabetes treatment in Chinese hospital

目的:研究分析中国药学会医药经济信息网(CMEI)网员医院糖尿病治疗基本药物使用情况及变化趋势,为进一步完善基本药物制度、提高糖尿病基本药物保障水平提出数据支持。方法:系统梳理2012年版《国家基本药物目录》中糖尿病治疗药物品种,在CMEI数据库中检索网员医院2016年糖尿病治疗基本药物使用金额、品规及用药频度,以及近3年使用变化情况,计算基药占比并对不同地区、不同级别医院糖尿病基本药物的使用情况进行统计学检验。结果:2016年CMEI网员医院中,使用的糖尿病治疗药物共137个品规,其中34个为基本药物,占总品规数的24.8%。2016年糖尿病治疗基本药物使用金额占比为37.88%,用药频度占比为42.4%,金额与频度排名前5位中均有3个为基本药物,分别为阿卡波糖、二甲双胍和格列美脲。2014-2016年糖尿病治疗基本药物使用金额及用药频度的增长率均低于非基本药物。不同地区、不同级别医院糖尿病基本药物的使用品种、金额及频度均无较大差异。结论:2012年版《国家基本药物目录》中的糖尿病治疗品种在医院糖尿病治疗中发挥了重要作用。糖尿病治疗基本药物在全国覆盖面较广,在二、三级医院使用的连续性较好。建议充分考虑提升基本药物的保障水平与可负担性,依据临床价值与优势,科学调整基本药物目录品种。

OBJECTIVE To analyze the utility and trends of essential medicines for diabetes treatment in membership hospital of Chinese medicine and economic information network（ CMEI） and offer data and evidences for the optimization of the essential medicine system. METHODS The utility of medicines for diabetes treatment in the national essential medicine list were analyzed. The indexes of usage amount,DDDs,increasing rate during recent 3 years were calculated. The utilities of essential medicines of diabetes treatment in different regions and different level of hospital were compared by statistical methods.RESULTS In 2016,137 products for diabetes were used in membership hospital of CMEI,among which 34 products were essential medicines. The percentage of essential medicines was 24. 8 %. The sum and DDDs proportion of essential medicines was37. 88 % and 42. 4 % respectively. 3 products of essential medicines were in the top 5 of sum and DDDs,which were Metformin,Acarbose,Glimepiride. From 2014 to 2016,the growth rates of sum and DDDs of essential medicine were lower than other medicines. There was no statistical difference of essential medicine utility among hospitals in different regions and different level.CONCLUSION The products which were listed in national essential medicine list issued in 2012 played an important role in the treatment of diabetes in Chinese hospital. The essential medicines for diabetes were widely used in China,which had been both used in secondary hospitals and tertiary hospitals. It was recommended that the essential medicine list should be adjusted scientifically according to the clinical worth and advantages,the support level and affordability could be further improved in the future.