某院短缺药品信息分析与应对策略探索

Analysis of Drug Shortage Characteristics and Countermeasures in a Hospital

目的:分析某医院短缺药品的特征、发生原因、替代药品特征等,医院短缺药品供应保障制度的建立提供参考。方法:回顾性分析某院2016~2018年短缺药品信息,并参照美国药师协会短缺药品指南,对短缺药品的品规数、短缺原因、价格与剂型特征、是否为基本药物及替代药物特征进行分类汇总。结果:2016~2018年某院短缺药品的品规数为107种,其中基本药物42个品规,占比39.3%。原材料短缺是导致药品短缺的首要原因(占比37.4%),发生短缺的药品多数价格相对低廉(<50元药品占比73.9%),注射剂更易发生短缺(占比41.1%)。某院对短缺药品主要以不同厂家同规格药品替代(占比51.4%),替代药品价格通常较短缺药品高(占比63.4%)。结论:药品短缺给医疗机构等药品使用单位带来了许多治疗问题。搭建医疗机构内部短缺药品信息平台;确定短缺药品上报与发布专职人员;医生、护士及药学工作人员协同做好短缺药品院内限制使用管理和替代药物遴选,避免药品短缺发生时的人为差错都是应对医疗机构药品短缺的关键要素。

Objective:To analyze the characteristics and causes of drug shortage,the characteristics of alternative medicines and so on in a certain hospital,and combined with the actual situation of Chinese hospitals,explore the countermeasures for drug shortage in medical institutions,so as to provide reference for the establishment of drug shortage security system.Methods:Referring to the American Society of Health-System Pharmacists Guidelines on Managing Drug Product Shortages in Hospitals and Health Systems,the drug shortage information from 2016 to 2018 was retrospectively analyzed in respects of the case number,shortage reasons,price,dosage forms,essential drugs and alternative drugs,etc.Results:Totally 107 drugs were in short supply during the past three years,including 42 essential drugs accounting for 39.3%.The shortage of raw materials was the leading cause of drug shortages(37.4%),and most of the shortage were relatively cheap(<50 yuan accounting for 73.9%),and injections were more prone to shortage(41.1%).The shortage drugs in the hospital were mainly replaced by the drugs with the same specification from different manufacturers(51.4%),and the price of alternative drug was usually higher than that of the drug in shortage(63.4%).Conclusion:Drug shortage poses a huge challenge to medical institutions.Setting up the information platform of drug shortage,determining the full-time personnel for reporting the shortage of drugs,doctors,nurses and pharmaceutical staff working together to manage the limited use of drugs and select alternative drugs,and avoiding human errors in drug shortages are the key factors to deal with drug shortages in hospitals and health systems.