2016~2018年南京地区降糖药物使用情况分析

Application Analysis of Hypoglycemic Drugs in Nanjing Area from 2016 to 2018

目的:系统分析南京地区降糖药物使用情况和发展趋势,为合理使用降糖药物以及制定药品价格提供参考。方法:根据降糖药物的问世时间分为传统降糖药物和新型降糖药物,对南京地区55家医院2016~2018年降糖药物的用药金额、用药频度(DDDs)、限定日费用(DDC)、用药金额与DDDs排序比(B/A)进行统计分析。结果:2016~2018年,南京地区共有10大类54种降糖药物供临床使用,降糖药物的用药金额和DDDs均逐年递增。用药金额排序中,胰岛素、α-糖苷酶抑制药和磺脲类在10大类药物中排名前3位;阿卡波糖、二甲双胍、格列美脲、格列齐特、精蛋白生物合成人胰岛素注射液(预混30R)、门冬胰岛素30注射液、地特胰岛素、甘精胰岛素在54种药物中连续3年排前10位。DDDs排序中,磺脲类、胰岛素和双胍类在10大类药物中排名前3位;二甲双胍、格列美脲、格列齐特、阿卡波糖、门冬胰岛素30注射液、格列吡嗪、甘精胰岛素、吡格列酮和精蛋白生物合成人胰岛素注射液(预混30R)在54种药物中连续3年排前10位。利拉鲁肽、艾塞那肽、地特胰岛素、甘精胰岛素的DDC始终排在前4位,阿卡波糖和甘精胰岛素的B/A值最小,仅为0.25。结论:在临床实践中,传统降糖药物占据绝对优势,但各类药物发展趋势不一;新型降糖药物增长迅速,但较传统降糖药物相差甚远;部分降糖药物经济负担较重。

Objective:To systematically analyze the application of hypoglycemic drugs in Nanjing area from 2016 to 2018 and provide reference for the rational use of hypoglycemic drugs and the establishment of drug prices.Methods:According to the advent time of hypoglycemic drugs,they were divided into traditional hypoglycemic drugs and new hypoglycemic drugs.Consumption sum,DDDs,DDC and B/A were used to analyze the hypoglycemic drugs in 55 hospitals in Nanjing area from 2016 to 2018.Results:From 2016 to 2018,there were 10 categories and 54 kinds of hypoglycemic drugs in clinic.Consumption sum and DDDs of hypoglycemic drugs in Nanjing area increased year by year.In terms of consumption sum,insulin,α-glucosidase inhibitors and sulfonylureas were the top 3 in the 10 categories;acarbose,metformin,glimepiride,gliclazide,isophane protamine biosynthetic human insulin injection(pre-mixed 30R),insulin aspart 30 injection,insulin detemir and insulin glargine were the top 10 among 54 drugs for 3 years.In terms of DDDs,sulfonylureas,insulin and biguanides were among the top 3 in the 10 categories;metformin,glimepiride,gliclazide,acarbose,insulin aspart 30 injection,pioglitazone,insulin glargine,pioglitazone and isophane protamine biosynthetic human insulin injection(pre-mixed 30R)were the top 10 among 54 drugs for 3 years.In terms of DDC,liraglutide,exenatide,insulin detemir and glargine were always the top 4.B/A values of acarbose and insulin glargine were the smallest,only 0.25.Conclusion:In clinical practice,traditional hypoglycemic drugs had absolute advantages,but the development trends of various drugs were different.And new types of hypoglycemic drugs had grown rapidly,but they were far from traditional hypoglycemic drugs.Some hypoglycemic drugs had a heavy economic burden.