国内17家儿童医院药品短缺现状调研分析及建议

Investigation and analysis on the status of drug shortage in 17 pediatric hospitals in China

目的:本研究旨在针对我国儿童用药短缺的现状和问题,开展儿童药品短缺监测和预警,并提出具有针对性的解决对策与建议。方法:通过收集2018年1—6月国内17所儿科专科医院上报的儿童用药短缺信息,梳理儿童用药的短缺品种,分析儿童用药短缺的现状及可能的影响因素。结果:调研显示,我国儿童用药短缺广泛分布在各个治疗领域,在参与调查的17家儿童医院中,涉及儿童使用的药品共有146个品规出现短缺,覆盖治疗学及化学(anatomical therapeutic chemical, ATC)分类的13个大类,44个亚类。其中84.25%的药品短缺品种仅在1个省市出现过短缺,而仅有2.74%的药品短缺品种在4个省市范围出现短缺,呈现出局部短缺的特点。在短缺程度上,146种短缺药品中有60种药品属于长期短缺药品,连续3个月以上不能正常供应。此外儿童用药短缺的发生与药品生产、流通、使用的各个环节均有关联,短缺原因较为复杂,受到药品供应链上下游的广泛影响。结论:我国儿童用药短缺与成人相比形势更为严峻、原因更为复杂,国家应继续采取定向政策,保证药品供应链的连贯通畅,满足儿科的临床用药需求。

Objectives:Pediatric drug shortage is a complex global problem. The aim of this study is to analyze, characterize, and assess this problem, and to identify possible solutions in China. Methods:Structured questionnaires were conducted from January to June 2018 in 17 pediatric hospitals to gather the information on the shortage status of pediatric medication in China, in pursuit of sorting out the varieties and analysis of the current situation and possible influencing factors of pediatric drug shortages. Results:The results of the survey show that the shortage of drugs for children in China widely covers various therapeutic fields. There are 146 varieties involved in children medication, covering 13 categories and 44 subcategories of the anatomical therapeutic chemical(ATC) classification among the 17 pediatric hospitals participating in the survey. Among them, 84.25% of the drug shortage only appeared in one province, and only 2.74% appeared in 4 provinces, indicating the characteristics of local shortage in the regional distribution. In terms of the degree of shortage, 60 of the 146 drug shortages were long-term, which have been unavailable for more than 3 consecutive months. In addition, the results show the shortage of pediatric drugs was related to all aspects of drug production, circulation, and application. The causes of shortages are complex and widely affected by the upstream and downstream of drug supply chain. Conclusions: The shortage of pediatric drugs in China is more serious and complicated than that of adults. Targeted policies should be continuously adopted by the state to ensure the consistency of drug supply chain and to meet the clinical demand of pediatric drugs.