中国二级和三级医院具有抗菌效果的中成药使用及费用变化趋势:2011–2015年药品采购数据分析

Trends of consumption and expenditure of antibacterial traditional Chinese medicine in secondary and tertiary hospitals in China:an analysis of pharmaceutical sales data,2011–2015

中成药在中国被普遍使用,其中一些中成药已被证明对特定的致病菌引起的感染有效。本研究旨在利用2011年1月至2015年12月的药品采购数据,描述中国二级和三级医院具有抗菌效果的中成药的使用和费用变化趋势。本文回顾性地分析了中国医院具有抗菌作用的中成药月度采购监测数据。采用人口加权的每日限定日剂量,即基于药品说明书中推荐的剂量方案的每日推荐量。具有抗菌效果的中成药的使用量以每1000人/天的DDD表示(DID)。具有抗菌效果的中成药费用以美元表示。使用复合年均增长率(CAGR)来描述具有抗菌效果的中成药的使用量和费用的增长。对来自28个省的468家三级医院和114家二级医院的1293种具有抗菌效果的中成药进行了匹配和分析。在研究期间,具有抗菌效果的中成药的使用量和费用总体表现出明显的上升趋势,使用量从4.07DID到6.82DID,年均复合增长率为13.75%;费用从8.3975亿美元到12.7682亿美元,年均复合增长率为11.04%。与东部省份相比,中部和西部省份具有抗菌效果的中成药的消费量更高。肠外用药占具有抗菌效果的中成药总消耗量的7.20%,但占总费用的近45%。中国具有抗菌效果的中成药的使用快速增长,这可能是抗菌药物管理的替代效应,但存在随之而来的过度使用的潜在风险。需要更多的研究来进一步探索具有抗菌效果的中成药的潜在疗效,使其成为感染治疗的替代方法,并帮助遏制细菌耐药。

Traditional Chinese medicines(TCMs)are commonly used in China,and some of them have been proved to be effective against infection caused by certain pathogenic bacteria.In the present study,we aimed to describe the trends of antibacterial-effect traditional Chinese medicine(AeTCM)consumption and expenditure in secondary and tertiary hospitals in China using pharmaceutical sales data from January 2011 to December 2015.Aggregated monthly surveillance data on AeTCM sales in China’s hospitals were retrospectively analyzed.Population weighted daily define doses,which are the recommended daily amounts based on dosage regimen recommended in the manufacturers’instructions,were adopted.The AeTCM consumption was expressed in DDD per 1000 inhabitants per day(DID).The AeTCM expenditure was expressed in US dollars.A compound annual growth rate(CAGR)was used to describe the growth of AeTCM consumption and expenditure.A total of 1293 AeTCMs were matched and analyzed from 468 tertiary hospitals and 114 secondary hospitals from 28 provinces.The total AeTCM consumption and expenditure demonstrated a significant upward trend during the study period from 4.07 DID to 6.82 DID with a CAGR of 13.75%,and 839.75 million US dollars to 1276.82 million US dollars with a CAGR of 11.04%,respectively.Compared with eastern provinces,the consumption of AeTCMs was higher in the central and western provinces.Parenteral AeTCMs accounted for 7.20%of the total Ae TCM consumption,but nearly 45%of the total AeTCM expenditure.The AeTCM use in China demonstrated a rapid growth,which could be the result of the substitutional effect from antimicrobial stewardship and brought a potential risk of overuse.More studies are needed to further explore the potential efficacy of AeTCMs as an alternative approach towards infection treatment and to help confine antimicrobial resistance.