滁州市国家集中采购政策实施前后药物的可负担性评价

Evaluation of affordability of drugs before and after the implementation of national centralized procurement policy in Chuzhou

目的调查滁州市第一批国家集中采购药品在集中采购政策实施前后患者的可负担性情况,为完善安徽省药品集中采购政策提供数据支持。方法选取滁州市二级及以上公立医疗机构2019-2020年中标药品及非中标药品的使用数据,采用药品的限定日费用方法、WHO/HAI测算法、药品费用占卫生总费用及GDP比值等方法来测算患者的可负担性。结果从限定日费用(DDDC)来看,政策实施后,21种药品的DDDC降低,培美曲塞二钠与右美托咪定的DDDC升高;从WHO/HAI测算法来看,22种药品的可负担性有所改善,苯磺酸氨氯地平、帕罗西汀的可负担性变差;从卫生医疗系统层面来看,财政部门和医保部门的可负担性明显提高。结论国家集中采购政策实施后,患者和政府对中标药品及非中标药品的可负担性均有所提高,政府和医疗机构应加大对中标药品的宣传,使更多患者了解中标药品,且在制定政策时应考虑实际情况,更好地保障患者的利益。

Objective To investigate the affordability of patients before and after the implementation of the first batch of national centralized drug procurement policy in Chuzhou,and to provide data support for Anhui Province to improve the centralized drug procurement policy.Methods This paper included the use data of bid winning drugs and non bid winning drugs in public medical institutions of Chuzhou City from 2019 to 2020,and the following methods were used,including limited daily cost of drugs,WHO/HAI measurement algorithm,the ratio of drug cost to total health cost and GDP,to calculate the affordability of patients.Results From the perspective of DDDC,after the implementation of the policy,the DDDC of 21 drugs decreased,while the DDDC of pemetrexed disodium and dexmedetomidine increased;according to the WHO/HAI calculation method,the affordability of 22 kinds of drugs was improved,while the affordability of amlodipine besylate and paroxetine became worse;from the perspective of health care system,the affordability of financial departments and medical insurance departments was significantly improved.Conclusion After the implementation of the national centralized procurement policy,the affordability of the patients and the government to the bid winning drugs and non bid winning drugs has been improved.The government and medical institutions should increase the publicity of the bid winning drugs,so that more patients can learn about the bid winning drugs,and the actual situation should be considered when formulating the policy to better protect the interests of patients.