常州市第二批国家药品集中采购政策实施效果研究——基于双组间断时间序列分析

Study on the implementation effects of the second batch of national drug centralized procurement policy in Changzhou City:Based on two groups interrupted time-series analysis model

目的:我国于2019年12月开展了第二批国家药品集中采购工作,本研究旨在探讨第二批国家集采政策实施效果。方法:使用江苏常州医疗机构2019年1月—2021年3月间36万条药品采购数据,以25种国家集采品种和20种在临床使用中与国家集采品种有替代关系的品种为研究样本,采用描述性统计和双组间断时间序列,分析药品使用频度、采购金额、日均费用、价格指数、仿制药数量替代率及金额替代率6个指标的变化。结果:国家集采政策下集采品种使用频度上涨、日均费用下降、价格指数下降、采购金额下降、仿制药数量和金额替代率均明显提高,替代品种使用频度略有增长、日均费用、价格指数、采购金额略为下降、同时仿制药数量和金额替代率有所增长。但模型运行结果显示,国家集采政策对集采品种影响显著,对替代品种影响不显著。结论:建议推行国家集采政策过程中,应当加强用药监测和合理用药管理,并在考虑临床用药实际情况下将更多品种纳入集采范围,真正实现惠及民生的政策目标。

Objective:The Chinese government implemented the second batch of national centralized drug procurement work in December 2019.This study aims to explore the impact of the second batch of national centralized procurement policy.Methods:This study used 360000 drug procurement data from medical institutions in Changzhou City,Jiangsu Province from January 2019 to March 2021.The research samples were 25 types of nationally collected drugs and 20 types of varieties that were substituted with the nationally collected varieties in clinical use.In this study,descriptive statistics and two-group interrupted time series were used to analyze the changes of 6 indicators which were Defined Drug Dose Numbers(DDDS),drug purchase amount,Defined Daily Dose Cost(DDDc),drug price index,the amount and value of generic drug substitution rate.Results:According to descriptive statistical results,as to the collected varieties,DDDs and the amount and value of generic drug substitution rate had increased,while DDDc,the price index and the purchase amount had decreased.As to the alternative varieties,the changing trend was similar to that of the included varieties.However,the model results showed that the NCDP policy had a significant impact on the collected varieties,and the impact of the alternative varieties was not significant.Conclusions:It suggested that in the process of implementing the NCDP policy,clinical drug monitoring should be strengthened.At the same time,in considering the specificity of clinical drug use,more varieties should be collected in the NCDP policy to achieve the goal of benefiting people's livelihood.