国家药品集中采购对3种抗肿瘤药物临床使用的影响

Influence of the National Centralized Drug Procurement Policy on Clinical Use of Three Anti-Tumor Drugs

目的为国家药品(特别是抗肿瘤药品)集中采购(简称集采)政策的进一步制定提供参考。方法采用限定日剂量法对国家药品集采政策实施前后上海市某三级综合医院吉非替尼片、甲磺酸伊马替尼片、注射用培美曲塞二钠(均含原研药、仿制药,以及集采中选药)的用药频度(DDDs)、日均费用(DDC)、可负担性等进行分析。结果政策实施后,3种药品中选品种及仿制药品种的DDC(包括自费和医保)均显著降低,降幅最高的为吉非替尼片,原研药除吉非替尼片外的降幅较小(均不超过15%);吉非替尼片和甲磺酸伊马替尼片的DDDs显著增加,中选品种占比均超85%。结论国家药品集采政策的实施,总体上降低了吉非替尼片、甲磺酸伊马替尼片、注射用培美曲塞二钠等3种抗肿瘤药的价格,减少了医保基金压力,减轻了患者的经济负担,但甲磺酸伊马替尼片及注射用培美曲塞二钠的原研药仍属不可负担的药物,有待后续政策出台时解决。

Objective To provide a reference for the further formulation of the National Centralized Drug Procurement(NCDP)policy,especially for the anti-tumor drugs.Methods Defined daily dose(DDD)method was used to analyze the DDDs,defined daily cost(DDC)and affordability of Gefitinib Tablets,Imatinib Mesylate Tablets and Pemetrexed Disodium for Injection(including original-patented drugs,generic drugs,and NCDP drugs)in a classⅢgeneral hospital in Shanghai before and after the implementation of the NCDP policy.Results After the implementation of the policy,the DDC of the selected varieties and generic drugs of the three kinds of drugs decreased significantly.Gefitinib Tablets had the highest decrease,and the decrease of the original-patented drug except Gefitinib Tablets was less(≤15%).DDDs of Gefitinib Tablets and Imatinib Mesylate Tablets increased significantly,and the selected varieties accounted for more than 85%.Conclusion The implementation of the NCDP policy has generally reduced the prices of three anti-tumor drugs,including Gefitinib Tablets,Imatinib Mesylate Tablets and Pemetrexed Disodium for Injection,relieved the pressure on the medical insurance fund and reduced the economic burden on patients.However,the original-patented drugs of Imatinib Mesylate Tablets and Pemetrexed Disodium for Injection are still affordable drugs,which need to be solved when the follow-up policies are issued.