“4+7”带量采购政策对某院核苷类抗乙型肝炎病毒药物使用影响分析

Analysis of the impact of"4+7"volume-based procurement policy on the medication of nucleoside anti-HBV drugs in a hospital

目的分析带量采购政策对核苷类抗乙型肝炎病毒(HBV)药物使用情况的影响,为进一步完善临床药学服务和医院药事管理提供参考依据。方法采用药物经济学方法,汇总“4+7”带量采购政策实施前一年(2018年12月至2019年12月)及实施后第一年(2020年1—12月)、第二年(2021年1—12月)核苷类抗HBV药物使用数量、金额、用药频度(DDDs)、日治疗费用(DDC)等数据,进行统计学分析。结果实施带量采购政策后,核苷类抗HBV药物第一年使用量DDDs增加75.05%,销售金额降低32.08%,第二年使用量同比增加6.56%,销售金额同比增加31.30%。“4+7”集采中选恩替卡韦片(ETV,商品名“木泽”)、富马酸替诺福韦二吡呋酯片(TDF,商品名“倍信”)的第一年和第二年使用量DDDs、销售金额占比分别为76.53%、4.64%和73.92%、3.86%。两药在集采后连续两年DDDs均大幅提高,DDC下降。抗HBV国谈新药富马酸丙酚替诺福韦(TAF)使用量和销售金额稳步增加。结论带量采购政策在医院落地实施2年,中选品种使用量逐年升高,销售额逐年下降,切实减轻了部分患者的用药负担,体现出“4+7”带量采购政策的稳步落地,医患对该政策的接受度逐渐增加。

Objective To analyze the impact of volume-based procurement(VBP)policy on the medication of nucleoside anti-HBV drugs,so as to provide reference basis for further improving clinical pharmaceutical services and hospital pharmaceutical affairs management.Methods The pharmacoeconomics methods were adopted.The data of medication quantity,amount of money and defined daily doses system(DDDs),daily drug cost(DDC),etc.,of nucleoside anti-HBV drugs one year before the implementation of the"4+7"VBP policy(from December 2018 to December 2019),the first year(from January to December 2020)and the second year(from January to December 2021)after the implementation were summarized in this paper.And the statistical analysis was conducted.Results After the implementation of the VBP policy,in the first year,the medication quantity of nucleoside anti-HBV drugs increased by 75.05%,and the sales amount decreased by 32.08%.In the second year,the medication quantity increased by 6.56%year on year,and the sales amount increased by 31.30%year on year.In the"4+7"centralized procurement,the medication quantity and sales amount of the selected Entecavir Tablets(ETV,and the trade name was"Muze")and Tenofovir Disoproxil Fumarate Tablets(TDF,and the trade name was"Beixin")in the first and second years accounted for 76.53%,4.64%and 73.92%,3.86%,respectively.DDDs of the two drugs both increased remarkably and DDC decreased for two consecutive years after centralized procurement.The medication quantity and sales amount of TAF,which was the new national negotiation anti-HBV drug,increased steadily.Conclusion The VBP policy has been landed and implemented in hospitals for two years.The medication quantity of selected varieties has increased year by year,and the sales amount has decreased year by year.It has effectively reduced the medication burden of some patients,reflecting the steady landing of the"4+7"VBP policy,and the acceptance of the policy by doctors and patients has gradually increased.