抗肿瘤药物分级管理规范初探

Hierarchical Management Standard of Anti-Tumor Drugs

目的为医疗机构制订抗肿瘤药物分级管理规范提供参考。方法结合国家政策、某三级甲等肿瘤专科医院抗肿瘤药物用药现状及相关文献,分析抗肿瘤药物分级管理标准。结果与结论可将抗肿瘤辅助用药从抗肿瘤药物目录中排除。可从毒副作用、上市时间、价格三方面对抗肿瘤药物分级,其中毒副作用由于其划定标准不易界定,可将不良反应发生率占比较高且影响DNA结构与功能的药物中毒副作用大的列入限制使用级;按上市时间2年划定,3倍人均国内生产总值作为参考阈值,并可根据各城市国内生产总值的不同作适当调整。处方权限可将专业及职称作为规范使用限制使用级抗肿瘤药物的划分门槛。

Objective To provide a reference for medical institutions to formulate hierarchical management standards for anti-tumor drugs.Methods Based on the national policies,the current situation of anti-tumor drug use in a tertiary A grade cancer hospital,and relevant literature,the hierarchical management standards for anti-tumor drugs were analyzed.Results and Conclusion It is recommended to exclude adjuvant anti-tumor drugs from the catalog of anti-tumor drugs.The classification of anti-tumor drugs can be considered from three aspects:toxic and side effects,time-to-market,and price.Due to the difficulty in defining the criteria for toxic and side effects,it is recommended to include cytotoxic drugs that affect DNA structure and function(with the higher incidence of adverse drug reactions)and have significant toxic and side effects in the restricted use level.According to the time-to-market of two years,three times the per capita gross domestic product(GDP)can be taken as the reference threshold,which can be adjusted appropriately according to the different GDP of each city.Prescription authority can use professional and professional titles as the threshold for standardizing the use of restricted use grade anti-tumor drugs.