2018—2021年南京地区预防化疗所致恶心呕吐药物应用现状调查与分析

Investigation and analysis on application of drugs to prevent chemotherapy induced nausea and vomiting in Nanjing from 2018 to 2021

目的:研究南京地区预防化疗所致恶心呕吐药物的应用现状和变化趋势,为该类药品管理及临床合理应用提供参考。方法:对2018—2021年南京地区46家医院预防化疗所致恶心呕吐药物的品种、销售金额、用药频度(DDDs)、限定日费用(DDC)等指标进行统计分析。结果:2018—2020年南京地区46家医院5-羟色胺3(5-HT_(3))受体拮抗剂销售金额逐年增长,但降幅放缓,平均年增长率分别为17.78%和12.39%,2021年环比下降46.21%,呈负增长。5-HT_(3)受体拮抗剂DDDs也在2019年小幅增长后持续下降,下降率分别为2.47%和1.36%。第1代5-HT_(3)受体拮抗剂销售金额和DDDs总体呈下降趋势,而第2代5-HT_(3)受体拮抗剂帕洛诺司琼逐年平稳增长。神经激肽-1(neurokinin-1,NK-1)受体拮抗剂销售金额和DDDs均逐年大幅度增长,福沙匹坦上市后迅速占领NK-1受体拮抗剂市场,上市第1年占领2成左右的市场份额,而第2年占领近9成的市场份额。2021年其DDDs环比增长达923.44%。而阿瑞匹坦的销售金额和DDDs则逐年大幅度下降。结论:南京地区预防化疗所致恶心呕吐的药物方案及福沙匹坦的应用可能存在不适宜的情况,应进一步进行用药专项评价。

Objective:To investigate the status and tendency of utilization of drugs to prevent chemotherapyinduced nausea and vomiting in Nanjing so as to provide a reference for the management of rational clinical use of these drugs.Methods:The drugs to prevent chemotherapy-induced nausea and vomiting used in 46 hospitals of Nanjing during 2018-2021 were analyzed statistically regarding their types,consumption sum,defined daily doses(DDDs)and defined daily cost(DDC).Results:The consumption sum of 5-hydroxytryptamine 3(5-HT,)receptor antagonist in 46 hospitals of Nanjing increased at an average annual rate of 17.78%and 12.39%,respectively,between 2018 and 2020.In 2021,the consumption sum decreased by 46.21%,showing negative growth.The DDDs of 5-HT_(3)receptor antagonist increased slightly in 2019 and continued to decrease thereafter,with decreasing rates of 2.47%and 1.36%,respectively.The consumption sum and DDDs of the first generation 5-HT,receptor antagonist decreased,while palonosetron,the second generation 5-HT,receptor antagonist,increased steadily year by year.The consumption sum and DDDs of neurokinin-1(NK-1)receptor antagonists increased significantly year by year.Fosaprepitant rapidly occupied the market of NK-1 receptor antagonist,which is about 20%market share in the first year and nearly 90%market share in the second year.In 2021,its DDDs increased by 923.44%.However,the consumption sum and DDDs of Aprepitant decreased significantly year by year.Conclusion:The drug regimen for preventing chemotherapy-induced nausea and vomiting and the unreasonable application of fosaprepitant in Nanjing should be further paid attention to.