摘要
目的为慢性阻塞性肺疾病(COPD)的规范化治疗和国家基本药物目录中COPD治疗药品的调整提供参考。方法邀请相关临床专家、药学专家、医保专家共同梳理国内外COPD临床指南、国家基本药物目录、WHO基本药物标准清单、国家医保目录等收录的COPD治疗药品,并进行比较分析。结果与结论相较于国内临床治疗指南,国外临床指南多收录了1种COPD三联复合制剂,但后者收录的祛痰药及抗氧化剂种类较少;WHO基本药物标准清单收录的COPD治疗药品仅有12种,而我国基本药物目录收录了18种,后者包含更多的茶碱类、祛痰药及抗氧化剂。有15种COPD治疗药品被我国临床指南和国家医保目录收录,但未被国家基本药物目录收录,包括特布他林、盐酸左沙丁胺醇、沙美特罗、福莫特罗、茚达特罗、倍氯米松、糠酸莫米松、沙丁胺醇异丙托溴铵、格隆溴铵福莫特罗、乌美溴铵维兰特罗、茚达特罗格隆溴铵、倍氯米松福莫特罗、布地奈德/格隆溴铵/富马酸福莫特罗(布地格福)、糠酸氟替卡松/维兰特罗/乌美溴铵(氟替美维)、福多司坦,主要为长效β2受体激动剂和三联复合制剂。这些药品具有一定的循证医学证据,其疗效和经济性均有一定优势,且对医保基金预算的影响可控,建议后续基本药物目录更新调整时可考虑纳入。
OBJECTIVE To provide a reference for the standardized treatment of chronic obstructive pulmonary disease(COPD)and the adjustment of therapeutic drugs for COPD in the national essential medicine list.METHODS Relevant clinical experts,pharmaceutical experts and medical insurance experts were invited to sort out the COPD treatment drugs involved in the domestic and foreign COPD clinical guidelines,the national essential medicine list,the WHO standard list of essential medicine,the national medical insurance catalogue,and comparatively analyzed the COPD treatment drugs.RESULTS&CONCLUSIONS Compared with domestic clinical guidelines,foreign clinical guidelines included an additional COPD triple preparation,while involving fewer types of expectorants and antioxidants;there were only 12 kinds of COPD treatment drugs included in the WHO standard list of essential medicine,while there were 18 kinds in the national essential medicine list in China,and more theophylline drugs,expectorants and antioxidants were included.In addition,15 kinds of COPD treatment drugs were found in both the national clinical guidelines and the national medical insurance catalogue,but not in the national essential medicine list,including terbutaline,levalbuterol hydrochloride,salmeterol,formoterol,indacaterol,beclometasone,mometasone furoate,salbutamol ipratropium,glycopyrronium formoterol,umeclidinium vilanterol,indacaterol glycopyrronium,beclometasone formoterol,budesonide/glycopyrrolate/formoterol fumarate,fluticasone furoate/vilanterol/umeclidinium,and fudosteine,which were mainly long-acting beta 2-agonists and COPD triple preparations.These drugs had certain evidence-based medicine evidence,their efficacy and economy had certain advantages,and their impact on the budget of the medical insurance fund was controllable.Therefore,it is suggested that the aforementioned drugs should be included in the essential medicines list in the subsequent update.
作者
张丽成
高明
封宇飞
马艳良
冷家骅
ZHANG Licheng;GAO Ming;FENG Yufei;MA Yanliang;LENG Jiahua(Medical Insurance Service Division/Key Laboratory of Malignant Tumor Pathogenesis and Transformation Research Co-constructed by Ministry of Education,Beijing Cancer Hospital&Beijing Institute for Cancer Research,Beijing 100142,China;Dept.of Pharmacy,Peking University People’s Hospital,Beijing 100044,China;Dept.of Respiratory Medicine,Peking University People’s Hospital,Beijing 100044,China)
出处
《中国药房》
CAS
北大核心
2023年第16期1931-1935,共5页
China Pharmacy
关键词
慢性阻塞性肺疾病
基本药物目录
医保目录
长效β_(2)受体激动剂
三联复合制剂
chronic obstructive pulmonary disease
essential medicine list
medical insurance catalogue
longacting beta 2-agonist
triple preparations