2012年至2021年甘肃省医疗机构降压药利用研究

Research on the Utilization of Antihypertensive Drugs of Medical Institutions in Gansu Province from 2012 to 2021

目的为优化降压药的用药模式提供参考。方法收集2012年至2021年甘肃省公共资源交易中心药品集中招标采购平台中的降压药相关数据,以限定日剂量(DDD)、用药频度(DDDs)、每千人每天用药消耗量(DID)、限定日费用(DDC)、使用金额排序/药品DID排序(B/A)和复合年均增长率(CAGR)描述甘肃省降压药的利用模式。结果共覆盖省内一级医疗机构1356家,二级238家,三级68家。2012年至2019年甘肃省医疗机构降压药的DID和DDC均逐年增加,并在2019年达峰值,2019年至2021年均逐年下降;累积DID占比最高的是肾素-血管紧张素系统(RAS)类降压药(39%),其次是钙离子通道阻断剂(31%)。2012年至2021年,各级医疗机构降压药的DID均总体呈上升趋势,其中一级医疗机构降压药的DID占比最高但总体呈下降趋势,二级、三级医疗机构DID占比总体呈上升趋势。甘肃省2021年DID累积占比前90%的降压药共9种,其中,缬沙坦DID占比最高(29.34%);RAS类降压药品种最多(6种);B/A为0.8~1.2的降压药有3种,分别为依那普利、替米沙坦和非洛地平。结论2012年至2021年甘肃省各级医疗机构降压药的用药结构和DDC基本合理,但消耗量未明显呈现向基层医疗机构下沉的趋势。

Objective To provide a reference for optimizing the utilization mode of antihypertensive drugs.Methods Relevant data of antihypertensive drugs in the centralized drug bidding and procurement platform of Gansu provincial public resource trading center from 2012 to 2021 were collected.The utilization mode of antihypertensive drugs in Gansu province was described by defined daily dose(DDD),defined daily doses(DDDs),daily consumption dose per thousand population(DID),defined daily cost(DDC),consumption amount ranking/drug DID ranking(B/A)and compound annual growth rate(CAGR).Results There were a total of 1356 primary medical institutions,238 secondary medical institutions and 68 tertiary medical institutions in the province involved.The DID and DDC of antihypertensive drugs of medical institutions in Gansu province increased year by year from 2012 to 2019,reaching a peak in 2019 and decreasing year by year from 2019 to 2021.The cumulative DID proportion of renin-angiotensin system(RAS)antihypertensive drugs was the highest(39%),followed by calcium channel blockers(31%).The DID of antihypertensive drugs in medical institutions at all levels showed an overall upward trend from 2012 to 2021,the DID proportion in primary hospitals was the highest but showed an overall downward trend,and that in secondary and tertiary medical institutions showed an overall upward trend.There were nine antihypertensive drugs with the top 90%cumulative DID proportion in Gansu province in 2021,among which valsartan had the highest DID proportion(29.34%).RAS antihypertensive drugs had the most varieties(six types).There were three types of antihypertensive drugs with a B/A in the range of 0.8 to 1.2,namely enalapril,telmisartan and felodipine.Conclusion The medication structure and DDC of antihypertensive drugs of medical institutions at all levels in Gansu province from 2012 to 2021 were basically rational,but the consumption of antihypertensive drugs dose not trend to the grass-roots medical institutions.