福建省使用的口服化学药品最小销售单元现状分析

Study on the Present Situation of Minimum Sales Package Unit of Oral Chemical Preparations Used in Fujian Province

目的:通过调查分析福建省上市药品口服制剂最小销售单元现状,为调整药品包装规格提供参考。方法:以《国家基本医疗保险、工伤保险和生育保险药品目录(2021年)》中的化学药品口服制剂为研究对象,选取福建省药械联合限价阳光采购平台数据,利用SPSS19.0进行数据处理与分析。结果:检索到口服制剂949个,装量范围为1~500片(粒或丸),使用天数范围为0.4~66.7天。装量和使用天数中位数M(P25,P75)分别为20(10,30)、7.2(4.7,13.3)。普通药品、慢性病用药和特殊药品在装量和使用天数上存有统计学差异(P<0.001)。“集采”药品较非“集采”药品装量更大,使用天数更长,两者有统计学差异(P<0.05)。销售金额排名前20位的口服制剂装量分布在5~50片(粒或丸)之间,使用天数1~30天不等,其中87.5%的慢性病用药使用天数均<14天。结论:上市药品慢性病用药(心血管系统、内分泌系统、血液系统用药、抗肿瘤药及免疫调节剂等)装量普遍过小,普通药品(全身激素制剂,泌尿生殖系统药和性激素,肌肉-骨骼系统用药)及特殊药品(第一类、第二类精神药品)装量偏大。建议普通药品最小销售单元装量采用<7天使用量小包装,慢性病用药采用4周使用量的倍量包装,特殊药品(精神药品、麻醉药品)采用特殊装量包装。

Objective:To provide reference for the adjustment of drug packaging specifications through investigation and analysis on the minimum sales unit of oral drug preparations in Fujian Province.Methods:The oral preparations of chemical drugs in The Catalogue of Drugs for National Basic Medical Insurance,Industrial Injury Insurance and Maternity Insurance(2021 Edition)were taken as the research object.The data of Fujian Drug&Medical Apparatus and Instruments Procurement platform were retrieved,and SPSS 19.0 was used for data processing and analysis.Results:There were 949 varieties of oral drugs,ranging from 1 to 500 tablet/granule/pill,the use-days ranged from 0.4 to 66.7 days.The median(P25,P75)of medications of loading quantities and use-days were 20(10,30)and 7.2(4.7,13.3),respectively.There were statistical differences in the loading and use days of common drugs,drugs for chronic diseases and specially managed drugs(P<0.001).Compared with non-centralized purchase by public bidding,centralized purchase by public bidding of drugs had a larger loading capacity and longer use days,and there was a statistical difference between the two(P<0.05).Among the top 20in terms of sales amount,the loading quantities of oral preparations ranged from 5 to 50 tablet/granule/pill,and the use-days ranged from 1 to 30 days,and 87.5%of the medication usage days for chronic diseases were less than 14days.Conclusion:The listed drugs of chronic diseases(cardiovascular system,endocrine system,blood system drugs,anti-tumor drugs and immune modulators etc.)are too small in volume,general drugs(systemic hormone preparations,genitourinary system drugs and sex hormones,musculoskeletal system drugs)and specially managed drugs(the first class and the second class psychoactive drugs)are loaded too much.It is recommended that the minimum unit packaging for general drugs should be packaged less than 7 days,the drugs of chronic diseases should be packaged in 4-week times dosage,and specially managed drugs(psychotropic and narcotic drugs)should be used in special packs.