带量采购政策对某医院口服抗肿瘤药临床使用的影响

Impact of Volume-based Procurement of Drugs on Clinical Usage of Oral Antineoplastic Drugs in a Hospital

目的探讨带量采购政策对某医院口服抗肿瘤药使用的影响,为政策制定和完善提供理论依据。方法选取医院带量采购政策执行前后3年同期(2019、2020、2021年5月20日-12月31日)口服抗肿瘤药的用药数据,对药物的用药频度、限定日费用及实际节省费用等进行动态分析。结果政策实施后除甲苯磺酸索拉非尼片未调价外,其他药品价格均出现不同幅度下调,降幅12.00%~76.01%。2020年中选药品除伊马替尼的用药频度较2019年上涨20%外,其他均呈下降趋势,降幅6.35%~86.96%。2021年中选药品的用药频度除替吉奥胶囊和甲苯磺酸索拉非尼片呈下降趋势,降幅分别为57.43%和46.10%,其他均呈上升趋势,涨幅10.71%~500.00%。中选药品2020年的限定日费用降幅1.42%~82.79%,至2021年仍持续下降,降幅61.94%~99.67%;未中选药品限定日费用在2021年也明显下降。带量采购政策实施后口服抗肿瘤药的药费呈逐年下降趋势,2020年实际节省药费总计227.40万元,2021年实际节省药费总计588.17万元。结论带量采购政策的实施对于减轻肿瘤患者的经济负担有显著意义,但要进一步优化中选药品临床应用,完善和监督政策的落实。

Objective To explore the influence of volume-based procurement on the use of oral antineoplastic drugs in a hospital and to provide data for decision-makers.Methods The frequency of drug use,defined daily cost and actual cost saved related to oral antineoplastic drugs used in the same period(from May 20 to December 31 in 2019,2020 and 2021)before and after implementation of the volumebased procurement policy were dynamically analyzed.Results Except sorafenib mesylate tablets whose price was not adjusted,the prices of other drugs were lowered to varying extents,with decreases ranging from 12.00%to 76.01%after the implementation of the policy.In 2020,except for the frequency of use of imatinib that increased by 20%compared with 2019,the rest of the selected drugs showed a downward trend,with decreases between 6.35%and 86.96%.In 2021 two years after the implementation of the policy,the frequency of use of the selected drugs trended up with increases of 10.71%to 500.00%except tegafur and sorafenib tosylate tablets,the frequency of which decreased by 57.43%and 46.10%,respectively.The defined daily cost of selected drugs decreased between 1.42%and 82.79%in 2020 and continued to decline between 61.94%and 99.67%in 2021.After the implementation of the policy,the cost of oral antineoplastic drugs trended down year by year.The actual drug cost saved totaled 2.2740 million yuan in 2020 and 5.8817 million yuan in 2021.Conclusion The implementation of the volume-based procurement policy is of great significance for reducing the financial burden of cancer patients,but the clinical application of selected drugs needs to be optimized while the implementation of the policy needs to be supervised.