淮南地区5家公立医院国家基本药物采购情况研究

Study on the procurement of national essential medicines in 5 public hospitals in Huainan area

目的为新医改政策下促进国家基本药物的推广及相关政策的制定提供建议。方法对5家公立医院国家基本药物品种、采购金额占比、系统分类情况以及国家医保谈判(以下简称国谈)药品、国家集中带量采购药品(以下简称国家集采)的采购情况利用Excel软件进行数据汇总分析。结果5家医院国家基本药物平均品种数和金额占比分别为43.15%、39.12%,其中中成药品种和金额仅占20.9%、20.35%;从系统分类来看,中成药及儿科、眼科用药和抗寄生虫药配备比低下;国谈涉及的国家基本药物品种数和采购金额平均占比分别为14.63%、26.77%,且逐年减少;2020年第一批国家集采涉及的国家基本药物采购数量较上一周期增长32.3%,采购金额下降73.88%,占同期国家基本药物采购总额的19.28%,品种数和采购金额占比呈下降趋势。结论医院中成药、儿科用药及抗寄生虫药等品种配备不足,部分国家基本药物短缺,国谈品种大量落地等原因导致国家基本药物品种和金额占比降低。建议完善儿科用药目录,将中成药纳入国家集采以提高基本药物比例,医院应完善儿科、眼科等科室基本药物品种,加强短缺药品预警和储备等措施,促进国家基本药物的推广。

Objective To provide suggestions for the promotion of national essential medicines and the formulation of related policies under the new medical reform policy.Methods The varieties of national essential medicines,the proportion of procurement amount,the system classification,as well as the variety and procurement amount of medicines purchased by national centralized drug procurement and national medical insurance negotiation were summarized and analyzed by Excel software.Results The average number of varieties and purchase amount of the national essential medicines in the 5 hospitals were 43.15%and 39.12%,respectively,of which only 20.9%and 20.35%were proprietary Chinese medicines,which was obviously insufficient.From the perspective of drug category,the allocation ratio of various types of Chinese patent medicines,pediatric,ophthalmic and antiparasitic drugs was low.The number of varieties of national essential medicines and the amount of purchase accounted for 14.63%and 26.77%respectively,and decreased year by year.In 2020,the quantity of national essential medicine procurement involved in the first batch of national procurement increased by 32.3%,and the purchase amount decreased by 73.88%,accounting for 19.28%of the total purchase amount of essential medicine in the same period.However,the proportion of varieties and purchase amount showed a downward trend.Conclusion Chinese patent medicine,pediatric medicines,anti-parasitic drugs and other varieties in hospitals were not fully equipped,some national essential medicines were in short supply,and the increase in the variety of national medical insurance negotiation has led to a decrease in the proportion of national essential medicines in terms of variety and procurement sum.It is suggested to improve the pediatric drug list and include Chinese patent medicines into national collection to increase the proportion of essential medicines.Hospitals should improve the varieties of essential medicines in pediatrics,ophthalmology and other departments,adjust the specifications and dosage forms of some medicines,strengthen the measures of early warning and reserve of medicines in shortage,to promote the proportion of national essential medicines.