我国儿童专用药品可及性真实世界数据的多中心调研

A multicenter survey of real-word data on the accessibility of specific medicines for children in China

目的:调研目前整理出的儿童专用药品目录中药品在儿童医院、妇幼保健院和综合医院的可及性现状。方法:根据儿童专用药定义,北京儿童医院、北京天坛医院、河南省儿童医院和安徽省儿童医院联合整理出我国目前的儿童专用药品目录。采用现况调查法,以问卷调查表的形式于2022年4月2—10日收集我国不同省市区域范围内67家医疗机构的儿童专用药品的可及性信息。调研内容包含可获得性、厂家、2021年使用量。结果:儿童专用药品目录共包含295个药品品规,其中有94个国家医保目录药品和16个国家基本药物目录药品。本次调研的67家医疗机构包括60家三甲医院、4家三乙医院和3家其他医院。经调研可知有140种(西药121种、疫苗19种)儿童专用药品可被获得,其西药品种在儿童医院、妇幼保健院和综合医院中的可获得性分别为42.85%,32.43%,27.41%,疫苗品种为50%,38.89%,47.22%。将儿童专用药品按照ATC解剖学分类分为12类,其可获得性基本呈现出儿童医院>妇幼保健院>综合医院。16个基本药品的可获得率≥30%的品种数分别为儿童医院10个、妇幼保健院7个、综合医院5个。46个儿童专用药品能够查询到限定日剂量值(DDD)并列出使用频度(DDDs)排名前10位的药品。本次调研经统计共有152家药品生产厂家,国内厂家为127家(83.6%)、国外厂家25家(16.4%)。结论:儿童专用药品中的西药和疫苗的可及性现状分别为:儿童医院西药可获得性低、疫苗可获得性比较高;妇幼保健院的西药和疫苗均可获得性低;综合医院的西药可获得性非常低、疫苗可获得性低。需要加强儿童专用药品的研发力度及可及性。

Objective:To investigate the accessibility status of drugs in the list of specific drugs for children in children's hospitals,maternal and child health care hospitals and general hospitals.Methods:According to the definition of child-specific drugs,Beijing Children's Hospital,Beijing Tiantan Hospital,Henan Provincial Children's Hospital and Anhui Provincial Children's Hospital jointly sorted out the current list of special drugs for children inChina. From April 2nd to April 10th,2022,a questionnaire was used to collect information on the accessibility ofchild-specific medicines in 67 medical institutions in different provinces and cities. The research included theavailability,manufacturer,and usage in 2021. Results: The list of child-specific medicines includes 295 medicineswith 115 generic names. Among them,there are 94 drugs listed in the National Medical Insurance List and 16drugs listed in the National Essential Medicine List. There were 67 medical institutions in this survey,including 60class A tertiary hospitals,4 class B tertiary hospitals and 3 other types. According to the research,140 kinds ( 121western medicines,19 vaccines) specific medicines for children could be obtained. The availability of westernmedicine in children's hospitals,maternal and child health hospitals and general hospitals were 42. 85%,32. 43%,and 27. 41%,respectively,and that of vaccine were 50%,38. 89%,and 47. 22%,respectively. Child-specificdrugs were divided into 12 categories based on ATC anatomical classification,and their availability in children'shospitals was the highest,followed by maternal and child health care hospitals and then general hospitals. Amongthe child-specific drugs,the numbers of essential drugs with availability higher than 30% were 10 in children'shospitals,7 in maternal and child health care hospitals,and 5 in general hospitals,respectively. The DDD valuesof 46 child-specific drugs could be queried,and the top 10 drugs were listed bases on the frequent use ( DDDs) .According to statistics,there were 152 drug manufacturers,including 127 domestic manufacturers ( 83. 6%) and25 foreign manufacturers ( 16. 4%) . Conclusion: The accessibility status of child-specific drugs were as follows:the availability of western medicines in children 's hospitals is low,and that of vaccines is relatively high;theaccessibility of western medicines and vaccines in maternal and child health hospitals is low;the accessibility ofwestern medicines in general hospitals is very low and that of vaccines is low. Research and development andaccess to medicines for children need to be strengthened.