抗菌药品国家集采政策实施四年效果与评价——以北京某三级医院为例

Effect and Evaluation of Volume-Based Procurement Policy on the Use of Antibiotics--in a Tertiary Hospital in Beijing

目的探究北京某三级医院抗菌药品集中带量采购的实施效果,为推动医院合理用药,完善抗菌药品集中采购提供参考。方法利用Excel软件,采用对比分析法探究医院2019年3月~2023年2月国家集采中选药品的使用情况,包括执行中选品种数、使用量、销售金额、中选抗菌药物约定量与处方量、DDDs、门诊/住院病人次均药费、药品不良反应等指标。结果各批集采任务量均超额完成,集采品种使用金额和占比逐年提高;中选与同种非中选品种处方数的比值平均为1.91;门诊/住院病人次均药费逐渐下降;部分抗菌药物中选品种DDDs明显高于非中选原研药;抗菌药物中选品种次均费用较集采前明显下降,平均降幅62.88%;与执行集采之前相比,药品不良反应例数并无明显增加。结论国家组织抗菌药品药品集中采购减轻了患者药费负担,促进了临床合理使用,但仍需精细化的措施平衡集采与抗菌药物管理之间的关系。

OBJECTIVE To explore the implementation effect of the volume-based procurement policy on the use of antibiotics in a tertiary hospital in Beijing,and to provide reference for promoting the rational drug use in hospitals and improving the centralized procurement of antibacterial drugs.METHODS We used Excel software to compare and analyze the use date of the selected drugs during March 2019-February 2023,including the number of selected varieties,usage,sales amount,the task amount and prescription of antibiotics,DDDs,outpatient/inpatient drug costs per time,adverse drug reactions,etc.RESULTS All tasks were over-fulfilled,and the sales amount and proportion of the selected varieties increased year by year;the ratio of the selected/not selected prescriptions was 1.91;the average drug cost per time for outpatient and inpatient patients gradually decreased;the DDDs of some selected antibiotics were significantly higher than the original antibiotics(not selected);the average cost of selected antibiotics decreased significantly with the average decrease of 62.88%;There was no significant increase of the number of ADR before and after the policy implementation.CONCLUSION The centralized procurement of antibiotics reduces the burden of drug costs for patients and has a certain role in promoting rational clinical use.However,detailed measures are still needed to balance the relationship between volume-based procurement policy and antibiotics management.