2010-2015年天津市肿瘤医院植物来源的抗肿瘤药及其衍生物类药物使用情况分析

目的：评价2010—2015年天津市肿瘤医院植物来源的抗肿瘤药及其衍生物类药物使用情况。方法对2010—2015年植物来源的抗肿瘤药及其衍生物类药物的用量、销售金额、用药频度（DDDs）、日均药费（DDC）和药品排序比（B/A）进行统计和分析。结果紫杉醇类的使用金额占植物来源的抗肿瘤药及其衍生物类药物的85%以上，同时增长势头强劲；鬼臼毒素类的使用金额占比最低，只有1%左右，而且使用金额从2012年以后逐年下降。植物来源的抗肿瘤药及其衍生物类药物的总使用金额是逐年增长的趋势，但2012年以后增幅较小。伊立替康、依托泊苷和长春地辛的使用金额呈逐年递增。从排序来看，紫杉醇、多西他赛、伊立替康和长春瑞滨连续6年排名前4位。总DDDs逐年增长，多西他赛的DDDs排名持续居于首位，紫杉醇居于次席。DDC和排序相对稳定，2010—2014年伊立替康的DDC排名持续居于首位，紫杉醇在2015年跃升至第1位。其中长春新碱的DDC最低，伊立替康的DDC最高。DDC超过100元的是伊立替康、紫杉醇、多西他赛和长春瑞滨。多西他赛的B/A最大，连续6年为2.00，紫杉醇的B/A连续6年均为0.50；替尼泊苷、长春新碱和长春地辛的 B/A 均接近1.00。结论天津市肿瘤医院植物来源的抗肿瘤药及其衍生物类药物的应用基本合理，但仍存在一些不足，还需进一步加强管理。

Analysis on usage of antineoplastic agents from plant source and its derivatives in Tianjin Cancer Hospital from 2010 to 2015

Objective To investigate the utilization of antineoplastic agents from plant source and its derivatives in Tianjin Cancer Hospital from 2010 to 2015. Methods The utilization information of antineoplastic agents from plant source and its derivatives in Tianjin Cancer Hospital from 2010 to 2015 was extracted, and the consumption sum, defined daily doses (DDDs), defined daily cost (DDC), and drug sequence ratio (B/A) were analyzed statistically. Results The consumption sums of Paclitaxel in each year accounted for more than 85% in all and increased year by year. The consumption sums of podophyllotoxins accounted for the lowest, only about 1%, and the consumption sums decreased year by year since 2012. From 2010 to 2015, the total consumption sums of antineoplastic agents from plant source and its derivatives were increased year by year, but the increase was smaller after 2012. The consumption sums of irinotecan, etoposide, and vindesin were increased year by year. From the terms of sequences, paclitaxel, docetaxel, irinotecan, and vindesin ranked the top 4 in 6 consecutive years. The total DDDs increased year by year, and DDDs of docetaxel ranked in the first place, and paclitaxel were in the second place. In addition, DDC and sequences were relatively stable. DDC of irinotecan sustained in the first place from 2010 to 2014, but paclitaxel ranked the first place in 2015. The lowest and highest DDC were vincristine and irinotecan, respectively. DDC of irinotecan, paclitaxel, docetaxel, and vinorelbine were above 100 Yuan. B/A of docetaxel and paclitaxel were 2.00 and 0.5 from 2010 to 2015, but those of teniposide, vincristine, and vindesin were close to 1.00. Conclusion The utilization of antineoplastic agents from plant source and its derivatives in Tianjin Cancer Hospital is rational on the whole, but there are still some problems, which needs further efforts to strengthen the management.