苯磺酸氨氯地平片带量采购对其他钙通道阻滞剂使用情况的影响研究

目的:探讨苯磺酸氨氯地平片带量采购对其他钙通道阻滞剂(calcium channel blocker,CCB)使用情况的影响,为政策制定和医院药事管理提供参考。方法:采用药物经济学方法,对苯磺酸氨氯地平片带量采购实施前(2018年12月22日至2019年12月21日)、带量采购实施后(2019年12月22日至2020年12月21日)该院门诊药房所有CCB类药品的销售数量、销售金额、用药频度(DDDs)和限定日费用(DDC)等进行分析;采用多因素有序Logistic回归分析,探讨苯磺酸氨氯地平带量采购对其他CCB类药品的影响。结果:带量采购实施后,苯磺酸氨氯地平片的销售数量较带量采购实施前增加了594片(从438200片增至438794片),其销售数量占CCB类药品总销售数量的比例较实施前增加了4.72%(从32.43%增至37.15%);销售金额较实施前减少了1478161.01元(从1503026.00元降至24864.99元),其销售金额占CCB类药品总销售金额的比例较实施前降低了34.73%(从35.80%降至1.07%);DDDs较实施前升高了0.14%(从438200增至438794);DDC降至0.06元/日,仅为实施前(3.43元/日)的0.02%。校正干扰因素后的多因素有序Logistic回归分析结果显示,苯磺酸氨氯地平片带量采购后使苯磺酸左旋氨氯地平的DDDs降低且差异有统计学意义(P<0.05),对其他CCB类药品无影响。结论:苯磺酸氨氯地平片带量采购后,患者的DDC较前明显降低,同时影响了其他CCB类药品的销售数量。随着医疗改革的进一步深入及带量采购的常态化、制度化,药品价格将更加趋于合理,惠及广大人民群众。

Effects of Volume-Based Procurement of Amlodipine Besylate Tablets on Application of Other Calcium Channel Blocker

OBJECTIVE:To probe into the effect of volume-based procurement of Amlodipine besylate tablets on application of other calcium channel blockers(CCB),so as to provide references for policy making and hospital pharmacy management.METHODS:Pharmacoeconomics method was used to analyze the consumption quantity,consumption sum,defined daily dose(DDDs)and defined daily cost(DDC)of CCB drugs in outpatient pharmacy in this hospital before(from Dec.22nd,2018 to Dec.21st,2019)and after(Dec.22nd,2019 to Dec.21st,2020)the implementation of volume-based procurement;multivariate orderly logistic regression analysis was used to discuss the effect of volume-based procurement of Amlodipine besylate tablets on the application of other CCB.RESULTS:After the implementation of volume-based procurement,the consumption quantity of Amlodipine besylate tablets had increased by 594 tablets(from 438200 tablets to 438794 tablets),and the proportion of its consumption quantity accounted for the total consumption quantity of CCB drugs had increased by 4.72%(from 32.43%to 37.15%);the consumption sum had decreased by 1478161.01 yuan(from 1503026.00 yuan to 24864.99 yuan),the proportion of its consumption sum accounted for the total consumption sum of CCB drugs had decreased by 34.73%(from 35.80%to 1.07%);the DDDs had increased by 0.14%(from 438200 to 438794);the DDC had decreased to 0.06 yuan/day,which was only 0.02%of before the implementation of volume-based procurement(3.43 yuan/day).The results of multivariate orderly logistic regression analysis after correcting interference factors showed that the DDDs of Amlodipine besylate tablets had decreased after the implementation of volume-based procurement and the difference was statistically significant(P<0.05),while had no effect on other CCB drugs.CONCLUSIONS:After the implementation of volume-based procurement of Amlodipine besylate tablets,the DDC of patients has significantly decreased,and it also affects the consumption quantity of other CCB drugs.With the further deepening of medical reform and the normalization and institutionalization of volume-based procurement,the drug prices will be more reasonable and benefit the general public.