论文部分内容阅读
目的:通过分析上海市抗肿瘤药物的采购配备与临床使用情况,为制定针对性的肿瘤药物规范管理策略提供参考。方法:基于上海市医疗机构药品招标采购数据库和医院临床用药信息分析系统,分析不同等级医疗机构、药品分类、通用名的抗肿瘤药品的采购金额分布情况,以及抗肿瘤药物处方的总数、总金额、单张处方金额、处方药品种类和数量。结果:从采购金额看,三级医院(占81.04%)、细胞毒类药品(占34.62%,尤其是影响核酸合成的药物)、生物反应调节药(占17.98%)、靶向治疗类药物(占11.91%,以单克隆抗体药和酪氨酸激酶抑制药为主)、辅助用药(占28.06%,其中造血生长因子占比最高)、采购金额最高的前十类药物(累计占比48.12%)都是合理用药和费用控制的关键点;从临床使用情况看,三级医院(处方数量占比70.32%,平均处方费用为1 110.46元)、40岁及以上中老年患者(处方数量占比90.20%,40~49岁区间人群的平均处方费用最高,为1 370.00元)、自费患者(平均处方费用为1 603.15元)都是处方使用的重点干预机构或人群,其中恶性淋巴瘤(3 818.31元/张处方)、肺恶性肿瘤(2 997.52元/张处方)、胰腺恶性肿瘤(2 737.62元/张处方)的处方费用较高。结论:基于上海市抗肿瘤药物采购端和使用端的数据分析结果,建议在限定医疗机构抗肿瘤药物和辅助用药品种品规数量、定期开展抗肿瘤药物重点品种使用的监测与评价、落实抗肿瘤药物和辅助用药的处方点评及公示制度等方面进行关键点控制。
OBJECTIVE: To provide a reference for the development of targeted oncology drug management strategies by analyzing the procurement and clinical use of anti-cancer drugs in Shanghai. Methods: Based on Shanghai Municipal Medical Institutions Drug Bidding and Purchasing Database and Hospital Clinical Drug Information Analysis System, the distribution of procurement amount of antineoplastic drugs of different levels of medical institutions, drug classification and common name were analyzed, and the total number of antineoplastic prescriptions, the total amount , The amount of prescriptions, the type and amount of prescription drugs. Results: According to the purchase amount, there are three levels of hospitals (81.04%), cytotoxic drugs (34.62%, especially those affecting nucleic acid synthesis), biological response modifiers (17.98%), targeted therapeutic drugs Accounting for 11.91%, with monoclonal antibody drugs and tyrosine kinase inhibitors mainly), adjuvant drugs (accounting for 28.06%, of which the highest proportion of hematopoietic growth factor), the highest purchase amount of the top ten drugs (cumulative accounted for 48.12% ) Are the key points of rational drug use and cost control; from the clinical use, tertiary hospitals (prescriptions accounted for 70.32% of the total number, the average prescription cost of 1110.46 yuan), 40 years of age and older patients (accounting for the number of prescriptions 90.20% of the patients in the 40-49 age group had the highest average prescription cost of 1,370.00 yuan), and the patients with self-pay (the average prescription cost was 1,603.15 yuan) were the key intervention institutions or people who used the prescriptions. Malignant lymphoma (3 818.31 Yuan / Zhang prescription), lung cancer (2997.52 yuan / Zhang prescription), pancreatic cancer (2 737.62 yuan / Zhang prescription) prescription costs higher. Conclusion: Based on the data analysis results of procuring and using antineoplastic drugs in Shanghai, it is suggested to regularly monitor and evaluate the use of anticancer drugs in key species by limiting the quantities of antineoplastic drugs and auxiliary medicinal products in medical institutions, and to implement antineoplastic drugs And prescription medication reviews and publicity system for key points control.