| 试点城市带量采购政策对某三级综合医院门诊心血管类原研药和仿制药利用状况的影响 |
| 投稿时间：2020-01-13 修订日期：2020-03-09 点此下载全文 |
| 引用本文：王辉,李歆,陈敬.试点城市带量采购政策对某三级综合医院门诊心血管类原研药和仿制药利用状况的影响[J].药学实践杂志,2020,38(4):373~378 |
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| 基金项目:国家自然科学基金（No.71874006；No.71673147） |
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| 中文摘要:目的 分析试点城市（4个直辖市和7个较大规模城市）（简称“4+7”城市）带量采购对心血管药物利用状况的影响，为仿制药替代原研药使用政策优化提供参考。方法 选择上海市某三级综合医院门诊治疗心血管疾病的11种既有仿制药也有原研药的药物，分析带量采购政策实施前（2018年4月1日至9月30日）及实施后（2019年4月1日至9月30日）仿制药和原研药使用量占比、使用金额占比、日费用比及仿制药替代原研药的潜在费用节省率。结果 带量采购政策实施后，原研药使用数量占比、使用金额占比分别由84.32%下降至58.12%、86.02%下降至78.16%；仿制药使用数量占比、使用金额占比分别由15.68%上升至41.88%、13.98%上升至21.84%，仿制药与原研药日费用比由0.87降至0.39。在疗效相同的条件下，政策实施前后仿制药替代原研药潜在可节省费用分别为337.03万元、333.99万元，费用节省率分别为35%、61%。结论 “4+7”带量采购政策大幅度增加了心血管类仿制药的使用数量，明显降低了药品费用；但对仿制药使用数量和金额占比影响较小，仍存在较大的费用节省空间。建议进一步加大仿制药替代原研药的政策宣传，加快仿制药一致性评价进程和采取措施避免原研药与仿制药价格差距的扩大。 |
| 中文关键词:“4+7”带量采购 心血管疾病 原研药 仿制药 节省费用 |
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| Impact of “4+7” City Drug Centralized Procurement Program on the utilization of original and generic cardiovascular drugs in a tertiary hospital |
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| Abstract:Objective To analyze the impact of “4+7” City Drug Centralized Procurement Program on the utilization of cardiovascular medicines, and to provide a reference for optimizing the policy of generic medicines as substitutes for original medicines.Methods Eleven drugs, both generic and original were selected for treatment of cardiovascular diseases in an outpatient clinic of a tertiary hospital in Shanghai. The proportion of use of generic drugs and original drug, ratio of used amount, daily cost ratio, and potential cost savings rate of replacement of original drug by generic drug were analyzed before the “4+7” (2018.04.01-2018.09.30) and after the “4+7” (2019.04.01-2019.09.30).Results After the “4+7”, the proportion of the original research drug used decreased from 84.32% to 58.12%, and the ratio of amount of used money decreased from 86.02% to 78.16%; the proportion of generic medicines used increased from 15.68% to 41.88%, and the ratio of amount used increased from 13.98% to 21.84%; the daily cost ratio of generic medicine to original medicine decreased from 0.87 to 0.39. Under the same condition, the potential cost savings of replacing the original drug with generic drugs before and after the “4+7” were RMB 3.703 million and RMB 3.399 million, respectively, and the cost saving rate was 35% and 61%, respectively.Conclusion The “4+7” City Drug Centralized Procurement Program significantly increase the use of cardiovascular generic drugs and significantly reduce the cost of drugs; however, it has a small impact on the quantity and amount of generic drugs used. There is still a significant potential for cost saving. It is recommended to further increase the publicity of the policy on the substitution of original drug by generic, expedite the consistency evaluation process of generic drugs and take measures to avoid the widening of the price gap between original drugs and generics. |
| keywords:“4+7”City Drug Centralized Procurement Program cardiovascular diseases innovator brand medicines generic medicines cost saving |
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