上海市抗肿瘤药物采购配备和临床使用情况分析

发布时间：2018-09-14 15:32

【摘要】：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。
[Abstract]:Objective: to analyze the procurement and clinical use of antitumor drugs in Shanghai, and to provide a reference for the establishment of standardized management strategies for cancer drugs. Methods: based on Shanghai Medical institutions' Drug bidding Database and Hospital Clinical Drug Information Analysis system, the distribution of purchase amount of anti-tumor drugs in different grades of medical institutions, drug classification and general name was analyzed. As well as the total number of prescriptions for anti-tumor drugs, the total amount of money, the amount of prescriptions, the types and quantities of prescribed drugs. Results: in terms of the amount of money purchased, Level 3 hospitals (81.04%), cytotoxic drugs (34.62%, especially those affecting nucleic acid synthesis), biological reaction regulators (17.98%), targeted therapeutic drugs (11.91%, mainly monoclonal antibody drugs and tyrosine kinase inhibitors), auxiliary drugs Medication (28.06%), hematopoietic growth factor (HGF) and the top ten kinds of drugs (48.12%) were the key points of rational drug use and cost control. According to the clinical usage, the average prescription cost was the highest in the third level hospital (70.32% of prescriptions and 1 110.46 yuan on average) in the middle and old patients aged 40 and above (the proportion of prescriptions was 90.20%), and the average prescription cost was the highest in the range of 4049 years old (the proportion of prescriptions was 90.20%). The patients at their own expense (the average prescription cost was 1 603.15 yuan) were all the key intervention organizations or people who used the prescription. The prescription cost of malignant lymphoma (3 818.31 yuan / prescription), lung malignant tumor (2 997.52 yuan / prescription) and pancreatic malignant tumor (2 737.62 yuan / prescription) was higher. Conclusion: based on the results of data analysis on the purchasing and using end of antitumor drugs in Shanghai, it is suggested that regular monitoring and evaluation of the use of key anti-tumor drugs should be carried out in medical institutions by limiting the quantity of anti-tumor drugs and auxiliary drugs. Carry out the key point control of prescription evaluation and publicity system of anti-tumor drugs and adjuvant drugs.
【作者单位】：上海市医学科学技术情报研究所;上海市卫生发展研究中心;复旦大学公共卫生学院;上海市卫生和计划生育委员会;上海市医药集中招标采购事务管理所信息管理科;
【基金】：美国中华医学基金会卫生体系研究与政策转化合作项目(CMB-CP 14-190) 第四轮上海市公共卫生体系建设三年行动计划(2015-2017)项目(GWIV-33) 上海市卫生计生委2016年度卫生政策研究定向委托课题(2016HP012)
【分类号】：R95

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