2023 年第 11 期 第 18 卷

国家药品集中采购政策下他汀类药物和依折麦布的应用分析

Application analysis of statins and ezetimibe under national centralized drug procurement policy

作者：边俊玉1石秀锦2杜海燕2刘之光2所伟2张沫2金贝多2林阳2

英文作者：Bian Junyu1 Shi Xiujin2 Du Haiyan2 Liu Zhiguang2 Suo Wei2 Zhang Mo2 Jin Beiduo2 Lin Yang2

单位：1首都医科大学药学院，北京100069；2首都医科大学附属北京安贞医院药事部，北京100029

英文单位：1School of Pharmaceutical Sciences Capital Medical University Beijing 100069 China; 2Department of Pharmacy Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：家药品集中采购；他汀类药物；依折麦布；用药频度；日用药金额；用药分析

英文关键词：Nationalcentralizeddrugprocurement;Statins;Ezetimibe;Frequencyofdruguse;Dailycostofuse;Analysisofdruguse

• 摘要：

• 目的  分析药品集中采购（以下简称集采）政策对他汀类药物和依折麦布应用情况的影响。方法  回顾性收集首都医科大学附属北京安贞医院医院信息系统中2018—2022年的门诊高胆固醇血症患者调脂药物使用数据，利用药物经济学方法分析各他汀类药物的价格、数量、金额、用药频度（DDDs）和日用药金额（DDC）等变化情况，并关注阿托伐他汀钙片集采仿制药和原研药与依折麦布联合使用情况。结果  药品集采政策实施后，他汀类原研药品使用量占比下降，集采仿制药使用量占比上升，2020年和2021年阿托伐他汀钙片中选仿制药（10 mg×14片/盒、20 mg×14片/盒）从第4位上升至第2位；2021年瑞舒伐他汀钙片中选仿制药（10 mg×14片/盒）替换中选仿制药（10 mg×28片/盒），至2022年其DDDs稳居第3位，而原研药DDDs已降为第4位。药品费用有明显的下降，集采后中选仿制药阿托伐他汀钙片（10 mg×7片/盒、20 mg×7片/盒）和（10 mg×14片/盒、20 mg×14片/盒）的DDC分别仅为原研药的15.38%、3.27%；瑞舒伐他汀钙片中选的仿制药（10 mg×28片/盒、10 mg×14片/盒）的DDC最低仅为原研药的4.33%、5.42%；辛伐他汀片中选的仿制药（20 mg×60片/盒）DDC仅为原研药的5.20%。另外联用依折麦布使用比例上升明显。结论  药品集采政策实施后中选仿制药使用量占比上升，显著降低了高胆固醇血症患者的用药经济负担。

• Objective  To analyze the influence of the policy of centralized drug procurement (hereinafter referred to as centralized drug procurement) on the application of statins and ezetimibe. Methods  The data on the use of lipid-regulating drugs in out-patients with hypercholesterolemia from 2018 to 2022 in the Hospital information system of Beijing Anzhen Hospital, Capital Medical University were retrospectively collected. Pharmacoeconomic Methods   were used to analyze the price, quantity, amount, frequency of drug use(DDDs) and daily cost of use (DDC) of various statins. Attention was paid to the generics of atorvastatin calcium tablets and the combination of the original drug and ezetimibe. Results  After the implementation of the drug collection policy, the proportion of original statin drug use decreased, and the proportion of generic drug use increased. In 2020 and 2021, the selected generic drug of atorvastatin calcium tablets (10 mg×14 tablets/box, 20 mg×14 tablets/box) rose from the fourth to the second place. In 2021, the selected generic of rosuvastatin calcium tablets (10 mg×14 tablets/box) replaced the selected generic drug (10 mg×28 tablets/box), and its DDDs remained in the third place by 2022, while the DDDs of the original drug has dropped to the fourth place. The drug cost decreased obviously, and the DDC of selected generics atorvastatin calcium tablets (10 mg×7 tablets/box, 20 mg×7 tablets/box and the DDC of selected generics atorvastatin calcium tablets (10 mg×14 tablets/box, 20 mg×14 tablets/box) only accounted for 15.38% and 3.27% of the original varieties, respectively. The DDC of rosuvastatin calcium tablets (10 mg×28 tablets/box) and the DDC of rosuvastatin calcium tablets (10 mg×14 tablets/box) only 4.33%, 5.42% of the original drugs at its lowest point, respectively. The DDC of the generic drug selected in simvastatin tablets (20 mg×60 tablets/box) only accounted for 5.20% of the original study. In addition, the proportion of combined use of ezetimibe increased significantly. Conclusion  After the implementation of the drug collection policy, the proportion of selected generics was increased, which significantly reduced the economic burden of medication for patients with hypercholesterolemia.