目的: 分析集中带量采购政策对不同等级公立医疗机构约定采购周期、续约期药品采购的影响。方法: 运用间断时间序列法分析7个试点城市不同等级公立医疗机构药品采购量、采购金额、日均费用的变化情况。结果: 集采品种在试点期、续约期采购量分别增加15.36%和4.61%,可替代品种试点期、续约期采购量增长率均高于集采品种增长率,分别为17.30%和5.60%。集采品种中原研药、过评仿制药和未过评仿制药基期采购量占比分别为27.07%、53.00%和19.93%,过评仿制药试点期、续约期占比分别增加了34.71个和0.92个百分点。集采品种原研药、过评仿制药和未过评仿制药基期采购金额占比分别为40.46%、42.87%和16.68%,过评仿制药试点期、续约期采购金额占比分别增加了20.07个和0.07个百分点。结论: 基层医疗机构政策效应具有滞后性。集采品种过评仿制药替代效应明显,基层医疗机构用药质量提升。三级医疗机构、二级医疗机构未过评仿制药续约期日均费用存在异常增长。
Abstract
Objective: The paper analyzes the influence of centralized procurement policy on drug procurement in the agreed procurement cycle and renewal period of public medical institutions at different levels. Methods: The changes of drug purchase volume, purchase expenditure and average daily cost of public medical institutions at different levels in 7 pilot cities were analyzed by interrupted time series analysis. Results: The purchase volume of centralized drug varieties increased by 15.36% and 4.61% in the pilot period and the renewal period, respectively. The growth rate of the purchase volume of alternative drug varieties in the pilot period and the renewal period was higher than that of centralize drug varieties, which was 17.30% and 5.60%, respectively. In the base period, the procurement volume of original drugs, reviewed generic drugs and unreviewed generic drugs accounted for 27.07%, 53.00% and 19.93%, respectively. The proportion of reviewed generic drugs in the pilot period and the renewal period increased by 34.71% and 0.92%, respectively. In the base period, the purchase volume of original drugs, reviewed generic drugs and unreviewed generic drugs accounted for 40.46%, 42.87% and 16.68%, respectively, while the proportion of reviewed generic drugs in the pilot period and the renewal period increased by 20.07% and 0.07%, respectively. Conclusion: The policy effect of primary medical institutions is behind schedule. The reviewed generic drug substitution effect of the centralized drug varieties was obvious, and the drug quality of primary medical institutions was improved. The DDDc of unreviewed generic drugs in the renewal period of Level-3 and Level-2 medical institutions increased abnormally.
关键词
集中带量采购 /
采购量 /
采购金额
Key words
national centralized drug procurement /
procurement volume /
procurement expenditure
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