目的: 探讨抑酸药从口服质子泵抑制剂药物（Proton Pump Inhibitors, PPI）向口服钾离子竞争性酸阻滞剂（Potassium ion Competitive Acid Blocker, P-CAB）迭代对医院门诊报销与门诊处方规范性的影响。方法: 本研究基于全国9个城市的18家三甲综合医院2021年第一季度到2024年第三季度的真实世界抽样数据,使用描述性统计方法,分析PPI与P-CAB药物处方信息与药品适应症间的适配性,以评估药品处方规范性以及患者因处方不规范造成潜在的医保报销损失。结果与结论: 在观测期内,P-CAB药物用药比例从0.6%上升到18.9%,实现了对PPI类药物的逐步替代。口服抑酸药门诊处方规范性正在逐年改善,P-CAB药物规范处方占比高于PPI药物,提示了口服抑酸药迭代过程有利于规范处方行为。处方不规范可能使得患者损失更多的医保报销机会,增加患者疾病经济负担。

Objective: The paper explored the impact of the iteration process of acid-suppressing drugs from oral proton pump inhibitorsto oral potassium ion competitive acid blockerson outpatient reimbursement, standardization of prescription in hospitals. Methods: This study used real-world sampling data from18hospitals of9cities, spanning from Q1of2021to Q3of2024. Descriptive statistical methods were used to analyze the compatibility between drug prescriptions of the PPI, P-CAB, their indications, in order to assess the standardization of prescription, the potential loss of medical insurance reimbursement due to non-standardized prescriptions. Results, Conclusion: During the observation period, the proportion of P-CAB drug usage increased from0.6% to18.9%, gradually replacing PPI drugs. Overall, the prescription compliance for oral acid suppressants in outpatient settings showed annual improvement. P-CAB drugs had a higher proportion of standardized prescriptions compared to PPI drugs, indicating that the iteration process of oral acid suppressants helps standardize prescribing behavior. Non-standardized prescriptions may lead to greater loss of medical insurance reimbursement opportunities for patients, increasing their economic burden