目的: 评估国家组织药品集中采购政策对口服降糖药在各级医疗机构间用药分布格局的影响。方法: 基于某省2018—2024年口服降糖药采购数据,采用中断时间序列分析,比较集采前后不同类别药品在一、二级医疗机构用药频度占比的即时水平与长期趋势变化。结果: 集采政策实施后,多数传统口服降糖药向二级医院下沉的趋势显著增强。新型口服降糖药中,仅部分集采品种呈现明显下沉趋势。结论: 集采政策有效促进了部分传统降糖品种的使用下沉,但对新型降糖品种的推动作用有待加强。未来政策应进一步优化药品遴选范围,以更好地引导合理用药与分级诊疗。
Abstract
Objective: The paper attempts to evaluate the impact of the centralized drug procurement (CDP) policy on the distribution of oral antidiabetic drugs across different levels of medical institutions. Methods: Utilizing drug procurement data from a provincial database from 2018 and 2024, an interrupted time series analysis was conducted to compare the immediate level changes and long-term trend changes in the proportion of Defined Daily Doses for different drug categories between primary and secondary medical institutions before and after the policy implementation. Results: Following the CDP policy, the trend of most traditional oral antidiabetic drugs shifting toward secondary hospitals significantly increased. Among novel oral antidiabetic drugs, only a subset of centrally procured oral antidiabetic drugs showed a shift toward lower-level healthcare institutions. Conclusion: The CDP policy effectively promoted the redistribution of some traditional oral drugs towards lower-level medical institutions, but its effect on novel antidiabetic drugs requires reinforcement. Future policy refinements should consider optimizing the scope of drug selection, thereby better facilitating rational drug use and promoting the hierarchical diagnosis and treatment.
关键词
药品集中带量采购 /
糖尿病药品 /
中断时间序列分析 /
分级诊疗
Key words
centralized drug procurement /
antidiabetic drugs /
interrupted time series analysis /
hierarchical diagnosis and treatment
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