Objective  To investigate the influence of the national volume-based procurement (NVBP) policy on the economy and use structure of anti-infective drugs in a general 3-A hospital, and to provide a reference for the standardization of clinical application management and policy implementation.

Methods  The price, defined daily doses (DDDs), average defined daily cost (DDDc), actual cost saving, substitution rate of selected drugs (SRSD) and avoidance rate of alternative drugs (ARAD) of anti-infective drugs before and after the implementation of 1-7 collection NVBP policy were analysed.

Results  The NVBP policy led to a>70% reduction in the price of 70.73% of the hospital's target drugs, 69.70% of the DDDs increased, 81.82% of the DDDc decreased and 63.64% showed the relationship of "volume increase and price decrease". The average SRSD was 84.49% in the first cycle and 95.94% in the second cycle. The average actual cost saving in the first cycle was 474 100 yuan, with an average saving rate of 407.60%, and in the second cycle was 803 100 yuan, with an average saving rate of 1 257.04%, showing an increasing trend year by year. The consumption of alternative drugs increased by 53.85% in the first cycle and 66.67% in the second cycle, with the highest annual increase of 555.63%, and the average of 74.65%.

Conclusion  After the implementation of NVBP policy, selected drugs mainly replaced unselected drugs, and the cost of anti-infection treatment was greatly reduced. However, it was necessary to strengthen the control of alternative drugs, standardize the management of clinical application, carry out clinical comprehensive evaluation of selected drugs and real world research.

1.倪寂, 范贇婷, 陆卿, 等. 某院执行药品带量采购的情况分析[J]. 中国药师, 2020, 23(4): 719-722. [Ni J, Fan  YT, Lu Q, et al. Analysis of quantity drug purchase in a hospital[J]. China Pharmacist, 2020, 23(4): 719-722.] DOI: 10.3969/j.issn.1008-049X.2020.04.030.

2.张睿智, 乔家骏, 毛宗福, 等. 我国公立医疗机构药品集中采购现状评述[J]. 药物流行病学杂志, 2019, 28(3): 199-204. [Zhang RZ, Qiao JJ, Mao ZF, et al. A review on the current situation of centralized drug procurement in China's public medical institutions[J]. Chinese Journal of Pharmacoepidemiology, 2019, 28(3): 199-204.] DOI: 10.19960/j.cnki.issn1005-0698.2019.03.011.

3.国务院办公厅. 国务院办公厅关于印发国家组织药品集中采购和使用试点方案的通知[EB/OL]. (2019-01-17) [2023-09-05]. https://www.gov.cn/zhengce/content/2019-01/17/content_5358604.htm?tdsourcetag= s_pcqq_aiomsg.

4.国家医疗保障局, 国家工业和信息化部, 国家财政部, 等. 国家医疗保障局等九部门关于国家组织药品集中采购和使用试点扩大区域范围实施意见[EB/OL]. (2019-09-30) [2023-09-05]. http://www.nhsa.gov.cn/art/2019/9/30/art_37_1817.html.

5.胡付品, 郭燕, 朱德妹, 等. 2021年CHINET 中国细菌耐药监测[J]. 中国感染与化疗杂志, 2022, 22(5):521-530. [Hu FP, Guo Y, Zhu DM, et al. CHINET surveillance of antimicrobial resistance among the bacterial isolates in 2021[J]. Chinese Journal of Infection and Chemotherapy, 2022, 22(5): 521-530.] DOI: 10.16718/j.1009-7708.2021.04.001.

6.赵婧, 老东辉, 张建中. 上海市三级医院抗菌药物临床使用结构在2012—2020年的变化分析[J]. 中国临床药学杂志, 2022, 31(8): 584-590. [Zhao J, Lao DH, Zhang JZ. Analysis of structural changes in clinical use of antimicrobials in tertiary hospitals in Shanghai from 2012 to 2020[J]. Chinese Journal of Clinical Pharmacy, 2022, 31(8): 584-590.] DOI: 10.19577/j.1007-4406.2022.08.005.

7.国家医疗保障局. 前七批国家组织药品集中采购品种可替代药品参考监测范围[EB/OL]. (2022- 09-19) [2023-09-05]. https://max.book118.com/html/2022/0928/6211201005004243.shtm.

8.World Health Organization.Guidelines for ATC classification and DDD assignment 2023[EB/OL]. (2023-03-01) [2023-09-05]. https://www.whocc.no/filearchive/publications/2023guidelinesweb.pdf.

9.陈新谦, 金有豫, 汤光, 主编.新编药物学. 第18版[M]. 北京: 人民卫生出版社, 2018: 36-183.

10.屈茹楠, 高岸, 范国荣, 等. 国家带量采购政策对上海某院原研和仿制降压药使用状况的影响[J]. 中国药业, 2022, 31(15): 10-15. [Qu RN, Gao A, Fan GR, et al. Effect of national centralized drug procurement policy on the use of original-patented and generic antihypertensive drugs in a hospital in Shanghai[J]. China Pharmaceuticals, 2022, 31(15): 10-15.] DOI: 10.3969/j.issn.1006-4931.2022.15.002.

11.李青桐, 万君, 焦曙光, 等. 带量采购政策对某院心血管药物原研药和仿制药使用影响[J]. 中国医院统计, 2022, 29(5): 377-387. [Li QT, Wan J, Jiao SG, et al. Impact of volume-based purchasing policy on the use of branded and generic cardiovascular drugs in a hospital[J]. Chinese Journal of Hospital Statistics, 2022, 29(5): 377-387.] DOI: 10.3969 /j.issn.1006-5253.2022.05.013.

12.范贇婷, 龚张珺, 倪寂. 某院首批国家药品带量采购实施效果评价与分析[J]. 中国药业, 2021, 30(5): 18-21. [Fan YT, Gong ZJ, Ni J. Evaluation and analysis of the implementation effect of the first batch of the national drug procurement with target quantity policy in a hospital[J]. China Pharmaceuticals, 30(5): 18-21.] DOI: 10.3969/j.issn.1006-4931.2021.05.005.

13.厉琳琳, 陈方亮, 梁小龙, 等. 集中带量采购背景下我院药品的精细化管控[J]. 中医药管理杂志, 2022, 30(21): 67-69. [Li LL, Chen FL, Liang XL, et al. Fine control of drugs in our hospital under the background of centralized procurement[J]. Journal of Traditional Chinese Medicine Management, 2022, 30(21): 67-69.] DOI: 10.16690/j.cnki.1007-9203.2022.21.103.

14.Yang Y, Chen L, Ke X, et al. The impacts of chinese drug volume -based procurement policy on the use of policy-related antibiotic drugs in Shenzhen, 2018-2019: an interrupted time-series analysis[J]. BMC Health Serv Res, 2021, 21(1): 668. DOI: 10.1186/s12913-021-06698-5.

15.国家卫生健康委办公厅. 关于做好国家组织药品集中采购中选药品临床配备使用工作的通知[EB/OL]. (2019-12-19) [2023-09-05]. http://www.gov.cn/xinwen/2019-12/19/content_5462458.htm.

16.过佳月, 刘金春, 张海霞, 等. 集中带量采购政策对注射用喹诺酮类药物处方行为和细菌耐药性影响分析[J]. 中南药学, 2024, 22(4): 1080-1086. [Guo JY, Liu  JC, Zhang HX, et al. Impact of centralized drug volume-based procurement policy on the prescribing behaviors and bacterial resistance of quinolone injection[J]. Central South Pharmacy, 2024, 22(4): 1080-1086.] DOI: 10.7539/j.issn.1672-2981.2024.04.040.