集中带量采购对公立医疗机构约定采购周期及续约期药品采购的影响.docxVIP

《中国卫生经济》第42卷 第6期（总第484期）2023年6月 □ 政策与评估? POLICYANDEVALUATION 集中带量采购对公立医疗机构约定采购周期 及续约期药品采购的影响* 文小桐①② , 刘雨欣②③ , 段凤然①② , 王 越①② , 赵秋玲①② , 吴雨欣①② , 罗 佳①② , 毛宗福①② 摘 要 目的：分析集中带量采购对公立医疗机构约定采购周期及续约期药品采购的影响，以期为政策协同提供科学依 据。方法：基于两干预点间断时间序列模型，分析2018年1月—2020年12月7个试点城市公立医疗机构药品采购量、采购金 额及日均费用的变化特征。结果：集中带量采购品种中原研药、未过评仿制药试点期采购量及其占比水平变化均为下降（P 0.05）。集中带量采购品种中原研药 (β2＝-0.58，P＝0.043）、过评仿制药 (β2＝-3.18，P＜0.001）、未过评仿制药 (β2＝5.83， P＜0.001）试点期日均费用水平变化均具有统计学意义。可替代品种中过评仿制药在试点期政策干预后采购量 (β3＝19.69， P＝0.025）及采购量占比均呈上升趋势，但在续约期政策干预后采购量及采购量占比均呈下降趋势。抗感染药、抗肿瘤药及 免疫用药试点期采购量水平变化均具有统计学意义（P＜0.05）。结论：加强药品使用监测和合理用药管理，制定并完善挂网 采购审核、价格监测、医保支付标准调整等相关配套措施。 关键词 药品集中带量采购；间断时间序列分析；日均费用 中图分类号 R1-9；R19-0 文献标志码 A 文章编号 1003-0743（2023）06-0008-05 Impact Impact of National Centralized Volume-Based Drug Procurement on the Agreed Procurement Cycle and Renewal Period Daily Cost in Public Medical Institutions/WEN Xiao-tong, LIU Yu-xin, DUAN Feng-ran, et al.//Chinese Health Economics, 2023,42(6):8-12 Abstract Objective:To evaluate the impact of national centralized volume-based drug procurement on the agreed procurement cycle and renewal period daily cost in public medical institutions, so as to provide scientific evidence for Policy synergy. Methods: Based on the Interrupted time-series analysis(ITSA)with two intervention points, the change of purchase volume, expenditure and daily cost of policy-related drug in the public medical institutions from 7pilot cities during January2018and July2020were anaW lyzed. Results:The changes in procurement volume and its share of the level of the pilot period for the original drugs and the generic drugs did not pass the CEQEamong the centralized volume-based drug procurement are all decreased(P＜0.05). The change in the level of the daily cost were statistically significant among original drugs(β2＝-0.58，P＝0.043), generic which passed the CEQE(β2= -3.18，P＜0.001)and generic which did not pass the CEQE(β2＝5.83，P＜0.001)in the pilot period.