目的 分析成都大學(xué)附屬醫(yī)院執(zhí)行“4+7”帶量采購(gòu)對(duì)調(diào)血脂藥使用的影響，為進(jìn)一步完善藥物政策和醫(yī)院藥事管理與服務(wù)提供參考。方法 提取“4+7”帶量采購(gòu)實(shí)施前后門(mén)診調(diào)血脂藥的用藥數(shù)據(jù)，比較藥品供應(yīng)目錄、價(jià)格、數(shù)量、處方數(shù)、金額、用藥頻度（DDDs）、日均費(fèi)用（DDC）、復(fù)合年均增長(zhǎng)率（CAGR）等變化情況。結(jié)果 2018—2020年，調(diào)血脂藥供應(yīng)目錄共涉及8個(gè)品種，16個(gè)品規(guī)。藥物類(lèi)別中，各類(lèi)調(diào)血脂藥使用數(shù)量和處方數(shù)構(gòu)成比變化不大；用藥金額逐年下降，CAGR為?31.24%；采購(gòu)類(lèi)別中，原研藥使用數(shù)量和處方數(shù)量構(gòu)成比逐年下降，國(guó)產(chǎn)藥逐年上升；各年DDDs逐年遞增，CAGR為44.77%。在8種調(diào)血脂藥DDDs排序中，瑞舒伐他汀和阿托伐他汀排名穩(wěn)居前2位，辛伐他汀逐年下降；中標(biāo)阿托伐他汀、瑞舒伐他汀和辛伐他汀及與中標(biāo)相同通用名稱(chēng)藥品DDC波動(dòng)明顯。結(jié)論 “4+7”帶量采購(gòu)政策落地2年，調(diào)血脂藥使用集中在他汀類(lèi)，尤其使用瑞舒伐他汀和阿托伐他汀患者相對(duì)穩(wěn)定，使用國(guó)產(chǎn)藥的患者數(shù)量大幅度上升，藥品費(fèi)用支出減少，切實(shí)降低了部分患者的用藥負(fù)擔(dān)。

Objective To analyze the influence of "4+7" procurement with quantity on the use of lipid-regulating drugs in The Affiliated Hospital of Chengdu University, and to provide reference for further improving drug policy and hospital pharmaceutical management and service.Methods The medication data of lipid-regulating drugs in outpatient department before and after the implementation of "4+7" with volume procurement were extracted, and the changes of drug supply catalog, price, quantity, prescription number, amount, DDDs, DDC, and compound annual growth rate (CAGR) were compared.Results From 2018 to 2020, the supply list of lipid-regulating drugs involves 8 varieties and 16 product specifications. In the category of drugs, the composition ratio of the quantity and prescription of all kinds of lipid-regulating drugs had little change. The amount of money spent on drugs has been decreasing year by year, and CAGR was ?31.24%. In the procurement category, the proportion of the use and prescription of original drugs were decreased, while domestic drugs were increased year by year. DDDs were increased year by year, and CAGR was 44.77%. Rosuvastatin and atorvastatin ranked first and second in DDDs ranking of 8 kinds of lipid-regulating drugs, while simvastatin decreased year by year. The DDC of atorvastatin, rosuvastatin, simvastatin and drugs with the same generic name fluctuated obviously.Conclusion In the two years since the implementation of the "4+7" purchase policy with quantity, the use of lipid-regulating drugs has been concentrated on statins, especially the patients using rosuvastatin and atorvastatin, which are relatively stable. The number of patients using domestic drugs has increased significantly, and the drug cost has been reduced, effectively reducing the drug burden of some patients.

R973

成都大學(xué)附屬醫(yī)院院級(jí)課題（Y2021096）