目的 分析“4＋7”帶量采購政策對(duì)內(nèi)蒙古自治區(qū)人民醫(yī)院口服抗腫瘤藥品原研藥和仿制藥使用的影響，為臨床藥學(xué)服務(wù)和醫(yī)院的藥事管理提供依據(jù)。方法 采用Excel軟件計(jì)算口服抗腫瘤藥品的使用數(shù)量、金額、價(jià)格、用藥頻度（DDDs）、限定日費(fèi)用（DDC）、占比、增幅、降幅，及仿制藥替代率、費(fèi)用節(jié)省率進(jìn)行分析。結(jié)果 “4＋7”帶量采購實(shí)施后，原研藥和仿制藥價(jià)格出現(xiàn)了不同幅度的降價(jià)，其中中選品種來曲唑單品價(jià)格降幅最大，降幅超過60%，原研藥中價(jià)格降幅最大的是阿斯利康制藥有限公司生產(chǎn)的吉非替尼，達(dá)30%?！?＋7”帶量采購實(shí)施后，甲磺酸伊馬替尼、替吉奧、來曲唑、阿那曲唑、卡培他濱、替莫唑胺仿制藥DDDs均增加，而銷售金額均下降。吉非替尼仿制藥DDDs增幅最大，達(dá)74.17%，銷售金額則增加57.38%。甲磺酸伊馬替尼原研藥受帶量采購政策影響，DDDs和銷售金額均增加，而其他相應(yīng)的原研藥的DDDs和銷售金額均減少?！?＋7”帶量采購的實(shí)施進(jìn)一步提高仿制藥的使用率，為醫(yī)保費(fèi)用節(jié)省899萬元，費(fèi)用節(jié)省率為49.99%。結(jié)論 帶量政策實(shí)施后，藥品費(fèi)用支出減少，切實(shí)減輕了部分患者的用藥負(fù)擔(dān)。

Objective To analyze the impact of "4 + 7" procurement with quantity on the use of original and generic oral antitumor drugs, and to provide a basis for clinical pharmacy services and hospital pharmacy management. Methods Excel software was used to calculate the drug use quantity, sum, price, DDDs, DDC, proportion, increase, decrease, substitution rate, and cost saving rate of oral anti-tumor drugs for analysis. Results After the implementation of "4 + 7" procurement with quantity, the prices of original drugs and generic drugs fell by different degrees. Among them, the price of letrozol single product dropped the most, by more than 60%. Among original drugs, the price of gefitinib produced by Astrazeneca Pharmaceutical Co., Ltd. dropped the most, by 30%. After the implementation of "4 + 7" procurement with quantity, generics DDDs of imatinib mesylate, tegafur, gimeracil and oteracil potassium, letrozole, anastrozole, capecitabine, and temozolomide were increased, while consumption sum decreased. The DDDs of generic gefitinib increased by 74.17%, and the consumption sum increased by 57.38%. DDDs and consumption sum of imatinib mesylate primary drug were increased due to the influence of purchase policy, while DDDs and consumption sum of other corresponding primary drug were decreased. The implementation of "4 + 7" purchase with quantity further increased the utilization rate of generic drugs, saving 8.99 million yuan for medical insurance costs, with a cost saving rate of 49.99%.Conclusion After the implementation of the policy, the cost of drugs is reduced, and the drug burden of some patients is effectively reduced.

R979.1