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南京地区34家医院2012-2014年呼吸系统吸入剂使用分析

     

摘要

OBJECTIVE:To provide reference for rational use of respiratory inhalants. METHODS:The utilization of respiratory inhalants in 34 hospitals from Nanjing area during 2012-2014 was analyzed by SPSS13.0 software in respects of DDDs,consumption sum,DDC,health insurance and self-paying cost and so on. RESULTS:Respiratory inhalants involved 4 kinds of drugs, 5 kinds of dosage forms,12 kinds of general name and 38 kinds of trade name(specification)in 34 hospitals from Nanjing area during 2012-2014. The total DDDs and total consumption sum of respiratory inhalants increased from 10 827.46×103 and 71,006, 500 yuan in 2012 and 14 627.25×103 and 99,137,100 yuan in 2014,there was no statistical significance(P>0.05). 4 categories of respiratory inhalants in the list of DDDs were anticholinergic agents,compound preparations,glucocorticoid and β2 receptor agonists; DDDs of each type increased year by year,but only that of anticholinergic agents had statistical significance(P<0.01). Consumption sum were glucocorticoid,compound preparations,anticholinergic agents and β 2 receptor agonists;consumption sum of each type increased year by year,but there was no statistical significance(P>0.05). 5 kinds of inhalants in the list of DDDs were aerosol preparation,power aerosols,atomizing solution,nasal spray and clickhaler. DDDs of aerosol preparation and power aerosols increased year by year,with statistical significance(P<0.05). Top one in the list of consumption sum was power aerosols during 2012-2013 and atomizing solution in 2014;power aerosols took up the first place in the list of total consumption in 3 years. Among 12 kinds of general name inhalants,top 4 inhalants in the list of DDDs were ipratropium bromide,salmeterol and fluticasone, albuterol and budesonide,and the constituent ratio of their total DDDs in 3 years were 40.16% ,16.71% ,13.51% and 13.39%,respectively;the sum of constituent ratio of total DDDs in 3 years was more than 80%. Top 3 inhalants in the list of consumption sum were budesonide,salmeterol and fluticasone, budesonide and formoterol,and the sum of constituent ratio of their total consumption sum in 3 years were 39.59%,20.81% and 12.50% ,respectively;the sum of constituent ratio was more than 70% . DDC of salbutamol was the lowest. Among 38 kinds of trade name(specification)inhalants,the type and cost of health insurance accounted for 92.11% and 95.02% .Pulmicort atomization suspension and Symbicort Turbuhaler(160 μg)took up the first place in the list of health insurance cost and self-paying cost respectively,and they were B directory of health insurance. CONCLUSIONS:The utilization of respiratory inhalants was basically reasonable in 34 hospitals from Nanjing during 2012-2014.%目的:为呼吸系统吸入剂的合理使用提供参考。方法:采用SPSS 13.0软件分析南京地区34家医院2012-2014年呼吸系统吸入剂的用药频度(DDDs)、销售金额、日均费用(DDC)和医保与自费金额等数据。结果:南京地区34家医院2012-2014年呼吸系统吸入剂共涉及4种类型、5种剂型、12种通用名和38种商品名(规格)。呼吸系统吸入剂总DDDs和总销售金额分别从2012年的10827.46×103和7100.65万元增至2014年的14627.25×103和9913.71万元,但增长趋势均无统计学意义(P>0.05)。4种类型呼吸系统吸入剂DDDs排名依次为抗胆碱能药物、复合制剂、糖皮质激素和β2受体激动药,各类型DDDs均逐年增加,但仅抗胆碱能药物DDDs增加趋势有统计学意义(P<0.01);销售金额排名依次为糖皮质激素、复合制剂、胆碱能药物和β2受体激动药,各类型销售金额均逐年增加,但增加趋势均无统计学意义(P>0.05)。5种剂型呼吸系统吸入剂DDDs排名依次为气雾剂、粉雾剂、雾化溶液、鼻喷剂和肺部输药器,气雾剂和粉雾剂DDDs均逐年增加,趋势有统计学意义(P<0.05);2012-2013年销售金额居首位的均为粉雾剂,2014年为雾化溶液,而3年总销售金额位居首位的仍为粉雾剂。12种通用名吸入剂DDDs排名前4位的药品是溴化异丙基阿托品、沙美特罗替卡松、沙丁胺醇和布地奈德,其3年总DDDs构成比分别为40.16%、16.71%、13.51%和13.39%,构成比合计>80%;销售金额排名前3位的药品是布地奈德、沙美特罗替卡松和布地奈德福莫特罗,其3年总销售金额构成比分别占39.59%、20.81%和12.50%,且构成比合计>70%。沙丁胺醇DDC最低。38种商品名(规格)吸入剂中,医保品种和医保金额分别占92.11%和95.02%。普米克令舒雾化混悬液医保金额居首位,信必可都保(160μg)自费金额居首位,都属乙类医保药品。结论:南京34家医院2012-2014年呼吸系统吸入剂总体使用基本合理。

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