Analysis on the Application of Oral Proton Pump Inhibitors in Xuanwu Hospital Under the Centralized Volume-based Procurement Policy
Objective:To analyze the effect of the volume-based procurement of omeprazole enteric-coated capsules on the use of other four oral PPIs and the prescriptions rationality,and to explore the problems existing in the implementation of volume-based procurement policy,and to promote clinical rational drug use and optimize volume-based procurement policy.Methods:The pharmacoeconomics method was used to analyze the changes in the sales quantity,the sales amount,defined daily doses(DDDs),defined daily cost(DDC),generic drug replacement rate,the component ratio of PPIs,daily dose,ranking ratio and other indicators of oral PPIs before and after the implementation of omeprazole volume-based procurement in outpatient department according to the use of PPIs in the first year.Results:After the volume-based procurement of omeprazole enteric-coated capsules,the DDDs of the original drug omeprazole enteric-coated tablets were reduced,which also had an impact on the use of other acid-inhibiting drugs.The structure of use of different specifications changed,and omeprazole DDDs were ranked second after volume-based procurement policy,replacing the ranking of lansoprazole before volume-based procurement.Rabeprazole DDDs remained at the top,and esomeprazole DDDs remained third.The DDC of PPIs decreased overall,the ranking ratio of omeprazole was B/A＞1,and the economic benefits brought by centralized volume-based procurement drugs were synchronized with social benefits.In terms of the proportion of double standard daily doses,omeprazole and rabeprazole increased while lansoprazole decreased.The decrease in the consumption of PPIs in nephrology was mainly related to the decrease in the use of omeprazole and a rise in the use of famotidine.In addition,13.87％of omeprazole prescriptions were still considered off-label that need to be regulated.Conclusion:After the implementation of centralized volume-based procurement,there exist some urgent problems to be solved while quantity increases and price decreases of oral PPIs,for example,the daily dose is not the minimum effective dose,the acceptance of centralized volume-based procurement drugs by nephrology is not high,and the off-label medication.These problems affect the positive role of the policy,and fine management should be strengthened to promote the rational use of centralized volume-based procurement drugs.
centralized volume-based procurementproton pump inhibitorsdefined daily dosesdaily doserationality of prescription
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