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目的:分析上海市降糖药物利用情况,并对各级医疗机构用药合理性进行评价。方法:对上海市医疗机构药品招标数据库中2013年11月—2014年10月一年期降糖药的采购金额、单价和剂量等进行统计,采用世界卫生组织(WHO)推荐的用药频度(DDDs)和日均费用(DDDc)方法。结果:分析药物构成发现,上海市各级医疗机构降糖药用药频率最高的为磺脲类药物(53.84%),其次为胰岛素和二甲双胍类降糖药。分析采购金额发现,一级、二级和三级医疗机构的降糖药采购金额分别为5.73亿元、3.22亿元和3.39亿元。将DDDs值按通用名排序后发现,上海市降糖药用药频率最高的药品为格列齐特、格列美脲和重组人胰岛素等。各级医疗机构降糖药采购的平均一致性为68.69%。结论:上海市糖尿病患者主要在社区配药,日治疗费用较为合理。糖尿病用药构成基本合理,降糖药以磺脲类、胰岛素和二甲双胍类为主,磺脲类占主导地位。一、二级医疗机构用药更为接近。
Objective: To analyze the utilization of hypoglycemic drugs in Shanghai and to evaluate the rationality of medication in medical institutions at all levels. Methods: The procurement amount, unit price and dosage of hypoglycemic drugs in the drug bidding database of Shanghai Medical Institutions from November 2013 to October 2014 were statistically analyzed. The frequency of medication recommended by the World Health Organization (WHO) DDDs) and daily average cost (DDDc) methods. Results: Analysis of drug composition found that the highest frequency of hypoglycemic agents in medical institutions in Shanghai was sulfonylureas (53.84%), followed by insulin and metformin hypoglycemic agents. Analysis of the purchase amount found that the purchase amount of hypoglycemic agents of primary, secondary and tertiary medical institutions were 573 million yuan, 322 million yuan and 339 million yuan respectively. According to the rankings of DDDs by common name, it is found that the drugs with the highest frequency of hypoglycemic agents in Shanghai are gliclazide, glimepiride and recombinant human insulin. The average consistency of hypoglycemic drug purchase at all levels of medical institutions was 68.69%. Conclusion: Diabetes patients in Shanghai mainly in the community dispensing, the cost of treatment is more reasonable. Diabetes drugs constitute a reasonable, hypoglycemic agents with sulfonylureas, insulin and metformin based, sulfonylureas dominated. One or two medical institutions are more similar to medication.