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2019 China Pharmaceutical Association Hospital Drug Monitoring Report Released

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On November 2nd, at the 19th China Pharmacist Week held in Chongqing, the Chinese Pharmaceutical Association released the "2019 China Pharmaceutical Association Hospital Drug Monitoring Report" (hereinafter referred to as the "Report"). The "Report" analyzes the annual hospital drug use and the trend of changes in the past five years, and scientifically evaluates the implementation effect of the national drug protection policy. The results of the study show that with the in-depth implementation of relevant national medical policies, clinical drugs are becoming more rational at the level of dosage forms, and the level of essential drug support is improved. The effect of “4+7” procurement is significant, and the beneficiaries of medical insurance negotiations are expanding.




The National Pharmaceutical Economic Information Network of China Pharmaceutical Association has long been committed to the scientific research of medical policy and is an important think tank in the field of medicine in China. In recent years, the "China Pharmaceutical Association Hospital Drug Monitoring Report" has become an authoritative drug research report that has received much attention from the industry. The "Report" is based on the drug use data submitted by the sample hospital of China National Pharmaceutical Economic Information Network of the Chinese Pharmaceutical Association. It uses statistical methods to carry out in-depth mining and scientific analysis, and formulates relevant government departments, drug use management and pharmaceutical industry at all levels. Development trend research provides scientific data support.




The National Medical Economic Information Network is from 31 provinces (municipalities and autonomous regions) covering more than 270 prefecture-level cities or county-level cities. In 2000, nearly 1,500 hospitals were admitted to the network. The sample hospitals were mainly second- and third-tier hospitals. . The "Report" used continuous samples from the first half of 2014-2019 as the research object, and included 926 consecutive sample hospitals.




Hospital medication structure is generally stable




According to the report, the number of drug use in hospitals at all levels has declined slightly in the past five years. In the first half of 2019, the total number of generic names in the sample hospitals was 2,145. From the hospital level, the total number of total medicinal products used in tertiary hospitals was 2,122, and the total number of total medicinal products used in secondary and lower hospitals was 1,888.




From the perspective of the ATC category, the number structure of the varieties is relatively stable. The top 3 ATC categories of total drug use are digestive system and metabolic drugs, nervous system drugs and systemic anti-infectives; the top 4 varieties of the total number of varieties account for nearly 50% of the total number of varieties.




According to the analysis of the usage amount and frequency ratio of different ATC classification varieties, the change amount of different ATC classification varieties was less than 2.5% within 5 years, and the frequency of use was less than 1%.




In general, the proportion of the number, amount, and dosage of different types of drugs in hospitals has slowed down, reflecting the overall stable state of hospital drug use.




Increase in basic drug support




According to the "Report", the amount and frequency of essential drugs used decreased slightly from 2014 to 2018. In 2018, after the adjustment of the National Essential Drugs List, the amount and frequency of basic drug use at all levels of hospitals increased.




Based on the data from the first half of 2019, the "Report on the National Essential Drugs List (2012 Edition) and the "National Essential Drugs List (2018 Edition)" found that the number of essential drug use regulations increased by 783. To 1052, the proportion increased from 12.1% to 27.2%, the usage frequency increased from 31.3% to 47.1%, and the average daily cost increased from 5 yuan to 7.5 yuan. The overall drug product regulations for essential drugs increased by 34.4%, the overall amount increased by 124.7%, and the overall use frequency increased by 50.8%. This shows that the level of basic drug protection has increased significantly.




The proportion of anti-tumor and immunomodulators has soared




According to the "Report", anti-tumor and immunomodulators accounted for 27.0% of the increase in the amount of use in the 2018 essential drug supplement adjustment.




According to the "Report", in recent years, the highest increase in the number of varieties is anti-tumor and immunomodulatory agents, which increased by 10% in 5 years. In 2018, the amount of anti-tumor and immunomodulatory agents used exceeded the first time for systemic anti-infectives. This ratio continued to rise in the first half of 2019, reaching 18%, the largest increase in the proportion of the five years.




Comparing the National Essential Drugs List (2012 edition) with the National Essential Drugs List (2018 edition), it can be found that the anti-tumor and immunomodulator specifications have increased by 81.4%. Therefore, anti-tumor and immunomodulator-related populations are the biggest beneficiaries of policy adjustments related to essential drugs.




Hospital dosage forms are becoming more reasonable




According to the Report, in recent years, the structure of hospital medications has become more rational at the dosage level. The study analyzed the amount and frequency of different dosage forms of the whole drug. It was found that the highest proportion of the dosage was the injection dosage type, and the highest frequency of use was the oral dosage form. In recent years, the amount and frequency of oral dosage forms increased slightly. The injection decreased slightly.




The number of beneficiaries of medical insurance negotiations expanded




The "Report" also carried out in-depth thematic data analysis and research around the two rounds of national medical insurance negotiation varieties.




The results pointed out that the price of the two rounds of national medical insurance negotiations was implemented in a short period of time across the country. Most of the varieties expanded the beneficiary population and realized the volume and price exchange, and the frequency of use of 75% of the varieties increased by more than 100%. However, there are also some varieties that fail to meet expectations. For example, the varieties such as Shenyi Capsule have not achieved the original intention of negotiation, and the frequency of use of sorafenib and other varieties has declined.




"4+7" quantity procurement implementation effect is remarkable




The "Report" also carried out data analysis on the use of "4+7" quantity purchases. The results showed that in the implementation of the national “4+7” quantity procurement policy, the implementation of most varieties was significant, and the selection of 15 varieties of irbesartan in the pilot cities accounted for more than 70%.




Changes in data on original and generic drugs are also worthy of attention. The frequency of use of 22 domestically produced varieties, such as atorvastatin, which has passed the quality consistency evaluation of generic drugs, was higher than that in the same period of 2018. The market of the original research products of 12 varieties of amlodipine was subjected to different degrees of crowding, and the frequency of use decreased. The range is from 5.49% to 28.44%.


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