目的 比較分析"4+7"帶量采購前/后1年上海市閔行區(qū)古美社區(qū)衛(wèi)生服務(wù)中心藥品用量及價格降幅情況。方法 參照國家第1批"4+7"帶量采購目錄，收集2018年3月20日-2019年3月19日及執(zhí)行"4+7"后2019年3月20日-2020年3月19日上海市閔行區(qū)古美社區(qū)衛(wèi)生服務(wù)中心用藥數(shù)據(jù)，統(tǒng)計本中心11個品種藥品的數(shù)量、金額、用藥頻度（DDDs）、日均費用（DDC）等指標進行分析。結(jié)果 "4+7"后的11個品種分別由7個廠家供貨。"4+7"前/后共用2個品種：阿托伐他汀鈣片（北京嘉林藥業(yè)股份有限公司）、氯沙坦鉀片（浙江華海藥業(yè)股份有限公司），藥品單片價格分別降幅84.01%和74.20%。執(zhí)行"4+7"前/后1年11個品種的用藥金額分別為787.73萬元與287.67萬元，降幅63.48%。"4+7"前DDDs最高的是苯磺酸氨氯地平（絡(luò)活喜，輝瑞制藥有限公司）從31.49萬日降至"4+7"后的3.39萬日，降幅89.23%。"4+7"后DDDs最高的阿托伐他汀鈣片（北京嘉林藥業(yè)股份有限公司）為50.00萬日，"4+7"前則為13.88萬日，增幅260.23%。結(jié)論 執(zhí)行國家"4+7"帶量采購政策，經(jīng)過傾斜使用"4+7"品種1年的實踐，印證了"4+7"品種用藥下沉至社區(qū)，實現(xiàn)本土化模式是可行的，降價幅度是明顯的。

Objective To compare and analyze the drug dosage and price decline of Gumei Community Health Service Center of Minhang District in Shanghai before/after the quantity drug purchase of "4+7". Methods Referring to the procurement catalogue of the first batch of "4+7" procurement directory, the drug use data in March 20th, 2018 to March 19th, 2019 (before) and March 20th, 2019 to March 19th, 2020 after the implementation of "4+7" were collected. The quantity, amount, defined daily dose system (DDDs) and defined daily cost (DDC) of 11 kinds of drugs in the center were analyzed. Results The 11 varieties after "4+7" are supplied by 7 manufacturers respectively. There are two varieties use before and after "4+7"; They are Atorvastatin Calcium Tablets (Jialing Pharmaceutical) and Losartan Potassium Tablets (Huahai Pharmaceutical); The price of single drug decreased by 84.01% and 74.20% respectively. In the year before and after the "4+7", the drug use amount of 11 varieties was 7.877 3 million yuan and 2.876 7 million yuan, a decrease of 63.48%. The highest DDDs of Amlodipine Besylate Tablets (Vioxx, Pfizer) before "4+7" was from 314 900 days to 339 00 days after "4+7", with a decrease of 89.23%. After "4+7", the highest DDDs of Atorvastatin Calcium Tablets (Jialing Pharmaceutical) was 500 000 days, and before the "4+7", the DDDs is 138 800 days, rise is 260.23%. Conclusion The implementation of the national "4+7" procurement policy and the practice of using "4+7" varieties for one year have proved that the "4+7" varieties are sinking to the community, and the localization mode is feasible, and the price reduction is obvious.

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