目的 分析南京中醫(yī)藥大學(xué)附屬南京醫(yī)院自2019年底開始執(zhí)行“4＋7”帶量采購后對核苷類抗病毒性肝炎藥物使用情況的影響，為臨床藥學(xué)服務(wù)和醫(yī)院藥事管理提供參考。方法 采用回顧性分析方法，匯總南京中醫(yī)藥大學(xué)附屬南京醫(yī)院自2018年7月—2021年6月6種核苷類抗肝炎藥物的門診使用數(shù)據(jù)，對用藥種類、消耗量、用藥頻度（DDDs）和日治療費用（DDC）等進行統(tǒng)計分析。結(jié)果 “4＋7”集采前后，6種藥物總的消耗量提高了27.91%，銷售總金額降低了80.66%；進入集采的3種藥物阿德福韋酯片（阿甘定）、恩替卡韋片（木澤）、富馬酸替諾福韋二吡呋酯片（倍信）的DDDs排名進入了前3位，DDC值也排進了前3，降價明顯；新上市的富馬酸丙酚替諾福韋片消耗量和銷售金額卻穩(wěn)步提高。結(jié)論 “4＋7”集中采購可以有效降低醫(yī)院藥占比，切實減輕了部分患者的用藥負(fù)擔(dān)，促進醫(yī)院合理用藥，提升了醫(yī)?；鸬氖褂眯?，創(chuàng)新藥物也有長足發(fā)展空間。

Objective To analyze the influence of the "4 + 7" purchase with quantity on the use of nucleoside anti-hepatitis drugs in Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine since the end of 2019, so as to provide reference for clinical pharmaceutical care and hospital pharmacy management. Methods Using retrospective analysis methods, the outpatient use data of six nucleoside anti-hepatitis drugs in our hospital from July 2018 to June 2021 were summarized, and the drug types, consumption sum, DDDs, and DDC were statistically analyzed. Results Before and after "4 + 7" intensive harvesting, the total consumption of 6 drugs increased by 27.91%, and the total consumption sum decreased by 80.66%. The DDDs of Adefovir Dipivoxil Tablets (Agardin), Entecavir Tablets (Musze), and Tenofovir Disoproxil Fumarate Tablets (Beaxin) were ranked in the top 3, and their DDC values were also ranked in the top 3, indicating obvious price reductions. The consumption and sales amount of the innovative propofol tenofovir fumarate tablets increased steadily. Conclusion "4 + 7" procurement with quantity can effectively reduce the proportion of hospital drugs, effectively reduce the drug burden of some patients, promote rational drug use in hospitals, improve the use efficiency of medical insurance funds, and there is considerable room for the development of innovative drugs.

R978.7