目的 探討“4＋7”帶量采購政策對上海市浦東新區(qū)人民醫(yī)院口服降糖藥使用的影響及帶來的經(jīng)濟(jì)效應(yīng)，為政策制定和完善提供理論依據(jù)。方法 對上海市浦東新區(qū)人民醫(yī)院“4＋7”帶量采購政策實(shí)施前后1年口服降糖藥的單價、使用量、銷售金額、用藥頻度（DDDs）、日均費(fèi)用（DDC）等進(jìn)行分析，并計(jì)算“4＋7”帶量采購政策后的實(shí)際節(jié)省費(fèi)用。結(jié)果 “4＋7”帶量采購政策實(shí)施后，中選品種阿卡波糖單價顯著降低，降價幅度達(dá)41.28%，其他未中標(biāo)品種的價格均未變；中選品種阿卡波糖和格列美脲的DDDs有明顯變化，DDC下降顯著；阿卡波糖節(jié)省費(fèi)用近6萬元。結(jié)論 “4＋7”帶量采購政策實(shí)施使上海市浦東新區(qū)人民醫(yī)院口服降糖藥中選品種的日均費(fèi)用大幅下降，切實(shí)減輕了患者和醫(yī)保的負(fù)擔(dān)，可為優(yōu)化藥品價格調(diào)整機(jī)制提供參考。

Objective To explore the impact of “4+7” volume procurement policy on the utilization of oral antidiabetic drugs and the economic effectiveness in Shanghai Pudong New Area People’s Hospital, and to provide a reference for the improvement of policy. Methods To analyze the unit price, consumption amount, consumption sum, DDDs and DDC of oral hypoglycemic drugs in Shanghai Pudong New Area People's Hospital one year before and after the implementation of “4+7” procurement policy, and calculate the actual cost savings after “4+7” procurement policy. Results After the implementation of “4+7” purchasing policy with quantity, the unit price of acarbose of the selected variety was significantly reduced, with a reduction of 41.28%, while the prices of other unsuccessful varieties remained unchanged. DDDs and DDC of acarbose and glimepirea were significantly decreased. Acarbose saves nearly 60 000 yuan. Conclusion The implementation of the “4+7” purchase policy with quantity significantly reduced the average daily cost of selected oral hypoglycemic drugs in Shanghai Pudong New Area People's Hospital, effectively alleviating the burden of patients and medical insurance, which can provide reference for optimizing the drug price integration mechanism.

R977