目的 分析“4＋7”带量采购政策对内蒙古自治区人民医院口服抗肿瘤药品原研药和仿制药使用的影响，为临床药学服务和医院的药事管理提供依据。方法 采用Excel软件计算口服抗肿瘤药品的使用数量、金额、价格、用药频度（DDDs）、限定日费用（DDC）、占比、增幅、降幅，及仿制药替代率、费用节省率进行分析。结果 “4＋7”带量采购实施后，原研药和仿制药价格出现了不同幅度的降价，其中中选品种来曲唑单品价格降幅最大，降幅超过60%，原研药中价格降幅最大的是阿斯利康制药有限公司生产的吉非替尼，达30%。“4＋7”带量采购实施后，甲磺酸伊马替尼、替吉奥、来曲唑、阿那曲唑、卡培他滨、替莫唑胺仿制药DDDs均增加，而销售金额均下降。吉非替尼仿制药DDDs增幅最大，达74.17%，销售金额则增加57.38%。甲磺酸伊马替尼原研药受带量采购政策影响，DDDs和销售金额均增加，而其他相应的原研药的DDDs和销售金额均减少。“4＋7”带量采购的实施进一步提高仿制药的使用率，为医保费用节省899万元，费用节省率为49.99%。结论 带量政策实施后，药品费用支出减少，切实减轻了部分患者的用药负担。

Objective To analyze the impact of "4 + 7" procurement with quantity on the use of original and generic oral antitumor drugs, and to provide a basis for clinical pharmacy services and hospital pharmacy management. Methods Excel software was used to calculate the drug use quantity, sum, price, DDDs, DDC, proportion, increase, decrease, substitution rate, and cost saving rate of oral anti-tumor drugs for analysis. Results After the implementation of "4 + 7" procurement with quantity, the prices of original drugs and generic drugs fell by different degrees. Among them, the price of letrozol single product dropped the most, by more than 60%. Among original drugs, the price of gefitinib produced by Astrazeneca Pharmaceutical Co., Ltd. dropped the most, by 30%. After the implementation of "4 + 7" procurement with quantity, generics DDDs of imatinib mesylate, tegafur, gimeracil and oteracil potassium, letrozole, anastrozole, capecitabine, and temozolomide were increased, while consumption sum decreased. The DDDs of generic gefitinib increased by 74.17%, and the consumption sum increased by 57.38%. DDDs and consumption sum of imatinib mesylate primary drug were increased due to the influence of purchase policy, while DDDs and consumption sum of other corresponding primary drug were decreased. The implementation of "4 + 7" purchase with quantity further increased the utilization rate of generic drugs, saving 8.99 million yuan for medical insurance costs, with a cost saving rate of 49.99%.Conclusion After the implementation of the policy, the cost of drugs is reduced, and the drug burden of some patients is effectively reduced.

R979.1