目的 比较分析"4+7"带量采购前/后1年上海市闵行区古美社区卫生服务中心药品用量及价格降幅情况。方法 参照国家第1批"4+7"带量采购目录，收集2018年3月20日-2019年3月19日及执行"4+7"后2019年3月20日-2020年3月19日上海市闵行区古美社区卫生服务中心用药数据，统计本中心11个品种药品的数量、金额、用药频度（DDDs）、日均费用（DDC）等指标进行分析。结果 "4+7"后的11个品种分别由7个厂家供货。"4+7"前/后共用2个品种：阿托伐他汀钙片（北京嘉林药业股份有限公司）、氯沙坦钾片（浙江华海药业股份有限公司），药品单片价格分别降幅84.01%和74.20%。执行"4+7"前/后1年11个品种的用药金额分别为787.73万元与287.67万元，降幅63.48%。"4+7"前DDDs最高的是苯磺酸氨氯地平（络活喜，辉瑞制药有限公司）从31.49万日降至"4+7"后的3.39万日，降幅89.23%。"4+7"后DDDs最高的阿托伐他汀钙片（北京嘉林药业股份有限公司）为50.00万日，"4+7"前则为13.88万日，增幅260.23%。结论 执行国家"4+7"带量采购政策，经过倾斜使用"4+7"品种1年的实践，印证了"4+7"品种用药下沉至社区，实现本土化模式是可行的，降价幅度是明显的。

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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