目的 分析成都大学附属医院执行“4+7”带量采购对调血脂药使用的影响，为进一步完善药物政策和医院药事管理与服务提供参考。方法 提取“4+7”带量采购实施前后门诊调血脂药的用药数据，比较药品供应目录、价格、数量、处方数、金额、用药频度（DDDs）、日均费用（DDC）、复合年均增长率（CAGR）等变化情况。结果 2018—2020年，调血脂药供应目录共涉及8个品种，16个品规。药物类别中，各类调血脂药使用数量和处方数构成比变化不大；用药金额逐年下降，CAGR为?31.24%；采购类别中，原研药使用数量和处方数量构成比逐年下降，国产药逐年上升；各年DDDs逐年递增，CAGR为44.77%。在8种调血脂药DDDs排序中，瑞舒伐他汀和阿托伐他汀排名稳居前2位，辛伐他汀逐年下降；中标阿托伐他汀、瑞舒伐他汀和辛伐他汀及与中标相同通用名称药品DDC波动明显。结论 “4+7”带量采购政策落地2年，调血脂药使用集中在他汀类，尤其使用瑞舒伐他汀和阿托伐他汀患者相对稳定，使用国产药的患者数量大幅度上升，药品费用支出减少，切实降低了部分患者的用药负担。

Objective To analyze the influence of "4+7" procurement with quantity on the use of lipid-regulating drugs in The Affiliated Hospital of Chengdu University, and to provide reference for further improving drug policy and hospital pharmaceutical management and service.Methods The medication data of lipid-regulating drugs in outpatient department before and after the implementation of "4+7" with volume procurement were extracted, and the changes of drug supply catalog, price, quantity, prescription number, amount, DDDs, DDC, and compound annual growth rate (CAGR) were compared.Results From 2018 to 2020, the supply list of lipid-regulating drugs involves 8 varieties and 16 product specifications. In the category of drugs, the composition ratio of the quantity and prescription of all kinds of lipid-regulating drugs had little change. The amount of money spent on drugs has been decreasing year by year, and CAGR was ?31.24%. In the procurement category, the proportion of the use and prescription of original drugs were decreased, while domestic drugs were increased year by year. DDDs were increased year by year, and CAGR was 44.77%. Rosuvastatin and atorvastatin ranked first and second in DDDs ranking of 8 kinds of lipid-regulating drugs, while simvastatin decreased year by year. The DDC of atorvastatin, rosuvastatin, simvastatin and drugs with the same generic name fluctuated obviously.Conclusion In the two years since the implementation of the "4+7" purchase policy with quantity, the use of lipid-regulating drugs has been concentrated on statins, especially the patients using rosuvastatin and atorvastatin, which are relatively stable. The number of patients using domestic drugs has increased significantly, and the drug cost has been reduced, effectively reducing the drug burden of some patients.

R973

成都大学附属医院院级课题（Y2021096）