目的 分析南京中医药大学附属南京医院自2019年底开始执行“4＋7”带量采购后对核苷类抗病毒性肝炎药物使用情况的影响，为临床药学服务和医院药事管理提供参考。方法 采用回顾性分析方法，汇总南京中医药大学附属南京医院自2018年7月—2021年6月6种核苷类抗肝炎药物的门诊使用数据，对用药种类、消耗量、用药频度（DDDs）和日治疗费用（DDC）等进行统计分析。结果 “4＋7”集采前后，6种药物总的消耗量提高了27.91%，销售总金额降低了80.66%；进入集采的3种药物阿德福韦酯片（阿甘定）、恩替卡韦片（木泽）、富马酸替诺福韦二吡呋酯片（倍信）的DDDs排名进入了前3位，DDC值也排进了前3，降价明显；新上市的富马酸丙酚替诺福韦片消耗量和销售金额却稳步提高。结论 “4＋7”集中采购可以有效降低医院药占比，切实减轻了部分患者的用药负担，促进医院合理用药，提升了医保基金的使用效率，创新药物也有长足发展空间。

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