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Background: DIP is a new medical insurance payment system developed in China which was implemented in Guangzhou in January 2018, but few studies have focused on its intervention effect on the drug burden of elderly hypertensive patients. Methods: Nine medical institutions in Guangzhou, China, were selected, among which, daily full medical orders of elderly hypertensive inpatients from 2016 to 2020 were randomly collected. To assess the impact of DIP policy intervention on patient drug burden, we took the data after policy implementation in January 2018, as the intervention data, and applied a segmented regression model with interrupted time series to analyze the trend and changes in average daily drug costs per month and medication structure, stratified by age, sex, and inpatient department. Results: A total of 34,276 elderly hypertensive patients' daily full medical orders were obtained. The immediate level change of drug costs after intervention was -23.884 RMB/month (P = 0.652), and the trend change was statistically significant (-15.642 RMB/month, P = 0.002). The relative cumulative effect at the end of the study was -78.860% (95% CI: -86.087% to -69.076%), and the intervention effect was more significant in surgical and male patients. The analysis of drug structure changes showed that after the implementation of the DIP policy intervention, the proportion of anti-infective drugs, anti-tumor drugs, and biological products all showed a significant downward trend (P < 0.05), while nutritional drugs showed a significant upward trend (P = 0.011), but no immediate horizontal change in slope was observed. Conclusion: The typical practice in China showed that DIP policy intervention can improve the drug burden of elderly hypertensive hospitalized patients and has a stable long-term effect, and the intervention effect is not consistent across different clinical department and populations with different characteristics, and it would also cause changes in the medication structure.
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OBJECTIVE： To investigate the application of antidepressants in Zhejiang province and to provide reference for rational drug use in clinic. METHODS： WHO-recommended defined daily dose （DDD） method was used to statistically analyze consumption sum， main types， defined daily dose system （DDDs）， daily drug cost （DDC） and ranking ratio （B/A value， i.e. consumption sum rank/DDDs rank， B/A＜1 means the price of drugs was higher， whereas the price of drugs was lower） of antidepressant drugs in 11 hospitals from Zhejiang province during 2013-2017. RESULTS： The consumption sum of antidepressants was increased year by year in 11 hospitals from Zhejiang during 2013-2017， and increased from 3 235 200 yuan in 2013 to 4 569 100 yuan in 2017； the proportion of consumption sum of antidepressants in total consumption sum of all drugs kept stable， ranging from 0.47％ to 0.50％. The top 5 drugs by consumption sum were fluoxetine， duloxetine， olanzapine and venlafaxine； consumption sum of escitalopram accounted for a larger increase （proportion ration increased from 8th place in 2013 to first place in 2017）. Within 5 years， DDDs of fluoxetine， paroxetine and sertraline took up the first 3 place； DDC of olanzapine， quetiapine and duloxetine took up the first 3 place； the drugs with B/A value＜1 included duloxetine， olanzapine， venlafaxine and quetiapine， etc； the drugs with B/A value＞1 were paroxetine and sertraline. CONCLUSIONS： The use of antidepressant drugs in 11 hospitals from Zhejiang province is rational in structure； selective 5-hydroxytryptamine （5-HT） reuptake inhibitors （SSRI）， selective 5-HT and noradrenaline reuptake inhibitor （SNRI） take up the predominant place. New antidepressant drug escitalopram shows a good clinical prospect.
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Objective: To investigate the application and tendency of carbapenems in the hospitals of Wuhan area.Methods: The application of carbapenems in 34 hospitals of Wuhan area during 2007-2014 was analyzed statistically in terms of consumption sum, DDDs, DDC and so on.Results: The total consumption sum of carbapenems increased year by year.Compared with that in 2007, the total consumption sum increased by 4-fold in 2014.The growing rate of total consumption sum of biapenem was the fastest among various varieties.Since 2009, three injections including meropenem, biapenem and imipenem / cilastatin predominated the market of Wuhan area, followed by faropenem with oral administration.The changing trend of DDDs was basically consistent with the total consumption sum.DDC of all the drugs was relatively high and demonstrated decreasing tendency, and that of biapenem decreased most notably, while still ranked the first place.DDC of meropenem and imipenem/cilastatin both exceeded 400 yuan.The price of faropenem fluctuated notably during 2007-2009, while increased by 2-fold in 2009 (453 yuan) and then remained stable.Conclusion: The special rectification measures show positive impact on the selection of antimicrobial agents in Wuhan area.The drug varieties are proper, while the average daily cost is still high.The government should continue to strengthen the management of antibiotics to ensure the rational use of carbapenems.
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Objective: To investigate the current situation of consumption and development tendency of antitumor Chinese herbal injections in Wuhan area. Methods:The analytical method of the defined daily dose ( DDD) recommended by WHO was used to ana-lyze the application of antitumor Chinese herbal injections in 32 hospitals of Wuhan area during the period of 2010-2012. Results:The consumption sum and the DDDs of antitumor Chinese herbal injections were increased year after year, while the daily drug cost ( DDC) was stable in general. The sort of consumption was generally in accordance with the sequence of DDDs. Conclusion:The status quo of antitumor Chinese herbal injections during the period of 2010-2012 is in line with the characteristics of clinical application, indicating the use is rational.
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Objective:To evaluate the current situation and the developing trend of 5-HT3 receptor antagonists used in 25 hospital of Wuhan during the period of 2003～2005 in order to provide reference for clinical doctors and pharmacists. Method:The 5-HT3 receptor antagonists were statistically analyzed in respect to the purchase sum of money,DDDs and daily costs. Result:During the 3 years, purchase sum of money of 5-HT3 receptor antagonists were yearly increasing. The share of the market of domestic drugs showed an increasing tendency,while the imported drugs decreased year by year. Granisetron, ondansetron and tropisetron were much more frequently used than others. Conclusion:The market of the oral agents of 5-HT3 receptor antagonists will further expand in China.
