中国临床药学杂志

目的 探讨上海市崇明区在胰岛素专项集中带量采购执行前和执行1年后胰岛素配备的变化情况，为更好地推进药品集中带量采购工作提供参考。方法 采集上海市崇明区4家二、三级医疗机构和18家一级医疗机构胰岛素相关信息，比较胰岛素专项集中带量采购执行前和执行1年后各家医疗机构的胰岛素配备情况以及执行1年的的协议采购量完成情况。结果 二、三级医疗机构在胰岛素专项集中带量采购执行前和执行1年后，胰岛素品种结构总体变化不大；一级医疗机构在执行1年后主要增加了预混人胰岛素的品规数；二、三级医疗机构协议采购量的完成情况良好，原研胰岛素的完成配备优于国产胰岛素；一级医疗机构协议采购量完成情况不理想，仅有22.22%的医疗机构完成了国产胰岛素品种协议采购量。结论 上海市崇明区在胰岛素专项集中带量采购执行过程中一级医疗机构存在申报品种欠合理的情况，原研胰岛素协议采购量完成情况优于国产胰岛素，建议医疗机构加强政策培训学习，理解采购规则，保证原研胰岛素与国产胰岛素的合理配比，保持区域内品种、品规的相对一致，有序推进分级诊疗，促进药品集中带量采购工作开展。

AIM To explore the changes in centralized volume-based insulin utilization in Chongming District of Shanghai, before and 1 year after the implementation of the insulin special procurement, providing references for advancing centralized volume-based drug procurement efforts. METHODS Data were collected on insulin from 4secondary and tertiary medical institutions and 18 primary healthcare institutions in Chongming District of Shanghai.The variations in insulin types and the completion status of the one-year agreement procurement quantity were compared before and after the implementation of the insulin special centralized procurement in each medical institution. RESULTS There were minimal overall changes in the composition construction of insulin types in secondary and tertiary medical institutions before and 1 year after the insulin special centralized volume-based procurement. Primary healthcare institutions primarily increased the number of specifications for pre-mixed human insulin after the implementation.The completion status of the agreement procurement quantity was satisfactory in secondary and tertiary medical institutions,with better performance for original research enterprise varieties compared to domestic enterprises.The completion status for agreement procurement quantity was less favorable in primary healthcare institutions, with only 22.22% of institutions completing the agreement quantity for domestic varieties. CONCLUSION In the process of implementing the insulin special centralized volume-based procurement in Chongming District, primary healthcare institutions demonstrated an inadequacy in declaring varieties. The completion status of agreement quantities for original research enterprise varieties was better than that of domestic enterprise varieties. It is recommended that medical institutions enhance policy training,understand procurement rules, ensure a reasonable balance between original research enterprise and domestic enterprise varieties, maintain relative consistency in varieties and specifications within the region, systematically promote tiered diagnosis and treatment, and facilitate the progress of centralized drug procurement efforts.