Page 108 - 《中国药房》2020年23期

注射用曲妥珠单抗分剂量调配、收费和报销模式的建立与应用 Δ

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耿魁魁 ，徐 文 ，吴凤芝 ，史天陆 ，姜 玲（1.中国科学技术大学附属第一医院南区药剂科，合肥 230036；
2.中国科学技术大学附属第一医院神经内科，合肥 230036）
中图分类号 R942 文献标志码 A 文章编号 1001-0408（2020）23-2914-04
DOI 10.6039/j.issn.1001-0408.2020.23.17

摘 要 目的：为规范和优化注射用曲妥珠单抗的临床使用，保证患者合理用药提供参考。方法：我院静脉用药调配中心
（PIVAS）牵头与财务、信息、医保等部门以及临床医师、护士沟通协调，建立了曲妥珠单抗分剂量调配、收费和报销模式——医师
可按照患者临床使用剂量开具医嘱，PIVAS按照实际剂量进行仓内调配，患者之间共用药品，药品的收费和报销按照患者实际使
用剂量进行。同时，采用问卷调查对60名患者在该模式实施前后的就医感受、节约的费用进行统计。结果：问卷调查显示，该模
式的应用在解决曲妥珠单抗使用安全隐患和患者就医不便方面，解决率为 100％；在提高患者就医感受和对治疗起帮助作用方
面，提高率为100％；在节省患者治疗费用方面，大部分（80.0％）的患者认为每次可节约500元以内，其余患者认为每次可节约500
元以上。结论：我院构建的注射用曲妥珠单抗分剂量调配、收费和报销模式解决了该药在临床使用中存在的药品浪费、调配职业
伤害、保存不便的问题，在用药安全、节约费用、方便患者等方面发挥了很好的效果。
关键词 静脉用药集中调配中心；曲妥珠单抗；分剂量；调配；收费；报销

Establishment and Application of Dispensing，Charging and Reimbursement Mode by Dose of Trastuzumab

for Injection
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GENG Kuikui ，XU Wen ，WU Fengzhi ，SHI Tianlu ，JIANG Ling（1. Dept. of Pharmacy，South District，the
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First Affiliated Hospital of USTC，Hefei 230036，China；2. Dept. of Neurology，the First Affiliated Hospital of
USTC，Hefei 230036，China）
ABSTRACT OBJECTIVE：To standardize and optimize the clinical use of Trastuzumab for injection，and to provide reference
for rational use of drugs in the patients. METHODS：The pharmacy intravenous admixture service（PIVAS）in our hospital took the
lead in communication and coordination with financial，information，medical insurance departments as well as clinicians and
nurses，to set up dispensing，charging and reimbursement mode by dose of trastuzumab. Under that，doctors could give orders
according to the clinical dosage of patients；PIVAS dispenses drugs according to the actual dose；the drugs were shared among
patients；the charge and reimbursement of drugs are carried out according to the actual dose of patients. At the same time，the
questionnaire survey was conducted among 60 patients about the medical experience and cost savings before and after the
implementation of the mode. RESULTS：The questionnaire survey showed that in terms of solving the potential safety problems of
trastuzumab and the inconvenience of patients’medical treatment，the solution rate of the mode was 100％；in terms of improving
patients’feeling of seeking medical treatment and helping treatment，the improvement rate was 100％；in terms of saving patients’
treatment costs，most（80％）of the patients thought that it could save less than 500 yuan each time，and rest of the patients
thought that it could save more than 500 yuan each time. CONCLUSIONS：The mode of dispensing，charging and reimbursement
of Trastuzumab for injection in our hospital has solved the problems of drug waste，occupational injury and inconvenient
preservation in clinical use，and has played a good role in drug safety，cost saving and patient convenience.
KEYWORDS PIVAS；Trastuzumab；By dose；Dispensing；Charging；Reimbursement

乳腺癌是最常见的女性癌症之一，居女性癌症相关 单抗（以下简称“曲妥珠单抗”）为重组DNA衍生的人源
死因的第 1 位 [1-2] 。我国乳腺癌发病率的增长速度高于 化单克隆抗体，是首个以原癌基因人类表皮生长因子受
世界平均增长速度，据统计，我国乳腺癌新发和死亡人 体 2（Her-2）为靶点的乳腺癌分子靶向药物，适用于
数分别占全球人数的 12.1％和 9.6％ 。注射用曲妥珠 Her-2 过度表达的转移性乳腺癌及乳腺癌的辅助治疗，
[3]
能有效地延长患者的生存时间 。目前，该药已被《中国
[4]
Δ 基金项目：安徽省自然科学基金资助项目（No.1808085QH244）
抗癌协会乳腺癌诊治指南与规范》推荐为乳腺癌和乳腺
＊主管药师，硕士。研究方向：静脉药物集中调配。电话：0551-
[5]
62284180。E-mail：gengkuikui@163.com 癌术后一线治疗药物 ，并纳入国家乙类医保报销范围，
·2914 · China Pharmacy 2020 Vol. 31 No. 23 中国药房 2020年第31卷第23期