Page 17 - 《中国药房》2023年16期

国家基本药物目录中COPD治疗药品的调整建议

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张丽成 ，高 明 ，封宇飞 ，马艳良 ，冷家骅 （1.北京大学肿瘤医院暨北京市肿瘤防治研究所医疗保险服务
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处/恶性肿瘤发病机制及转化研究教育部重点实验室，北京 100142；2. 北京大学人民医院药剂科，北京
100044；3.北京大学人民医院呼吸内科，北京 100044）
中图分类号 R974；R95 文献标志码 A 文章编号 1001-0408（2023）16-1931-05
DOI 10.6039/j.issn.1001-0408.2023.16.03

摘 要 目的 为慢性阻塞性肺疾病（COPD）的规范化治疗和国家基本药物目录中COPD治疗药品的调整提供参考。方法 邀请
相关临床专家、药学专家、医保专家共同梳理国内外COPD临床指南、国家基本药物目录、WHO基本药物标准清单、国家医保目录
等收录的COPD治疗药品，并进行比较分析。结果与结论 相较于国内临床治疗指南，国外临床指南多收录了1种COPD三联复合
制剂，但后者收录的祛痰药及抗氧化剂种类较少；WHO基本药物标准清单收录的COPD治疗药品仅有12种，而我国基本药物目
录收录了18种，后者包含更多的茶碱类、祛痰药及抗氧化剂。有15种COPD治疗药品被我国临床指南和国家医保目录收录，但未
被国家基本药物目录收录，包括特布他林、盐酸左沙丁胺醇、沙美特罗、福莫特罗、茚达特罗、倍氯米松、糠酸莫米松、沙丁胺醇异丙
托溴铵、格隆溴铵福莫特罗、乌美溴铵维兰特罗、茚达特罗格隆溴铵、倍氯米松福莫特罗、布地奈德/格隆溴铵/富马酸福莫特罗（布地
格福）、糠酸氟替卡松/维兰特罗/乌美溴铵（氟替美维）、福多司坦，主要为长效β2受体激动剂和三联复合制剂。这些药品具有一定的
循证医学证据，其疗效和经济性均有一定优势，且对医保基金预算的影响可控，建议后续基本药物目录更新调整时可考虑纳入。
关键词 慢性阻塞性肺疾病；基本药物目录；医保目录；长效β2受体激动剂；三联复合制剂

Suggestions on the adjustment of therapeutic drugs for COPD in the national essential medicine list
ZHANG Licheng ，GAO Ming ，FENG Yufei ，MA Yanliang ，LENG Jiahua （1. Medical Insurance Service
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Division/Key Laboratory of Malignant Tumor Pathogenesis and Transformation Research Co-constructed by
Ministry of Education， Beijing Cancer Hospital & Beijing Institute for Cancer Research， Beijing 100142，
China； 2. Dept. of Pharmacy， Peking University People’s Hospital， Beijing 100044， China； 3. Dept. of
Respiratory Medicine， Peking University People’s Hospital， Beijing 100044， China）
ABSTRACT OBJECTIVE To provide a reference for the standardized treatment of chronic obstructive pulmonary disease
（COPD） and the adjustment of therapeutic drugs for COPD in the national essential medicine list. METHODS Relevant clinical
experts， pharmaceutical experts and medical insurance experts were invited to sort out the COPD treatment drugs involved in the
domestic and foreign COPD clinical guidelines， the national essential medicine list， the WHO standard list of essential medicine，
the national medical insurance catalogue， and comparatively analyzed the COPD treatment drugs. RESULTS & CONCLUSIONS
Compared with domestic clinical guidelines， foreign clinical guidelines included an additional COPD triple preparation， while
involving fewer types of expectorants and antioxidants； there were only 12 kinds of COPD treatment drugs included in the WHO
standard list of essential medicine， while there were 18 kinds in the national essential medicine list in China， and more theophylline
drugs， expectorants and antioxidants were included. In addition， 15 kinds of COPD treatment drugs were found in both the national
clinical guidelines and the national medical insurance catalogue， but not in the national essential medicine list， including
terbutaline， levalbuterol hydrochloride， salmeterol， formoterol， indacaterol， beclometasone， mometasone furoate， salbutamol
ipratropium， glycopyrronium formoterol， umeclidinium vilanterol， indacaterol glycopyrronium， beclometasone formoterol，
budesonide/glycopyrrolate/formoterol fumarate， fluticasone furoate/vilanterol/umeclidinium， and fudosteine， which were mainly
long-acting beta 2-agonists and COPD triple preparations. These drugs had certain evidence-based medicine evidence， their efficacy
and economy had certain advantages， and their impact on the budget of the medical insurance fund was controllable. Therefore， it
is suggested that the aforementioned drugs should be included in the essential medicines list in the subsequent update.
KEYWORDS chronic obstructive pulmonary disease；
＊第一作者 研究实习员，硕士。研究方向：医疗保障。E-mail：
zhanglicheng2018@163.com essential medicine list； medical insurance catalogue； long-
# 通信作者 副主任医师，博士。研究方向：医疗保障。E-mail： acting beta 2-agonist； triple preparations
lengybc@126.com

中国药房 2023年第34卷第16期 China Pharmacy 2023 Vol. 34 No. 16 · 1931 ·