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·药物经济学·


          胰岛素专项集采对我国胰岛素日费用和可负担性的影响研究
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          雷凤萍    1, 2* ,章洁琼 ,刘星宸 ,韦皓琪 ,刘星雨 ,杨才君 (1.西安交通大学药学院,西安 710061;2.西安航天
                                     1
          医院药剂科,西安 710100;3.宜兴市生命健康产业创新服务中心,江苏 无锡 214000)
          中图分类号  R977.1+5;R956      文献标志码  A      文章编号  1001-0408(2025)12-1483-05
          DOI  10.6039/j.issn.1001-0408.2025.12.11

          摘  要  目的  评估胰岛素专项集采政策对我国胰岛素日费用和可负担性的影响,为相关政策的完善提供数据支撑。方法  通过
          各省份独立的药品集中采购平台收集胰岛素专项集采前后(2021年10-12月、2022年10-12月)的胰岛素采购数据,以各类胰岛
          素的限定日费用(DDDc)为指标,分析专项集采前后的日费用变化;以各类胰岛素年支出占年人均可支配收入的百分比(即年支出
          占比)为指标,评估专项集采前后各类胰岛素的可负担性变化。结果  专项集采后,各类胰岛素DDDc的降幅为20.7%~71.8%,平
          均降幅为45.7%,且三代胰岛素的降幅超过二代胰岛素;胰岛素年支出占比的降幅为24.3%~73.4%,平均降幅为48.5%,预混胰岛
          素类似物的降幅最大(73.4%)。专项集采后,所有纳入省份的胰岛素DDDc均有所下降;除广西(10.2%)外,其余各省份胰岛素的
          平均年支出占比均降至10%以内。结论  胰岛素专项集采政策显著降低了胰岛素费用、提高了可负担性、降低了糖尿病患者的经
          济负担,但省际及胰岛素类型间的日费用和可负担性差异明显,需重点关注。
          关键词  胰岛素;国家专项集采;日费用;可负担性

          Study  on  the  impact  of  the  specialized  centralized  procurement  for  insulin  on  the  daily  cost  and
          affordability of insulin in China
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          LEI Fengping ,ZHANG Jieqiong ,LIU Xingchen ,WEI Haoqi ,LIU Xingyu ,YANG Caijun(1.  School  of
          Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China;2. Dept. of Pharmacy, Xi’an Aerospace Hospital,
          Xi’an  710100,  China;3.  Yixing  Life  and  Health  Industry  Innovation  Service  Center,  Jiangsu  Wuxi  214000,
          China)
          ABSTRACT   OBJECTIVE To evaluate the impact of the specialized centralized procurement policy for insulin on daily cost and
          affordability of insulin, and provide data support for the enhancement of relevant policies. METHODS In this research, the insulin
          purchasing  data  were  obtained  from  provincial  centralized  procurement  platforms  in  provinces  before  and  after  the  specialized
          centralized procurement of insulin (October-December 2021 and October-December 2022), and the cost variations of insulin before
          and  after  the  centralized  procurement  were  analyzed  by  the  defined  daily  dose  cost (DDDc)  of  various  types  of  insulins.  The
          changes  in  the  affordability  of  various  types  of  insulins  before  and  after  the  specialized  centralized  procurement  were  evaluated,
          using  the  percentage  of  annual  expenditure  on  various  types  of  insulins  relative  to  annual  per  capita  disposable  income (i.e.  the
          proportion of annual expenditure) as an indicator. RESULTS After the specialized centralized procurement, DDDc of various types
          of insulins decreased by 20.7%-71.8%, with an average reduction of 45.7%. Moreover, the reduction in DDDc for third-generation
          insulin  exceeded  that  for  second-generation  insulin.  The  reduction  in  the  proportion  of  annual  expenditure  on  insulin  ranged  from
          24.3%  to  73.4%,  with  an  average  decrease  of  48.5%.  Premixed  insulin  analogs  experienced  the  greatest  reduction (73.4%).
          Following  the  specialized  centralized  procurement,  DDDc  of  insulin  decreased  in  all  provinces.  Except  for  Guangxi (10.2%),  the
          average  proportion  of  annual  expenditure  on  insulin  in  the  remaining  provinces  dropped  to  below  10%.  CONCLUSIONS  The
          specialized  centralized  procurement  policy  for  insulin  has  significantly  reduced  insulin  costs  and  improved  affordability,  thereby
          alleviating  the  economic  pressure  on  patients  with  diabetes.  There  are  notable  cost  disparities  among  provinces  and  among  insulin
          categories, which require attention.
          KEYWORDS    insulin; national centralized procurement; daily cost; affordability


             Δ 基金项目 国家自然科学基金项目(No.72174166)                      据统计,2021 年我国糖尿病相关健康总支出达
             *第一作者 副主任药师,硕士研究生。研究方向:药事管理、医院
                                                             1 653 亿美元,仅次于美国;与此同时,全球糖尿病相关
          药学。E-mail:lfpingvip@163.com                                                                      [1]
             # 通信作者 教授,博士生导师,博士。研究生方向:药物政策与药                 人均医疗费用高达 1 173.5 美元,经济负担较为沉重 。
          品供应保障。E-mail:yangcj@xjtu.edu.cn                    胰岛素是治疗糖尿病的重要药物之一,根据其来源,可


          中国药房  2025年第36卷第12期                                              China Pharmacy  2025 Vol. 36  No. 12    · 1483 ·
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