【摘要】 目的 分析自2019年3月开始执行带量采购政策后左乙拉西坦片(LEV)的使用情况。利用治疗药物浓度监测(TDM)对比原研与中选品种浓度剂量比(C/D),为临床药学服务和医院药事管理提供参考。方法 采用回顾性分析方法，汇总左乙拉西坦片自2017年3月25日-2022年3月24日西安交通大学第二附属医院门急诊、住院部使用数据，对销售量、用药频度(DDDs)、用药金额和每日治疗费用(DDC)等进行统计分析。收集2019年4月-2021年1月我院小儿内科使用中选及原研左乙拉西坦片患者的相关信息，并按1∶1最邻近匹配法分析匹配前后两组年龄、体重、给药剂量、血药浓度、浓度剂量比的差异。结果 带量采购实施后国产左乙拉西坦片销售量、用药频度提高6倍，占比提高5倍余。2021年左乙拉西坦用药总金额较2017年下降24.58%,日均费用较2017年降低35.42%(由17.76元降至11.47元)。中选与原研左乙拉西坦片倾向性匹配前后浓度剂量比(C/D)差异均无统计学意义(P>0.05)。结论 中选与原研左乙拉西坦片浓度剂量比(C/D)相似，带量采购政策实施后，可以有效降低医院药占比，减轻患者的用药负担，提升医保资金的使用效率，但仍需进一步研究证实。更多还原

【Abstract】 Objective To analyze the usage of levetiracetam tablets(LEV) after the implementation of the volume-based procurement policy since March 2019.To compare the concentration dose ratio(C/D) of the original and selected varieties by therapeutic drug monitoring, and provide reference for clinical pharmacy service and hospital pharmacy management.Methods Retrospective analysis of levetiracetam tablets used in outpatient and inpatient departments of the Second Affiliated Hospital of Xi′an Jiaotong university from March 25,2017 to March 24,2022 was performed, and statistical analysis was made on the sales volume, defined daily dose(DDDs),sum of money in drug use and daily drug cost(DDC).Tthe information of the children who used original was collected and levetiracetam tablets were selected from April 2019 to January 2021.According to the 1∶1 nearest-neighbor propensity score matching(PSM) method, the differences in the age, weight, dosage, serum concentration and C/D before and after matching were counted and analyzed.Results The sales volume and DDDs of selected levetiracetam tablets increased by 6 times and the proportion increased by more than 5 times after the implementation of volume-based procurement.The total cost of levetiracetam in 2021 decreased by 24.58% compared with 2017,and the DDC reduced by 35.42%,from 17.76 yuan to 11.47 yuan.There was no significant difference in the C/D between the selected and original levetiracetam tablets before and after the PSM(P>0.05).Conclusion The C/D of the selected and original levetiracetam tablets is basically the same.After policy implementation, the drug proportion and the drug burden of patients can be effectively reduced, and the use efficiency of medical insurance fund is increased, but more trials are required for confirmation.更多还原