Wu Min, Lu Peng, Shi Luwen, Li Shao
Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.
Institute of Automation, Chinese Academy of Sciences, Beijing, China.
Oncotarget. 2015 Nov 10;6(35):38283-95. doi: 10.18632/oncotarget.5711.
Based on the nationwide survey into inpatients' utilization of the health service covered by China's urban basic medical insurance from 2008 to 2010, we analyzed the use rate, cancer profile and combined use of anticancer Chinese patent medicines (CPMs) on 51,382 insured cancer patients by using statistical, bi-clustering and network methods. We found that 42.4% of 51,382 cancer patients used 33 anticancer CPMs, and 51.7% used 71 anticancer Western medicines (WMs). The CPMs were most often used in lung (52%) and nasopharynx (52%) cancer patients, and least in bladder cancer (21%) and leukemia of unspecified cell type (21%) patients. The cost per patient for all 33 anticancer CPMs was 2069RMB, lower than that of the WMs (3458RMB). The cancer profile of commonly used CPMs and WMs for the top 17 cancers (>500 sampled patients) were provided, indicating anticancer CPMs had a broad spectrum of cancers and lacked selectivity in cancer treatment (CPM mean CV = 49%; WM mean CV = 152%). Moreover, 24.8% of the cancer patients used both CPMs and WMs, and CPM-WM combined use networks were constructed for four major cancers. This first nationwide analysis revealed the use characteristics and herb-drug combined use patterns of insurance covered anticancer CPMs in China. The study offers valuable information to guide future studies of the precision, safety and standard use of CPMs.
基于2008年至2010年全国范围内对中国城镇基本医疗保险覆盖的住院患者医疗服务利用情况的调查，我们运用统计、双聚类和网络方法，对51382名参保癌症患者的抗癌中成药使用率、癌症谱及联合使用情况进行了分析。我们发现，在51382名癌症患者中，42.4%使用了33种抗癌中成药，51.7%使用了71种抗癌西药。中成药在肺癌（52%）和鼻咽癌（52%）患者中使用最为频繁，在膀胱癌（21%）和未指定细胞类型的白血病（21%）患者中使用最少。33种抗癌中成药的人均费用为2069元，低于西药（3458元）。我们提供了前17种癌症（>500例抽样患者）常用中成药和西药的癌症谱，表明抗癌中成药的癌症谱广泛，在癌症治疗中缺乏选择性（中成药平均变异系数=49%；西药平均变异系数=152%）。此外，24.8%的癌症患者同时使用了中成药和西药，并针对四种主要癌症构建了中成药-西药联合使用网络。这项首次全国性分析揭示了中国医保覆盖的抗癌中成药的使用特征和中药-西药联合使用模式。该研究为指导未来中成药精准、安全和规范使用的研究提供了有价值的信息。
